Indian Journal of Critical Care Medicine最新文献

{"title":"Effectiveness of a Need-based Interventional Tracheostomy Care Protocol on Knowledge and Practice of Tracheostomy Care among Nurses.","authors":"Alice R Bilung, Janet P Dsouza, Sagar S Maddani","doi":"10.5005/jp-journals-10071-24826","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24826","url":null,"abstract":"<p><strong>Aim and background: </strong>Tracheostomy is a commonly conducted surgical intervention in intensive care settings, and many complications result from tracheostomy. The use of an evidence-based methodology for tracheostomy care can effectively mitigate the occurrence of complications. This study aimed to assess tracheostomy complications among patients, determine nurses' knowledge and practice of tracheostomy care, and evaluate the effectiveness of a tracheostomy care protocol (TCP) in terms of improving knowledge and practice of tracheostomy care and reducing complications among patients.</p><p><strong>Materials and methods: </strong>To conduct this study, a quasi-experimental research design was selected. Ninety-eight intensive care nurses were divided into two groups, with 49 nurses in each group. The experimental group received an intervention, and both groups underwent pre- and posttests using tools related to tracheostomy care knowledge and practice checklists. Complications among patients were observed using a tracheostomy complication checklist. Data analysis involved both descriptive and inferential statistics.</p><p><strong>Results: </strong>This study identified complications, including bleeding, tube obstruction, hypoxia, and local wound site infection, among tracheostomy patients. About 49% of the nurses in the experimental group and 34.7% in the control group had poor knowledge. There was a statistically significant difference in pre- and postintervention knowledge and practice scores between the groups (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>This study revealed a gap in participants' knowledge and practices regarding tracheostomy care. After the TCP was implemented, intensive care nurses improved their knowledge and practices. Postintervention, the number of complications and the length of hospital stay among patients were reduced.</p><p><strong>How to cite this article: </strong>Bilung AR, Dsouza JP, Maddani SS. Effectiveness of a Need-based Interventional Tracheostomy Care Protocol on Knowledge and Practice of Tracheostomy Care among Nurses. Indian J Crit Care Med 2024;28(11):1050-1055.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 11","pages":"1050-1055"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068795","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":"Author Response: Before the Stump Flow on the TCD in SAH can be Attributed to an SAH Relapse all Other Possible Causes must be Ruled Out.","authors":"Ripenmeet Salhotra","doi":"10.5005/jp-journals-10071-24832","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24832","url":null,"abstract":"<p><p><b>How to cite this article:</b> Salhotra R. Author Response: Before the Stump Flow on the TCD in SAH can be Attributed to an SAH Relapse all Other Possible Causes must be Ruled Out. Indian J Crit Care Med 2024;28(11):1085.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 11","pages":"1085"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinical Impression of NDM-producing <i>Acinetobacter baumannii</i> in Intensive Care Units of the University Referral Hospital in North India.","authors":"Sangeeta Singh, Anuragani Verma, Vimala Venkatesh, Sheetal Verma, D Himanshu Reddy, Avinash Agrawal","doi":"10.5005/jp-journals-10071-24834","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24834","url":null,"abstract":"<p><strong>Aims and background: </strong>Carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAb), a major public health threat, causes severe infections in Intensive Care Unit (ICU) patients. It resists β-lactam antibiotics through mechanisms like New Delhi metallo-beta-lactamase (NDM).</p><p><strong>Materials and methods: </strong>In ICU patients, 69 <i>Acinetobacter</i> species were isolated from 86 non-fermenting Gram-negative bacilli. Isolates were identified using biochemical methods and Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS), and carbapenem resistance detection was done by both phenotypic (mCIM and eCIM) and molecular methods.</p><p><strong>Results: </strong>Out of 66 <i>A. baumannii</i>, 61 were carbapenem-resistant, with 20 confirmed as NDM producers. NDM-positive isolates exhibited higher resistance and were associated with significant mortality (75%).</p><p><strong>Conclusion: </strong>NDM-positive <i>Acinetobacter</i> isolates are significant ICU pathogens with poor outcomes. Key risk factors include prolonged ICU stays, prior antimicrobial use, and inadequate therapy. Early detection and infection control are crucial.</p><p><strong>Clinical significance: </strong>NDM-positive <i>Acinetobacter</i> infections in ICU patients are linked to poor outcomes, highlighting the need for early detection and control measures.</p><p><strong>How to cite this article: </strong>Singh S, Verma A, Venkatesh V, Verma S, Reddy DH, Agrawal A. The Clinical Impression of NDM-producing <i>Acinetobacter baumannii</i> in Intensive Care Units of the University Referral Hospital in North India. Indian J Crit Care Med 2024;28(11):1044-1049.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 11","pages":"1044-1049"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068763","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":"Using Bayesian Hypothesis-testing to Reanalyze Randomized Controlled Trials: Does it Always Tell the Truth, the Whole Truth and Nothing but the Truth?","authors":"Kwok Ming Ho, Anna Lee","doi":"10.5005/jp-journals-10071-24833","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24833","url":null,"abstract":"<p><p>Adequately powered randomized controlled trials (RCTs) are considered the highest level of evidence in guiding clinical practice. Reports using Bayesian hypothesis-testing to reanalyze RCTs are increasing. One distinct advantage of Bayesian analysis is that we can obtain a range of numerical probabilities that reflect how likely a study intervention is more effective than the alternative after considering both pre-existing available evidence and the alternate hypotheses. A recent analysis of critical care trials showed that some trials with an indeterminate result according to the frequentist analysis could have a high probability of being effective when reinterpreted by Bayesian analysis. In this perspective article, we will discuss the caveats in interpreting the results of Bayesian reanalysis of RCTs before we change clinical practice. When overoptimistic hypothesis prior probabilities are used, it carries a risk to translate noises into false signals. Using Bayes factors (BFs) to quantify evidence contained in data (by the ratio of the probability of data under each hypothesis) is thus more preferable than using a single prior probability, such that the BF approach becomes the mainstream in Bayesian hypothesis-testing. Still, BFs are dependent on the prior parameter distributions; comparing different hypotheses would invariably result in different results.</p><p><strong>How to cite this article: </strong>Ho KM, Lee A. Using Bayesian Hypothesis-testing to Reanalyze Randomized Controlled Trials: Does it Always Tell the Truth, the Whole Truth and Nothing but the Truth? Indian J Crit Care Med 2024;28(11):1005-1008.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 11","pages":"1005-1008"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068768","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":"Optimal Nutrition in ICU! Less is More? Food for Thought or Feed for Survival!","authors":"Akshaykumar A Chhallani","doi":"10.5005/jp-journals-10071-24841","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24841","url":null,"abstract":"<p><p><b>How to cite this article:</b> Chhallani AA. Optimal Nutrition in ICU! Less is More? Food for Thought or Feed for Survival! Indian J Crit Care Med 2024;28(11):999-1001.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 11","pages":"999-1001"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068518","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":"Role of Intravenous Dexamethasone in Prevention of Postextubation Airway Obstruction in Mechanically Ventilated Children in Pediatric Intensive Care Unit: A Double-blind Randomized Controlled Trial.","authors":"Anjali R Varghese, Pratyusha Kambagiri, Manas R Sahoo, Atul Jindal, Anil K Goel","doi":"10.5005/jp-journals-10071-24830","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24830","url":null,"abstract":"<p><strong>Objective: </strong>To study the efficacy of intravenous dexamethasone in preventing postextubation airway obstruction (PEAO).</p><p><strong>Design: </strong>A double-blinded randomized controlled trial.</p><p><strong>Study setting: </strong>The study was conducted in level 3 PICU at AIIMS, Raipur, India, from December 2019 to September 2022.</p><p><strong>Subjects: </strong>Children requiring intubation for at least 24 hours and not beyond 14 days were included. Children with upper airway anomalies or who received corticosteroids within the last 7 days were excluded.</p><p><strong>Intervention: </strong>The children who satisfied the inclusion criteria were randomized into dexamethasone or placebo group by stratified variable block randomization. Dexamethasone (0.5 mg/kg/dose) or placebo was given four doses (-12 hr., -6 hr., 0 hr., and 6 hr. of extubation).</p><p><strong>Outcome: </strong>The occurrence of any clinically significant stridor (Westley stridor score ≥3) was the primary outcome.</p><p><strong>Measurements and main results: </strong>Of the seventy (<i>n</i> = 70) children included in the study, 35 received dexamethasone while 35 received placebo. Westley stridor score ≥3 was present in 25.71% (<i>n</i> = 9) in dexamethasone group vs 31.42% (<i>n</i> = 11) in placebo (<i>p</i> = 0.792). Reintubation occurred in 14.28% (<i>n</i> = 10/70) patients, 11.42% (4/35) in dexamethasone group, and 17.14% (6/35) in placebo group (<i>p</i> = 0.734). Five children in the dexamethasone group and six in placebo group died (<i>p</i> = 1.00). There was no difference in the length of PICU stay (<i>p</i> = 0.84) and hospital stay (<i>p</i> = 0.75) among both the groups.</p><p><strong>Conclusion: </strong>Administration of multiple doses of dexamethasone may not help in the prevention of reintubation but may help in the reducing the incidence of clinically significant stridor.</p><p><strong>How to cite this article: </strong>Varghese AR, Kambagiri P, Sahoo MR, Jindal A, Goel AK. Role of Intravenous Dexamethasone in Prevention of Postextubation Airway Obstruction in Mechanically Ventilated Children in Pediatric Intensive Care Unit: A Double-blind Randomized Controlled Trial. Indian J Crit Care Med 2024;28(11):1063-1068.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 11","pages":"1063-1068"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068678","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":"Echoes and Shadows: Predicting Hepatorenal Syndrome Outcomes with Lung Ultrasound and X-rays.","authors":"Amol T Kothekar, Keyurkumar B Shah","doi":"10.5005/jp-journals-10071-24836","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24836","url":null,"abstract":"<p><p><b>How to cite this article:</b> Kothekar AT, Shah KB. Echoes and Shadows: Predicting Hepatorenal Syndrome Outcomes with Lung Ultrasound and X-rays. Indian J Crit Care Med 2024;28(11):993-994.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 11","pages":"993-994"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068870","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":"Salt Based or BaLanced SolUtion-Trends Existing in Indian Intensive Care Units: A Multicenter Prospective Observational Cohort Study (SOLUTE Study).","authors":"Sachin Gupta, Subhal Dixit, Deeksha S Tomar, Kapil Zirpe, Deepak Govil, Dhruva Choudhry, Yatin Mehta, Anand Gupta, Lakkireddigari Siva Kumar Reddy, Adarsh Singamsetty, Sarala Kumari Daram, Pooja R Murthy, Kv Venkatesha Gupta, Pratibha Dileep, Kapildev Thakkar, Sweta J Patel, Divya Pal, Naveen Paliwal, Pooja Bihani, Lakshmikanthcharan Saravana Bavan, M N Sivakumar, Sourabh S Ambapkar, Saanvi S Ambapkar, Yogendra Pal Singh, Akhil Taneja, Rajeeb K Mishra, Suparna Bharadwaj, Anuj Clerk, Krunalkumar Patel, Mehul Shah, Zakariya Kaidawala","doi":"10.5005/jp-journals-10071-24825","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24825","url":null,"abstract":"<p><strong>Introduction: </strong>Fluid administration is a commonly practiced intervention in the intensive care unit (ICU) with normal saline being the preferred fluid. We sought to understand the current practice of fluid administration and choice of fluids in Indian ICUs and its effect on renal outcomes.</p><p><strong>Materials and methods: </strong>The Indian Society of Critical Care Medicine (ISCCM)-endorsed multicenter prospective observational study was conducted on practice of fluid administration in critically ill patients between May 1, 2020, and January 31, 2023. SPSS software was used for statistical analysis.</p><p><strong>Results: </strong>Private sector hospitals contributed 79.16% of data out of 144 ICUs. Around 961 patients belonged to the normal saline (NS) group, 672 to the Ringer's lactate (RL) group, and 891 to the balanced salt solution (BSS) group out of 2,452 patients. Patients with chronic obstructive pulmonary disease were more in the BSS and NS group as compared to RL group (<i>p</i> < 0.00001). Acute kidney injury (AKI) incidence was higher in the NS group, followed by RL and BSS (<i>p</i> < 0.0001). The serum creatinine rise was higher in the NS group on the first 2 days (<i>p</i> < 0.001). Daily fluid balance, urine output, and renal replacement therapy (RRT) needs were similar among the groups. The BSS group had shorter ICU and hospital length of stay (LOS) than the NS group (<i>p</i> < 0.001). The ICU survival was 63.3% in the NS group and 79.44% in the BSS group (<i>p</i> < 0.001). The AKI patients had higher survival in the BSS group (78.81%) as compared to the NS group (63.08%) (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Balanced salt solution is the preferred intravenous fluid with a safe renal profile among critically ill patients. The AKI patients had shorter hospital and ICU LOS with BSS as compared to NS.</p><p><strong>How to cite this article: </strong>Gupta S, Dixit S, Tomar DS, Zirpe K, Govil D, Choudhry D, <i>et al.</i> Salt Based or BaLanced SolUtion-Trends Existing in Indian Intensive Care Units: A Multicenter Prospective Observational Cohort Study (SOLUTE Study). Indian J Crit Care Med 2024;28(11):1028-1037.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 11","pages":"1028-1037"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Frailty on Postoperative Outcomes Following Major Abdominal Surgeries: A Prospective Observational Study.","authors":"Malini Joshi, Shilpushp J Bhosale, Jayant Pandhare, Resham Rathod, Sohan L Solanki, Atul P Kulkarni","doi":"10.5005/jp-journals-10071-24839","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24839","url":null,"abstract":"<p><strong>Background: </strong>Frailty poses unique challenges for patients undergoing major cancer surgeries due to their extreme vulnerability to physiological stressors and can be an important factor in determining postoperative outcomes.</p><p><strong>Aims and objective: </strong>The objective of the study was to determine the incidence of frailty in patients undergoing major abdominal cancer surgeries and identify the risk factors predicting poor outcomes.</p><p><strong>Materials and methods: </strong>This was a prospective observational study conducted following institutional ethics approval and CTRI registration. We included 308 adult patients who underwent major abdominal cancer surgeries over two years. The preoperative frailty score was calculated using the 11-point modified frailty index score (mFI scale). Patients with a mFI score ≥ 3 points were considered frail. Clinical outcomes such as postoperative complications (Clavien-Dindo grades III and IV), surgical site infections, need for vasopressors, mechanical ventilation, acute kidney injury (AKI), length of ICU and hospital stay, and mortality at 30 days were recorded.</p><p><strong>Results: </strong>The overall incidence of frailty according to the mFI scale was 8.1%. Age and higher American Society of Anesthesiology (ASA) status were significantly associated with frailty (OR -1.073, <i>p</i> < 0.001, and OR -10.220, <i>p</i> < 0.001) respectively. Frailty was an independent predictor of major postoperative complications (OR -8.147, 95%; CI -2.524-26.292, <i>p</i> < 0.001). Frailty was also significantly associated with an increased duration of mechanical ventilation and length of stay (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The modified frailty index (mFI) score remains a strong predictor of postoperative complications in patients undergoing major abdominal cancer surgeries and can help optimize risk factors to minimize complications.</p><p><strong>How to cite this article: </strong>Joshi M, Bhoslae SJ, Pandhare J, Rathod R, Solanki SL, Kulkarni AP. Effect of Frailty on Postoperative Outcomes Following Major Abdominal Surgeries: A Prospective Observational Study. Indian J Crit Care Med 2024;28(11):1038-1043.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 11","pages":"1038-1043"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068871","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":"Enhancing Disaster Preparedness.","authors":"Khusrav Bajan","doi":"10.5005/jp-journals-10071-24838","DOIUrl":"https://doi.org/10.5005/jp-journals-10071-24838","url":null,"abstract":"<p><p><b>How to cite this article:</b> Bajan K. Enhancing Disaster Preparedness. Indian J Crit Care Med 2024;28(11):995-996.</p>","PeriodicalId":47664,"journal":{"name":"Indian Journal of Critical Care Medicine","volume":"28 11","pages":"995-996"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067695","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}