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Managing Diastolic Dysfunction Perioperatively. 围手术期舒张功能不全的处理。
IF 1.4
Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2023-03-01 DOI: 10.1177/10892532221142441
Theodore J Cios, John C Klick, S Michael Roberts
{"title":"Managing Diastolic Dysfunction Perioperatively.","authors":"Theodore J Cios,&nbsp;John C Klick,&nbsp;S Michael Roberts","doi":"10.1177/10892532221142441","DOIUrl":"https://doi.org/10.1177/10892532221142441","url":null,"abstract":"<p><p>Preoperative cardiac evaluation is a cornerstone of the practice of anesthesiology. This consists of a thorough history and physical attempting to elucidate signs and symptoms of heart failure, angina or anginal equivalents, and valvular heart disease. Current guidelines rarely recommend preoperative echocardiography in the setting of an adequate functional capacity. Many patients may have poor functional capacity and/or have medical history such that echocardiographic data is available for review. Much focus is often placed on evaluating major valvular abnormalities and systolic function as measured by ejection fraction, but a key impactful component is often overlooked-diastolic function. A diagnosis of diastolic heart failure is an independent predictor of mortality and is not uncommon in patients with normal systolic function. This narrative review addresses the clinical relevance and management of diastolic dysfunction in the perioperative setting.</p>","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":"27 1","pages":"42-50"},"PeriodicalIF":1.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/82/10.1177_10892532221142441.PMC9968995.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10793848","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}
引用次数: 1
A Review of Biventricular Repair for the Congenital Cardiac Anesthesiologist. 先天性心脏麻醉师双心室修复术综述。
IF 1.4
Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2023-03-01 DOI: 10.1177/10892532221143880
Sean J Davies, James A DiNardo, Sitaram M Emani, Morgan L Brown
{"title":"A Review of Biventricular Repair for the Congenital Cardiac Anesthesiologist.","authors":"Sean J Davies,&nbsp;James A DiNardo,&nbsp;Sitaram M Emani,&nbsp;Morgan L Brown","doi":"10.1177/10892532221143880","DOIUrl":"https://doi.org/10.1177/10892532221143880","url":null,"abstract":"<p><p>The management of children with a borderline ventricle has been debated for many years. The pursuit of a biventricular repair in these children aims to avoid the long-term sequelae of single ventricle palliation. There is a lack of anesthesia literature relating to the care of this complex heterogenous patient population. Anesthesiologists caring for these patients should have an understanding on the many different forms of physiology and the impact on provision of anesthesia and hemodynamic parameters, the goals of biventricular staging and completion as well as the pre-operative, intra-operative, and post-operative considerations relating to this high-risk group of patients.</p>","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":"27 1","pages":"51-63"},"PeriodicalIF":1.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10781922","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}
引用次数: 1
Bleeding Complications from Transesophageal Echocardiography for Liver Transplantation: A Systematic Review. 经食管超声心动图检查肝移植出血并发症的系统回顾。
IF 1.1
Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-12-01 Epub Date: 2022-08-20 DOI: 10.1177/10892532221122666
W Jonathan Dunkman, David A Williams, Michael W Manning
{"title":"Bleeding Complications from Transesophageal Echocardiography for Liver Transplantation: A Systematic Review.","authors":"W Jonathan Dunkman, David A Williams, Michael W Manning","doi":"10.1177/10892532221122666","DOIUrl":"10.1177/10892532221122666","url":null,"abstract":"<p><p>Transesophageal echocardiography (TEE) for liver transplant has historically been avoided due to concern it may cause bleeding from esophageal varices. However, several recent studies, as well as increasing clinical experience, have indicated that it may be safe in many circumstances. We performed a systematic review of the literature to identify and summarize studies reporting complications in patients having TEE during liver transplant. Studies were identified by searching relevant key terms on PubMed as well as citation searching in relevant reviews. We identified 6 studies between 1996 and 2015 which evaluated complications of TEE during liver transplant. They reported an overall bleeding complication rate between .3% and 2.8% and a major bleeding complication rate between .0% and .8%. Most of the major bleeds had identifiable high-risk features such as recent variceal bleeding or banding. Review of the literature suggests that TEE may be safely used in patients undergoing liver transplantation, even with known varices, with a complication rate similar to that of all patients undergoing TEE. However, the risks of TEE may outweigh the potential benefits among patients undergoing liver transplant with particular high-risk features.</p>","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":" ","pages":"304-309"},"PeriodicalIF":1.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40716174","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}
引用次数: 0
A Randomized Pilot Study Assessing if SEDLine Monitoring During Induction of Surgical Patients is Associated With Reduced Dosage of Administered Induction Agents. 一项评估外科患者诱导过程中SEDLine监测是否与诱导药物剂量减少相关的随机试验研究。
IF 1.4
Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-12-01 Epub Date: 2022-10-05 DOI: 10.1177/10892532221130660
Martin Krause, Albert Nguyen, Orestes O'Brien, Swapnil Khoche, Ulrich Schmidt
{"title":"A Randomized Pilot Study Assessing if SEDLine Monitoring During Induction of Surgical Patients is Associated With Reduced Dosage of Administered Induction Agents.","authors":"Martin Krause,&nbsp;Albert Nguyen,&nbsp;Orestes O'Brien,&nbsp;Swapnil Khoche,&nbsp;Ulrich Schmidt","doi":"10.1177/10892532221130660","DOIUrl":"https://doi.org/10.1177/10892532221130660","url":null,"abstract":"<p><p><i>Background</i>. Intubations, especially in emergent settings, carry a high risk of hemodynamic instability with potentially catastrophic outcomes. Weight-based dosing of induction drugs can be inappropriately high for elective or emergent intubations and lead to hemodynamic instability. We hypothesized that monitoring the patient state index of SEDLine monitors (Masimo, Irvine, CA) would decrease the dose of induction drugs in the operating room during elective intubations.<i>Methods</i>. In this randomized study, SEDLine monitoring was provided to the intervention group but not to the control group during the induction of anesthesia in the operating room. Anesthesia providers in the intervention group were advised to titrate induction drugs to a Patient State Index of <50 before proceeding with intubation. The primary outcome was the induction dose of propofol and etomidate per kilogram normalized to propofol dose equivalents. Secondary outcomes included supplemental doses of ketamine, midazolam, fentanyl, phenylephrine, and ephedrine per kg, time from induction to intubation, administration of additional propofol or vasopressors after induction, mean arterial pressure <b>≥</b> or <65 mmHg, and lowest mean arterial pressure post-induction.<i>Results</i>. We found no significant difference in propofol equivalents between groups (<i>P</i> = .41). Using a SEDLine decreased the odds that a patient would require vasopressors during induction (odds ratio of .39 [95% confidence interval, .15-.98]).<i>Conclusion</i>. SEDLine monitoring during induction did not decrease dosing of the induction drugs etomidate and propofol but decreased the odds of receiving vasopressors. Further studies are warranted to assess the utility of processed electroencephalography in emergent intubations outside of the operating room.</p>","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":" ","pages":"260-265"},"PeriodicalIF":1.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33505568","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}
引用次数: 1
Challenging Paradigms and Trusting Evidence: New Approaches to Perioperative Care. 挑战范式和信任证据:围手术期护理的新方法。
IF 1.4
Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-12-01 DOI: 10.1177/10892532221138170
Meghan Prin, Nathan Clendenen, Hillary Lum, Miklos D Kertai, Benjamin A Abrams
{"title":"Challenging Paradigms and Trusting Evidence: New Approaches to Perioperative Care.","authors":"Meghan Prin,&nbsp;Nathan Clendenen,&nbsp;Hillary Lum,&nbsp;Miklos D Kertai,&nbsp;Benjamin A Abrams","doi":"10.1177/10892532221138170","DOIUrl":"https://doi.org/10.1177/10892532221138170","url":null,"abstract":"the novel perspectives on the complexities of clinical perioperative care are impera-tive. This issue of Seminars in Cardiothoracic and Vascular Anesthesia (SCVA) emphasizes this ethos. Two original research studies evaluate methods to reduce the quantity of anesthetic and opioid medications needed for surgery, and a comprehensive two-part review evaluates the evidence for “ prehabilitation ” before cardiac surgery. This issue is rounded out by two systematic reviews on the use of TEE in liver transplantation, and two case reports describing the challenging management of intracardiac masses. This literature will guide readers towards a more patient-centered approach with less dependence on polypharmacy and, hopefully, optimize outcomes for cardiac surgery. This approach is all the more relevant as the population ages; surgical populations are aging faster than the general population and phrases like “ potentially inappropriate medications ” and “ deprescribing ” entered the perioperative lexicon. we the the are visible on the horizon and the of famed to The you know, the less you","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":"26 4","pages":"257-259"},"PeriodicalIF":1.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9117732","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}
引用次数: 0
Prehabilitation of Cardiac Surgical Patients, Part 1: Anemia, Diabetes Mellitus, Obesity, Sleep Apnea, and Cardiac Rehabilitation. 心脏手术患者的康复，第1部分:贫血，糖尿病，肥胖，睡眠呼吸暂停和心脏康复。
IF 1.4
Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-12-01 Epub Date: 2022-08-25 DOI: 10.1177/10892532221121118
Joshua B Knight, Harikesh Subramanian, Ibrahim Sultan, David J Kaczorowski, Kathirvel Subramaniam
{"title":"Prehabilitation of Cardiac Surgical Patients, Part 1: Anemia, Diabetes Mellitus, Obesity, Sleep Apnea, and Cardiac Rehabilitation.","authors":"Joshua B Knight,&nbsp;Harikesh Subramanian,&nbsp;Ibrahim Sultan,&nbsp;David J Kaczorowski,&nbsp;Kathirvel Subramaniam","doi":"10.1177/10892532221121118","DOIUrl":"https://doi.org/10.1177/10892532221121118","url":null,"abstract":"<p><p>The concept of \"prehabilitation\" consists of screening for and identification of pre-existing disorders followed by medical optimization. This is performed for many types of surgery, but may have profound impacts on outcomes particularly in cardiac surgery given the multiple comorbidities typically carried by these patients. Components of prehabilitation include direct medical intervention by preoperative specialists as well as significant care coordination and shared decision making. In this two-part review, the authors describe existing evidence to support the optimization of various preoperative problems and present a few institutional protocols utilized by our center for cardiac presurgical care. This first installment will focus on the management of anemia, obesity, sleep apnea, diabetes, and cardiac rehabilitation prior to surgery. The second will focus on frailty, malnutrition, respiratory disease, alcohol and smoking cessation, and depression.</p>","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":" ","pages":"282-294"},"PeriodicalIF":1.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40415768","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}
引用次数: 1
Anesthetic Management of a Large Right Ventricular Mass due to Idiopathic Hypereosinophilic Syndrome in a Patient Undergoing Cardiac Surgery, a Case Report. 心脏手术患者特发性嗜酸性粒细胞增多综合征引起的大右心室肿块的麻醉处理，一例报告。
IF 1.4
Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-12-01 Epub Date: 2022-10-07 DOI: 10.1177/10892532221132967
Giacomo Scorsese, Austin Hake, Alexa Christophides, Jeremy Poppers, Eric Zabirowicz
{"title":"Anesthetic Management of a Large Right Ventricular Mass due to Idiopathic Hypereosinophilic Syndrome in a Patient Undergoing Cardiac Surgery, a Case Report.","authors":"Giacomo Scorsese,&nbsp;Austin Hake,&nbsp;Alexa Christophides,&nbsp;Jeremy Poppers,&nbsp;Eric Zabirowicz","doi":"10.1177/10892532221132967","DOIUrl":"https://doi.org/10.1177/10892532221132967","url":null,"abstract":"<p><p>Cardiovascular complications of hypereosinophilic syndrome (HES) constitute a significant source of morbidity and mortality, with heart involvement found in approximately 40%-80% of patients. In patients with right heart failure due to an intracardiac mass, induction of general anesthesia poses numerous challenges. The effects of positive pressure ventilation on right ventricular (RV) physiology can quickly lead to precipitous cardiovascular collapse, which increases the importance of maintaining adequate negative pressure ventilation strategies. Current strategies involve awake femoro-femoral cannulation with partial vs full flow femoro-femoral cardiopulmonary bypass (CPB), but both methods increase the risk of intraoperative blood loss due to systemic heparinization prior to sternotomy. In this case report, the authors describe an approach to anesthetizing a patient with severe right ventricular heart failure due to an intracardiac mass due to idiopathic HES. This approach involves femoral cannulation prior to induction of general anesthesia, airway topicalization, inhalational induction with fiberoptic intubation, and sternotomy with aortic/bicaval cannulation before paralysis.</p>","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":" ","pages":"310-314"},"PeriodicalIF":1.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33493009","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}
引用次数: 0
Pre-Habilitation of Cardiac Surgical Patients, Part 2: Frailty, Malnutrition, Respiratory disease, Alcohol/Smoking cessation and Depression. 心脏外科病人的预康复，第2部分:虚弱，营养不良，呼吸系统疾病，戒酒/戒烟和抑郁。
IF 1.4
Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-12-01 Epub Date: 2022-10-02 DOI: 10.1177/10892532221130922
Harikesh Subramanian, Joshua Knight, Ibrahim Sultan, David J Kaczorowski, Kathirvel Subramaniam
{"title":"Pre-Habilitation of Cardiac Surgical Patients, Part 2: Frailty, Malnutrition, Respiratory disease, Alcohol/Smoking cessation and Depression.","authors":"Harikesh Subramanian,&nbsp;Joshua Knight,&nbsp;Ibrahim Sultan,&nbsp;David J Kaczorowski,&nbsp;Kathirvel Subramaniam","doi":"10.1177/10892532221130922","DOIUrl":"https://doi.org/10.1177/10892532221130922","url":null,"abstract":"<p><p>The concept of \"pre-habilitation\" comprises screening for and identification of pre-existing disorders followed by medical optimization. This is performed for many types of surgeries, but may have profound impacts on outcomes, particularly in cardiac surgery given the multiple comorbidities typically carried by these patients. Components of pre-habilitation include direct medical intervention by preoperative specialists as well as significant care coordination and shared decision-making. In this second part of a two-part review, the authors describe existing evidence to support the optimization of various preoperative problems and present a few institutional protocols utilized at out center for cardiac presurgical care. This second installment will focus on alcohol and smoking cessation and the management of frailty, malnutrition, respiratory disease, and depression.</p>","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":" ","pages":"295-303"},"PeriodicalIF":1.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40393640","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}
引用次数: 2
Multi-Disciplinary Management and Surgical Resection of Intracardiac Fibromas Causing Bilateral Ventricular Outflow Tract Obstructions in an Infant. 1例婴儿双侧心室流出道梗阻的心内纤维瘤的多学科治疗和手术切除。
IF 1.4
Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-12-01 Epub Date: 2022-08-25 DOI: 10.1177/10892532221123693
Matthew L Stone, Megan L Albertz, Csaba Galambos, Mark D Twite, David N Campbell, Michael Di Maria, Brian Fonseca, Shelley D Miyamoto, Richard J Ing
{"title":"Multi-Disciplinary Management and Surgical Resection of Intracardiac Fibromas Causing Bilateral Ventricular Outflow Tract Obstructions in an Infant.","authors":"Matthew L Stone,&nbsp;Megan L Albertz,&nbsp;Csaba Galambos,&nbsp;Mark D Twite,&nbsp;David N Campbell,&nbsp;Michael Di Maria,&nbsp;Brian Fonseca,&nbsp;Shelley D Miyamoto,&nbsp;Richard J Ing","doi":"10.1177/10892532221123693","DOIUrl":"https://doi.org/10.1177/10892532221123693","url":null,"abstract":"<p><p>Cardiac tumors remain rare in children with benign pathologies predominating. Indications for surgical management often result from compromised ventricular chamber size, biventricular outflow tract obstruction, impaired ventricular function, or the presence of medically refractory dysrhythmias. We present a case of a six-month-old infant with two intracardiac fibromas originating in the interventricular septum. The fibromas were causing significant biventricular outflow obstruction. The patient successfully underwent tumor resection on cardiopulmonary bypass The literature on pediatric cardiac tumors is reviewed. Multi-disciplinary medical planning is necessary for successful anesthetic and surgical treatment of this high-risk patient population.</p>","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":" ","pages":"315-322"},"PeriodicalIF":1.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40419887","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}
引用次数: 0
Patterns of Use in Transesophageal Echocardiography for Liver Transplantation: A Systematic Review. 经食管超声心动图在肝移植中的应用模式：系统综述。
IF 1.1
Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-12-01 Epub Date: 2022-10-06 DOI: 10.1177/10892532221133247
W Jonathan Dunkman, Michael W Manning, David A Williams
{"title":"Patterns of Use in Transesophageal Echocardiography for Liver Transplantation: A Systematic Review.","authors":"W Jonathan Dunkman, Michael W Manning, David A Williams","doi":"10.1177/10892532221133247","DOIUrl":"10.1177/10892532221133247","url":null,"abstract":"<p><p>Transesophageal echocardiography is frequently but not always used to guide anesthetic management during liver transplantation. We performed a systematic review of the literature to identify and summarize any studies reporting on the frequency and characteristics of TEE use for liver transplantation. Studies were identified by searching several relevant terms on PubMed and citation searching of relevant reviews. We identified 5 studies reporting the results of surveys performed between 2003 and 2018. Use of TEE for liver transplantation increased from 11.3% of centers in 2003 to greater than 90% of centers by 2014 and 2018. Only 38%-56% of centers use it routinely with the rest using it only in special circumstances. About a third of centers usually perform a comprehensive exam, with the majority performing a more limited exam based on the needs of the case. Use of TEE for liver transplantation is common but not universal. This review summarizes the current knowledge about the frequency and circumstances of use, but there is an opportunity for further systematic study and discussion.</p>","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":" ","pages":"274-281"},"PeriodicalIF":1.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33508500","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}
引用次数: 0
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