Trends in Anaesthesia and Critical Care最新文献

{"title":"Flexible bronchoscope versus video-laryngoscope for nasotracheal intubation in patients with anticipated difficult airway under topical anesthesia and dexmedetomidine infusion: A randomized controlled trial","authors":"Aritra Kundu ,&nbsp;Nishant Patel ,&nbsp;Dalim Kumar Baidya ,&nbsp;Arshad Ayub ,&nbsp;Devalina Goswami ,&nbsp;Kanil Ranjith Kumar ,&nbsp;Rakesh Kumar ,&nbsp;Shailendra Kumar ,&nbsp;Ajoy Roychoudhury","doi":"10.1016/j.tacc.2025.101547","DOIUrl":"10.1016/j.tacc.2025.101547","url":null,"abstract":"<div><h3>Background</h3><div>Managing difficult airways with restricted mouth opening remains a challenge. In this regard, flexible bronchoscopes (FB) are considered the gold standard, offering precise tube placement. However, they require expertise and can be time-consuming. Video-laryngoscopes (VLs), such as the CMAC D-blade, provide enhanced glottic visualization and may reduce intubation time. While VLs are gaining popularity, data comparing them with FBs in this setting are limited. This study evaluates whether the CMAC D-blade VL can reduce intubation time compared to FB while maintaining similar success rates.</div></div><div><h3>Methods</h3><div>In this randomized controlled trial, 100 adult patients scheduled for elective head and neck or oral and maxillofacial surgery with anticipated difficult airways were randomized to receive awake nasotracheal intubation using either an FB or CMAC D-blade VL. The primary outcome was intubation time. Secondary outcomes included first-attempt success rate, overall success rate, and satisfaction scores.</div></div><div><h3>Results</h3><div>Out of 100 patients, 97 patients completed the study (FB: n = 49, VL: n = 48). Median intubation time was significantly shorter in the VL group (62 [53–71] sec) compared to the FB group (118 [107–134] sec; p &lt; 0.0001). Success rates and intubation scores were similar, but anesthesiologist and patient satisfaction scores were better in the FB group.</div></div><div><h3>Conclusion</h3><div>The CMAC D blade video-laryngoscope reduces intubation time while maintaining similar success rates compared to the flexible bronchoscope for awake nasotracheal intubation with limited mouth opening. Despite the time advantage, the flexible bronchoscope was preferred by anesthesiologists and patients had more comfort.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"61 ","pages":"Article 101547"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792724","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":"Navigating the anaesthetic maze: The VATS challenge in an infant with anterior mediastinal mass","authors":"Amrita Rath,&nbsp;Babli Kumari,&nbsp;Reena,&nbsp;Steffi Dua,&nbsp;Premkumar T.","doi":"10.1016/j.tacc.2025.101545","DOIUrl":"10.1016/j.tacc.2025.101545","url":null,"abstract":"<div><div>The anterior mediastinal mass (AMM) is a rare but life-threatening entity in an infant. The symptoms mostly depend on the size and the extent of the tumour and its relationship with the surrounding structures. Anaesthetic challenges are multi-fold when such a child is posted for video assisted thoracoscopic surgery (VATS): risk of airway or cardiovascular collapse during anaesthesia, supine positioning, one lung ventilation in the setting of difficult airway, pneumo-mediastinum in a small child with a space occupying lesion in thorax leading to further lowering of venous return and cardiac output, development of hypercarbia and challenges in maintaining lung protective ventilatory strategy, risk of major bleeding and collapse. Definitive management requires a team of experts in a well-equipped centre with clear cut management strategy and open discussion with family members. We describe one such challenging case of infant AMM posted for VATS which was successfully managed at our institute.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"61 ","pages":"Article 101545"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776553","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":"From algorithms to airways: Applying artificial intelligence to enhance airway assessment, management, and training","authors":"Mingzhu Guo,&nbsp;Yongheng Hou,&nbsp;Yan Liu,&nbsp;Bo Yang,&nbsp;Chuhan Qiao,&nbsp;Jian Li","doi":"10.1016/j.tacc.2025.101548","DOIUrl":"10.1016/j.tacc.2025.101548","url":null,"abstract":"<div><div>Artificial intelligence(AI) is advancing airway management applications, especially for airway assessment, clinical decision support, and training. Traditional assessment methods struggle with time and precision as complex airway disorders become more common. AI's powerful data processing and pattern recognition capabilities can assess patient imaging and clinical characteristics using deep learning algorithms to predict airway complications. In dynamic clinical environments, AI-assisted management solutions can improve airway control safety and efficiency by providing unique decision support. Additionally, AI systems using virtual reality and simulation training technologies can customize training programs for healthcare professionals based on airway difficulty, improving learning curves and clinical competencies in complex airway scenarios. AI in airway management shows its potential in assessment, clinical decision-making, and medical education. In clinical applications, we must also weigh AI's advantages and disadvantages. This review examines AI technology's current uses, future potential, and limitations in clinical practice and medical education.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"61 ","pages":"Article 101548"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792723","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":"Volume status and volume responsiveness assessment: A literature review of systematic reviews","authors":"Mansoureh Fatahi ,&nbsp;Azam Mohammadi ,&nbsp;Mahdi Foroughian","doi":"10.1016/j.tacc.2025.101546","DOIUrl":"10.1016/j.tacc.2025.101546","url":null,"abstract":"<div><div>Intravenous fluid administration is an essential and life-saving procedure in every hospital setting. Balancing fluid resuscitation could be challenging due to the risk associated with both hypovolemia and hypervolemia. We conducted an extensive literature review on systematic reviews related to this topic to examine the effectiveness of various invasive and non-invasive methods for assessing volume status and fluid responsiveness. Traditional invasive methods, including central venous pressure measurements, have limited predictive values. Noninvasive sonographic measurements of the inferior vena cava, internal jugular vein, and carotid artery have the potential to be reliable alternatives for assessing volume status. Measuring cardiac output with echocardiographic methods provides valuable information. Volume responsiveness can be evaluated reliably through stroke volume and pulse pressure variations, as well as the end-expiratory occlusion test in patients under mechanical ventilation.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"61 ","pages":"Article 101546"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800047","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":"Dorsal penile nerve block versus caudal block for circumcision in pediatric patients: A systematic review and meta-analysis","authors":"Dora Alexandra Carreira de Oliveira ,&nbsp;Rafael Oliva Morgado Ferreira ,&nbsp;Susimar Picado-Loaiza ,&nbsp;Matheus Pedrotti ,&nbsp;Eric Pasqualotto ,&nbsp;Sara Amaral","doi":"10.1016/j.tacc.2025.101543","DOIUrl":"10.1016/j.tacc.2025.101543","url":null,"abstract":"<div><h3>Background</h3><div>The efficacy of dorsal penile nerve block versus caudal block among children undergoing circumcision has been studied in several trials with conflicting results. We aimed to perform an updated systematic review and meta-analysis comparing both techniques in children undergoing circumcision under general anesthesia.</div></div><div><h3>Methods</h3><div>MEDLINE, Embase, and Cochrane Library were systematically searched for studies comparing dorsal penile nerve block versus caudal block in children undergoing circumcision. We computed mean differences (MD) or standardized mean difference (SMD) for continuous outcomes and risk ratios (RR) for binary outcomes, with 95 % confidence intervals (CIs). Heterogeneity was assessed using I² statistics. Statistical analyses were performed using R Software, version 4.2.3.</div></div><div><h3>Results</h3><div>We included 14 studies, comprising 1425 participants, of whom 645 (45.3 %) underwent dorsal penile nerve block. There were no significant differences between groups in time to first analgesic requirement (MD -14.79 min; 95 % CI -59.42 to 29.83; p = 0.52), and postoperative pain at 1h (SMD 0.10; 95 % CI -0.60 to 0.79; p = 0.79), 3h (SMD 0.00; 95 % CI -0.98 to 0.99; p = 0.99), and 24h (SMD 0.30; 95 % CI -2.57 to 3.17; p = 0.84). Dorsal penile nerve block was associated with a shorter time to first walk (MD -30.28 min; 95 % CI -44.50 to −16.05; p &lt; 0.01) and length of hospital stay (MD -28.61 min; 95 % CI -42.13 to −15.10; p &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>In children undergoing circumcision, dorsal penile nerve block and caudal block had similar times to first rescue analgesic and postoperative pain scores within 24h, although dorsal penile nerve block was associated with a shorter time to first walk and length of hospital stay.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"61 ","pages":"Article 101543"},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643819","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":"Alternative sources for high flow nasal oxygen in low-resource settings: Exploring the potential of auxiliary oxygen ports and wall flowmeters","authors":"Johan J Swart ,&nbsp;Claire Pfister ,&nbsp;Hayli Geffen ,&nbsp;Ross Hofmeyr","doi":"10.1016/j.tacc.2025.101542","DOIUrl":"10.1016/j.tacc.2025.101542","url":null,"abstract":"<div><h3>Background</h3><div>High flow nasal oxygen (HFNO) therapy delivers pure oxygen at rates over 40 L/min during preoxygenation and 60 L/min during apnoea, preventing hypoxia and extending safe apnoeic time. HFNO is beneficial in certain clinical scenarios. However, cost and limited availability of HFNO devices restrict routine use. Auxiliary oxygen outlets on anaesthesia workstations present a potential alternative HFNO source.</div></div><div><h3>Aim</h3><div>This study aimed to assess the maximum flow rates from auxiliary oxygen outlets on various anaesthesia workstations and wall flowmeters, to explore their viability as a source for HFNO.</div></div><div><h3>Methods</h3><div>After calibration in Switzerland, a CITREX H4 gas flow analyser was used to measure flow rates across multiple anaesthesia workstations and wall-mounted flowmeters at five hospitals affiliated with one academic anaesthesia department.</div></div><div><h3>Results</h3><div>Only two of nine tested workstations could reliably support flows sufficient for high flow apnoeic oxygenation. The General Electric (GE) CS 650 workstation had the highest average flow rate (120 L/min) while the Dräger Fabius GS Premium had the lowest (13 L/min). Wall flowmeters had flow rates ranging from 108 to 28 L/min, with most supporting flow rates greater than 60L/min.</div></div><div><h3>Conclusion</h3><div>The auxiliary oxygen outlet on anaesthetic workstations and general oxygen flowmeters is underutilised. Sufficient flow rates to function as a source of HFNO are attainable with many types, but should be individually tested. In a resource-limited environment, this could provide a cost-effective alternative in providing apnoeic oxygenation for a time-limited period, although safety has not yet been established.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"61 ","pages":"Article 101542"},"PeriodicalIF":1.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610313","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":"Optimizing tracheostomy anesthesia: A comparative study of nerve blocks","authors":"Tarek I. Ismail ,&nbsp;Rabab S.S. Mahrous ,&nbsp;Ahmed A. Bedewy","doi":"10.1016/j.tacc.2025.101541","DOIUrl":"10.1016/j.tacc.2025.101541","url":null,"abstract":"<div><h3>Background</h3><div>Tracheostomy is increasingly performed as a planned procedure for a wide range of indications. While superficial cervical plexus block (SCPB) is widely used as regional anesthesia for tracheostomy, its limitation in suppressing laryngeal reflexes may lead to discomfort and complications. Combining bilateral SCPB with bilateral superior laryngeal nerve block (SLNB) could potentially improve patient outcomes by reducing airway reflexes.</div></div><div><h3>Objective</h3><div>This study aimed to compare the effectiveness of bilateral SCPB alone versus bilateral SCPB combined with bilateral SLNB in sedated patients undergoing surgical tracheostomy.</div></div><div><h3>Methods</h3><div>A double-blind, randomized controlled trial was conducted at Alexandria University Hospital. A total of 120 adult patients, both intubated and non-intubated, requiring elective tracheostomy was randomly allocated into two groups: Group 1 received an ultrasound-guided bilateral SCPB alone, while Group 2 received a combination of ultrasound-guided bilateral SCPB and bilateral SLNB. The primary outcome was the incidence of intraoperative coughing and laryngospasm. Secondary outcomes included postoperative pain, cumulative analgesic requirements, time to first analgesic request, postoperative complications and patients’ satisfaction.</div></div><div><h3>Results</h3><div>Group 2 (SCPB + SLNB) demonstrated a significantly lower occurrence of coughing and laryngospasm compared to Group 1 (p &lt; 0.05). No significant difference was observed in postoperative pain intensity between the two groups. Additionally, postoperative complications and patients’ satisfaction were comparable between both groups, with no significant differences noted.</div></div><div><h3>Conclusion</h3><div>The addition of bilateral SLNB to SCPB significantly suppresses airway-related reflexes during tracheostomy.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"61 ","pages":"Article 101541"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548042","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":"Effectiveness of dipyrone (metamizole) in postoperative analgesia: A systematic review and meta-analysis","authors":"Mariana Luz ,&nbsp;Selma Alves Valente do Amaral Lopes ,&nbsp;Bruna Brandao Barreto ,&nbsp;Jamine da Silva Vieira ,&nbsp;Julia Tavares-Pereira ,&nbsp;Luisa Pereira Novaes ,&nbsp;Dimitri Gusmao-Flores","doi":"10.1016/j.tacc.2025.101540","DOIUrl":"10.1016/j.tacc.2025.101540","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative pain requires effective management. This study reviews the effectiveness and safety of dipyrone/metamizole for postoperative pain management in adults and children.</div></div><div><h3>Materials and methods</h3><div>The online databases Medline, OVID, Embase, and LILACS were searched in November 2024 for randomized controlled trials comparing dipyrone/metamizole with other drugs or placebo in postoperative settings. Outcomes included immediate postoperative pain scores and opioid consumption (Oral Morphine Equivalence, OME) in the first 24 h.</div></div><div><h3>Results</h3><div>Thirty studies were included. In adult patients, no significant OME differences were found between dipyrone and NSAIDs (2.1 mg; 95%CI -3.4 to 7.7), paracetamol (−1.3 mg; 95%CI -5.9 to 3.3), or placebo (−2.7 mg; 95%CI -9.2 to 3.8). In the ICU study, dipyrone showed lower OME than paracetamol (−9.9 mg; 95%CI -18.2 to −1.6). In pediatric studies, there were no differences in OME between dipyrone and paracetamol (0 mg; 95%CI -0.1 to 0.1) or placebo (−0.1 mg; 95%CI -0.3 to 0.2). No significant side effects were reported.</div></div><div><h3>Conclusion</h3><div>Dipyrone is as effective as other non-opioid analgesics commonly used for postoperative analgesia, and more effective than paracetamol in ICU patients. The reviewed studies indicate that its use is safe, and therefore it should be considered as an option for multimodal analgesia in pain management guidelines.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"61 ","pages":"Article 101540"},"PeriodicalIF":1.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535233","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":"Characteristics and outcome of critical care patients undergoing tracheostomy in a medical intensive care setting: A retrospective single center analysis of 1570 procedures in 12 years","authors":"Tim Schroeder,&nbsp;Jens Nee,&nbsp;Sarah Kamel,&nbsp;Christian Storm,&nbsp;Carl Hinrichs,&nbsp;Florian Marcy ,&nbsp;Bettina Schueler","doi":"10.1016/j.tacc.2025.101519","DOIUrl":"10.1016/j.tacc.2025.101519","url":null,"abstract":"<div><div>Tracheostomy is often indicated for patients requiring prolonged ventilation, as it can facilitate weaning from the ventilator, reduce work of breathing and allow cessation of sedation. Optimal timing and mode of tracheostomy is still under debate.</div></div><div><h3>Objective</h3><div>To evaluate the technique, timing, and clinical outcomes of tracheostomy in a large single-center cohort of medical intensive care unit (ICU) patients.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was conducted on consecutive patients undergoing tracheostomy between 2006 and 2018 in a medical ICU. Patients received either a percutaneous dilatational tracheostomy or surgical tracheostomy. Data collected included patient demographics, APACHE-II scores, ICU mortality, duration of mechanical ventilation, length of ICU stays, tracheostomy technique, and timing of tracheostomy relative to intubation and initiation of mechanical ventilation.</div></div><div><h3>Results</h3><div>A total of 1570 tracheostomies were analyzed, comprising 1323 (84.2 %) dilatational tracheostomies and 247 (15.8 %) surgical tracheostomies. The type of tracheostomy did not significantly affect length of stays or length of mechanical ventilation. Subgroup analysis based on tracheostomy timing revealed that early tracheostomy (&lt;7 days post-intubation) was associated with shorter length of mechanical ventilation (p &lt; 0.001), reduced length of stays (p &lt; 0.001), and lower mortality (p = 0.01). Multivariate regression analysis identified early tracheostomy as an independent predictor of reduced mortality, while tracheostomy type had no significant effect on mortality outcomes.</div></div><div><h3>Conclusion</h3><div>Early tracheostomy, within seven days of intubation, was associated with improved survival, shorter length of mechanical ventilation, and reduced ICU stays, independent of the tracheostomy technique in our retrospective cohort in medical ICU patients.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"60 ","pages":"Article 101519"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153849","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 in laryngeal mask ventilation: Case of a vocal cord polyp","authors":"Sangrà-Puig M,&nbsp;Tena B,&nbsp;Bergé R,&nbsp;Barranco de Santiago A,&nbsp;Garavito L,&nbsp;Magaldi M","doi":"10.1016/j.tacc.2025.101517","DOIUrl":"10.1016/j.tacc.2025.101517","url":null,"abstract":"<div><div>The most frequent causes of airway obstruction during the use of laryngeal mask airway (LMA) devices are related to a superficial plane of anesthesia or misposition. However, uncommon causes must also be considered. This case report presents a patient scheduled for elective surgery, encountering unexpected difficulties during airway management due to a previously undiagnosed giant vocal cord polyp. The steps for managing a difficult airway were followed correctly finally leading to awakening the patient to prevent a potentially dangerous “can't intubate, can't ventilate” scenario.</div><div>This case emphasizes the importance of thorough preoperative airway assessment, early recognition of airway difficulties and the strategic use of awake intubation techniques in complex airway management situations.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"60 ","pages":"Article 101517"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153845","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}