Journal of Critical Care Medicine最新文献

{"title":"A Comparative Analysis of the Effects of Haloperidol and Dexmedetomidine on QTc Interval Prolongation during Delirium Treatment in Intensive Care Units.","authors":"Ali Haspolat, Fuat Polat, Ali Şefik Köprülü","doi":"10.2478/jccm-2024-0027","DOIUrl":"10.2478/jccm-2024-0027","url":null,"abstract":"<p><strong>Background: </strong>Haloperidol and dexmedetomidine are used to treat delirium in the intensive care unit (ICU). The effects of these drugs on the corrected QT (QTc) interval have not been compared before. It was aimed to compare the effects of haloperidol and dexmedetomidine treatment on QTc intervals in patients who developed delirium during ICU follow-up.</p><p><strong>Method: </strong>The study is single-center, randomized, and prospective. Half of the patients diagnosed with delirium in the ICU were treated with haloperidol and the other half with dexmedetomidine. The QTc interval was measured in the treatment groups before and after drug treatment. The study's primary endpoints were maximal QT and QTc interval changes after drug administration.</p><p><strong>Results: </strong>90 patients were included in the study, the mean age was 75.2±12.9 years, and half were women. The mean time to delirium was 142+173.8 hours, and 53.3% of the patients died during their ICU follow-up. The most common reason for hospitalization in the ICU was sepsis (%37.8.). There was no significant change in QT and QTc interval after dexmedetomidine treatment (QT: 360.5±81.7, 352.0±67.0, p= 0.491; QTc: 409.4±63.1, 409.8±49.7, p=0.974). There was a significant increase in both QT and QTc interval after haloperidol treatment (QT: 363.2±51.1, 384.6±59.2, p=0.028; QTc: 409.4±50.9, 427.3±45.9, p=0.020).</p><p><strong>Conclusions: </strong>Based on the results obtained from the study, it can be concluded that the administration of haloperidol was associated with a significant increase in QT and QTc interval. In contrast, the administration of dexmedetomidine did not cause a significant change in QT and QTc interval.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"10 3","pages":"222-231"},"PeriodicalIF":0.9,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898597","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":"Challenges of the Regional Anesthetic Techniques in Intensive Care Units - A Narrative Review.","authors":"Alexandra Elena Lazar, Mihaela Butiulca, Lenard Farczadi","doi":"10.2478/jccm-2024-0023","DOIUrl":"10.2478/jccm-2024-0023","url":null,"abstract":"<p><p>Effective pain management is vital for critically ill patients, particularly post-surgery or trauma, as it can mitigate the stress response and positively influence morbidity and mortality rates. The suboptimal treatment of pain in Intensive Care Unit (ICU) patients is often due to a lack of education, apprehensions about side effects, and improper use of medications. Hence, the engagement of pain management and anesthesiology experts is often necessary. While opioids have been traditionally used in pain management, their side effects make them less appealing. Local anesthetics, typically used for anesthesia and analgesia in surgical procedures, have carved out a unique and crucial role in managing pain and other conditions in critically ill patients. This work aims to offer a comprehensive overview of the role, advantages, challenges, and evolving practices related to the use of local anesthetics in ICUs. The ability to administer local anesthetics continuously makes them a suitable choice for controlling pain in the upper and lower extremities, with fewer side effects. Epidural analgesia is likely the most used regional analgesic technique in the ICU setting. It is primarily indicated for major abdominal and thoracic surgeries, trauma, and oncology patients. However, it has contraindications and complications, so its use must be carefully weighed. Numerous challenges exist regarding critically ill patients, including renal and hepatic failure, sepsis, uremia, and the use of anticoagulation therapy, which affect the use of regional anesthesia for pain management. Appropriate timing and indication are crucial to maximizing the benefits of these methods. The advent of new technologies, such as ultrasonography, has improved the safety and effectiveness of neuraxial and peripheral nerve blocks, making them feasible options even for heavily sedated patients in ICUs.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"10 3","pages":"198-208"},"PeriodicalIF":0.9,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898599","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":"Rate of Sodium Correction and Osmotic Demyelination Syndrome in Severe Hyponatremia: A Meta-Analysis.","authors":"Xin Ya See, Yu-Cheng Chang, Chun-Yu Peng, Shih-Syuan Wang, Kuan-Yu Chi, Cho-Hung Chiang, Cho-Han Chiang","doi":"10.2478/jccm-2024-0030","DOIUrl":"10.2478/jccm-2024-0030","url":null,"abstract":"<p><strong>Introduction: </strong>Current guidelines recommend limiting the rate of correction in patients with severe hyponatremia to avoid severe neurologic complications such as osmotic demyelination syndrome (ODS). However, published data have been conflicting. We aimed to evaluate the association between rapid sodium correction and ODS in patients with severe hyponatremia.</p><p><strong>Materials and methods: </strong>We searched PubMed, Embase, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials from inception to November 2023. The primary outcome was ODS and the secondary outcomes were in-hospital mortality and length of hospital stay.</p><p><strong>Results: </strong>We identified 7 cohort studies involving 6,032 adult patients with severe hyponatremia. Twenty-nine patients developed ODS, resulting in an incidence rate of 0.48%. Seventeen patients (61%) had a rapid correction of serum sodium in the first or any 24-hour period of admission. Compared with a limited rate of sodium correction, a rapid rate of sodium correction was associated with an increased risk of ODS (RR, 3.91 [95% CI, 1.17 to 13.04]; I² = 44.47%; p = 0.03). However, a rapid rate of sodium correction reduced the risk of in-hospital mortality by approximately 50% (RR, 0.51 [95% CI, 0.39 to 0.66]; I² = 0.11%; p < 0.001) and the length of stay by 1.3 days (Mean difference, -1.32 [95% CI, -2.54 to -0.10]; I² = 71.47%; p = 0.03).</p><p><strong>Conclusions: </strong>Rapid correction of serum sodium may increase the risk of ODS among patients hospitalized with severe hyponatremia. However, ODS may occur in patients regardless of the rate of serum sodium correction.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"10 3","pages":"209-212"},"PeriodicalIF":0.9,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898606","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":"Understanding the Correlation between Blood Profile and the Duration of Hospitalization in Pediatric Bronchopneumonia Patients: A Cross-Sectional Original Article.","authors":"Dessika Listiarini, Dev Desai, Yanuar Wahyu Hidayat, Kevin Alvaro Handoko","doi":"10.2478/jccm-2024-0031","DOIUrl":"10.2478/jccm-2024-0031","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric bronchopneumonia is a prevalent life-threatening disease, particularly in developing countries. Affordable and accessible blood biomarkers are needed to predict disease severity which can be based on the Duration of Hospitalization (DOH).</p><p><strong>Aim of the study: </strong>To assess the significance and correlation between differential blood profiles, especially the Neutrophil-Lymphocyte Ratio (NLR), and the DOH in bronchopneumonia children.</p><p><strong>Material and methods: </strong>A record-based study was conducted at a secondary care hospital in Indonesia. After due ethical permission, following inclusion and exclusion criteria, 284 children with confirmed diagnoses of bronchopneumonia were included in the study. Blood cell counts and ratios were assessed with the DOH as the main criterion of severity. Mann-Whitney test and correlation coefficient were used to draw an analysis.</p><p><strong>Results: </strong>Study samples were grouped into DOH of ≤ 4 days and > 4 days, focusing on NLR values, neutrophils, lymphocytes, and leukocytes. The NLR median was higher (3.98) in patients hospitalized over 4 days (P<0.0001). Lymphocyte medians were significantly higher in the opposite group (P<0.0001). Thrombocyte medians were similar in both groups (P=0.44481). The overall NLR and DOH were weakly positively correlated, with a moderate positive correlation in total neutrophils and DOH, and a moderate negative correlation in total lymphocytes and DOH. The correlation between the DOH ≤ 4 days group with each biomarker was stronger, except for leukocyte and thrombocyte. Analysis of the longer DOH group did not yield enough correlation across all blood counts.</p><p><strong>Conclusions: </strong>Admission levels of leukocyte count, neutrophil, lymphocyte, and NLR significantly correlate with the DOH, with NLR predicting severity and positively correlated with the DOH.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"10 3","pages":"254-260"},"PeriodicalIF":0.9,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898608","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":"Uncommon Malposition of an Ultrasound-Guided Central Venous Catheter in the Renal Vein through the Superficial Femoral Vein: A Case Report.","authors":"Ting-Chia Remus Young, Kuang-Hua Cheng, Kuan-Pen Yu","doi":"10.2478/jccm-2024-0026","DOIUrl":"10.2478/jccm-2024-0026","url":null,"abstract":"<p><strong>Introduction: </strong>Malposition is a relatively rare complication associated with peripherally inserted central catheters (PICCs), particularly in cases of superficial femoral vein (SFV) catheterization. To the best of our knowledge, we are the first to report this rare case of SFV PICC malposition in the contralateral renal vein.</p><p><strong>Case presentation: </strong>An 82-year-old woman underwent bedside cannulation of the SFV for PICC under ultrasound guidance. Subsequent radiographic examination revealed an unexpected misplacement, with the catheter tip positioned toward the contralateral renal vein. After pulling out the catheter on the basis of the X-ray result, it was observed that the catheter retained its function.</p><p><strong>Conclusion: </strong>Although rare, tip misplacement should be considered in SFV PICC placement. Prompt correction of the tip position is crucial to prevent catheter malfunction and further catastrophic consequences. For critical patients receiving bedside SFV PICC insertion, postoperational X-ray is crucial for enhancing safety.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"10 3","pages":"266-270"},"PeriodicalIF":0.9,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898607","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 Profile and Course of Patients with Acute Respiratory Distress Syndrome due to COVID-19 in a Middle-Income Region in Mexico.","authors":"José Antonio Villalobos-Silva, Gladis Lucia Acros-López, Gracia Lizbeth Velázquez-Estrada, Camilo José Muñoz-Chavez, German Antonio Aguirre-Gómez, Obed Isaí Aguilera-Olvera, Alfredo Sánchez-González","doi":"10.2478/jccm-2024-0022","DOIUrl":"10.2478/jccm-2024-0022","url":null,"abstract":"<p><strong>Introduction: </strong>COVID-19 leads to severe clinical complications that culminate in respiratory failure and acute respiratory distress syndrome (ARDS). Despite reports of some comorbidities that contribute to the development of COVID-19-mediated ARDS, there is great variation in mortality rates among critical COVID-19 patients in the world. To date, no studies have described the incidence and comorbidities associated with ARDS due to COVID-19 in the northeastern region of Mexico.</p><p><strong>Aim of the study: </strong>To describe patients diagnosed with ARDS due to COVID-19 in the northeastern region of Mexico, as well as its variations in comparison with other regions of the country.</p><p><strong>Material and methods: </strong>We conducted a prospective and observational study in a tertiary care center in Northeastern Mexico. All patients diagnosed with SARS-CoV-2 infection and requiring management in the intensive care unit were included. We developed a database that was updated daily with the patients' demographic information, pre-existing diseases, disease severity, and clinical variables.</p><p><strong>Results: </strong>The incidence of ARDS secondary to COVID-19 in HRAEV was high in comparison with other reports. Diabetes mellitus was the risk factor most associated with COVID-19-mediated ARDS.</p><p><strong>Conclusion: </strong>Based on our findings and those previously reported in the literature, there are differences that we discuss between northeastern and central Mexico, and analyze other areas evaluated around the world.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"10 3","pages":"245-253"},"PeriodicalIF":0.9,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898600","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":"Intensive Care Fundamentals in Romania. A Critical Step in Romanian Intensive Care Education.","authors":"Cosmin Balan, Serban-Ion Bubenek-Turconi, Mo Al-Haddad","doi":"10.2478/jccm-2024-0029","DOIUrl":"10.2478/jccm-2024-0029","url":null,"abstract":"","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"10 3","pages":"279-281"},"PeriodicalIF":0.9,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898604","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":"Ventilator-Associated Events Cost in ICU Patients Receiving Mechanical Ventilation: A Multi-State Model.","authors":"Alkmena Kafazi, Eleni Apostolopoulou, Vasiliki Benetou, Georgia Kourlaba, Christos Stylianou, Ioanna D Pavlopoulou","doi":"10.2478/jccm-2024-0016","DOIUrl":"10.2478/jccm-2024-0016","url":null,"abstract":"<p><strong>Introduction: </strong>Cost analysis is complicated by the fact that patients acquire infections during their hospital stay, having already spent time at risk without having an infection. Multi-state models (MSM) accounts for this time at risk treating infections as time-dependent exposures from ICU admission.</p><p><strong>Aim of the study: </strong>To estimate ventilator-associated events (VAEs) direct additional cost in ICU patients.</p><p><strong>Material and methods: </strong>This was a prospective, observational study carried out for a two-year period in four medical-surgical ICUs of Athens, Greece. The sample consisted of adult patients who received mechanical ventilation for ≥4 days and were followed until discharge from the ICU or until death. CDC standard definitions were used to diagnose VAEs. To estimate VAEs additional length of stay (LOS), we used a four-state model that accounted for the time of VAEs. The direct hospital cost was calculated, consisting of the fixed and variable cost. The direct additional cost per VAEs episode was calculated by multiplying VAEs extra LOS by cost per day of ICU hospitalization.</p><p><strong>Results: </strong>In the final analysis were included 378 patients with 9,369 patient-days. The majority of patients were male (58.7%) with a median age of 60 years. Of 378 patients 143 (37.8%) developed 143 episodes of VAEs. VAEs crude additional LOS was 17 days, while VAE mean additional LOS after applying MSM was 6.55±1.78 days. The direct cost per day of ICU hospitalization was € 492.80. The direct additional cost per VAEs episode was € 3,227.84, € 885.56 the fixed and € 2,342.28 the variable cost. Antibiotic cost was € 1,570.95 per VAEs episode. The total direct additional cost for the two-year period was € 461,581.12.</p><p><strong>Conclusions: </strong>These results confirm the importance of estimating VAEs real cost using micro-costing for analytical cost allocation, and MSM to avoid additional LOS and cost overestimation.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"10 2","pages":"168-176"},"PeriodicalIF":0.9,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11193978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898595","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":"Cefiderocol and Intraventricular Colistin for Ventriculitis due to an Extensively Drug-Resistant <i>Pseudomonas Aeruginosa</i>.","authors":"João Melo E Silva, Diogo Oliveira, João A Louro, Elisabete Monteiro","doi":"10.2478/jccm-2024-0020","DOIUrl":"10.2478/jccm-2024-0020","url":null,"abstract":"<p><p>Rheumatoid arthritis, an inflammatory rheumatic disease predominantly affecting small limb joints, frequently compromises the cervical spine, resulting in spinal instability and the potential surgical necessity. This may result in severe complications, such as ventriculitis, often associated with a high mortality rate and multidrug-resistant organisms. A major challenge lies in achieving therapeutic antimicrobial concentrations in the central nervous system. The authors present a case of a 65-year-old female, with cervical myelopathy due to severe rheumatoid arthritis. Following surgery, the patient developed ventriculitis caused by an extensively drug-resistant <i>Pseudomonas Aeruginosa</i>. Early diagnosis and prompt treatment played a crucial role in facilitating neurological and cognitive recovery.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"10 2","pages":"183-187"},"PeriodicalIF":0.9,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11193941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898556","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":"Extracorporeal Membrane Oxygenation as Circulatory Support in Adult Patients with Septic Shock: A Systematic Review.","authors":"Muhammad Faisal Khan, Mohsin Nazir, Muhammad Khuzzaim Khan, Raj Kumar Rajendram, Faisal Shamim","doi":"10.2478/jccm-2024-0017","DOIUrl":"10.2478/jccm-2024-0017","url":null,"abstract":"<p><strong>Introduction: </strong>The utilization of extracorporeal membrane oxygenation (ECMO) in adult patients experiencing septic shock is a subject of ongoing debate within the medical community. This study aims to comprehensively address this issue through a systematic review conducted in accordance with the PRISMA guidelines.</p><p><strong>Aim of study: </strong>The primary objective of this study is to assess the outcomes of ECMO utilization in adult patients diagnosed with septic shock, thereby providing insights into the potential benefits and uncertainties associated with this treatment modality.</p><p><strong>Materials and methods: </strong>Our research encompassed a thorough search across electronic databases for relevant English-language articles published up until April 2023. The inclusion criteria were based on studies reporting on ECMO usage in adult patients with septic shock. Among the eligible studies meeting these criteria, a total of eleven were included in our analysis, involving a cohort of 512 patients. The mean age of the participants was 53.4 years, with 67.38% being male.</p><p><strong>Results: </strong>In the pooled analysis, the mean survival rate following ECMO treatment was found to vary significantly across different ECMO modalities. Patients receiving venovenous-ECMO (VV-ECMO) and veno-venous-arterial ECMO (VVA-ECMO) demonstrated higher survival rates (44.5% and 44.4%, respectively) compared to those receiving venoarterial-ECMO (VA-ECMO) at 25% (p<0.05). A chi-square test of independence indicated that the type of ECMO was a significant predictor of survival (χ²(2) = 6.63, p=0.036). Additionally, patients with septic shock stemming from respiratory failure demonstrated survival rates ranging from 39% to 70%. Predictors of mortality were identified as older age and the necessity for cardiopulmonary resuscitation (CPR).</p><p><strong>Conclusions: </strong>In septic shock patients, ECMO outcomes align with established indications like respiratory and cardiogenic shock. VV-ECMO and VVA-ECMO suggest better prognoses, though the optimal mode remains uncertain. Patient selection should weigh age and CPR need. Further research is vital to determine ECMO's best approach for this population.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"10 2","pages":"119-129"},"PeriodicalIF":0.9,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11193963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898558","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}