Journal of Anaesthesiology Clinical Pharmacology最新文献

{"title":"Comparison of induction of spinal anesthesia in sitting position with legs parallel and crossed for cesarean section: A randomized controlled trial","authors":"N. Puthenveettil, Sajan Rahman, Arun Ramayyan Achary, Sobha S. Nair, Dilesh Kadapamannil, Jerry Paul","doi":"10.4103/joacp.joacp_11_22","DOIUrl":"https://doi.org/10.4103/joacp.joacp_11_22","url":null,"abstract":"\u0000 \u0000 \u0000 The position of the patient during subarachnoid block has a role in its success. Landmarks of the spine can be easily identified in sitting position. Sitting position with legs parallel (LPSP) produces a reversal of lumbar lordosis. The crossed-leg sitting position (CLSP) is an alternative position. In this study, we compared the ease of performing subarachnoid blocks in these two positions. The objectives were to compare the attempts at subarachnoid placement, patient comfort, ease of landmark palpation, level of block, hypotension, and neonatal outcomes.\u0000 \u0000 \u0000 \u0000 This randomized trial was performed in 80 parturients posted for elective cesarean section. Parturients were assigned randomly to two groups. In group LPSP, the subarachnoid block was performed in sitting position with legs parallel and in group CLSP in the CLSP with knees and hips flexed.\u0000 \u0000 \u0000 \u0000 The percentage of parturients with a successful subarachnoid block in the first attempt was higher in the CLSP than in LPSP group (87.5% versus 55%). The remaining 12.5% parturients in the CLSP group had successful block in the second attempt. In the LPSP group, 32.5% required two attempts and 12.5% required more than two attempts. This difference was statistically significant (P-value of 0.003). The landmark was easily palpable in 92.5 versus 67.5% of parturients in CLSP and LPSP, respectively, with a P-value of 0.014.\u0000 \u0000 \u0000 \u0000 CLSP is better than a sitting position with legs parallel for reducing the number of attempts and improving the ease of performing the subarachnoid block.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":" 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139791749","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":"Comparison of two different doses of dexmedetomidine for continuous epidural analgesia for lower limb surgeries: A randomized double-blind study","authors":"P. Kurhekar, Sam Blessy Sheba, Sathyasuba Meenakshisundaram, R. Sethuraman, Neeta Parlikar","doi":"10.4103/joacp.joacp_88_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_88_23","url":null,"abstract":"\u0000 \u0000 \u0000 Bolus epidural dexmedetomidine provides potent analgesia but the incidence of hemodynamic instability is high. There are only a few studies that have evaluated the efficacy of epidural dexmedetomidine infusion but none of them compared different doses to find the optimum safe dose. We compared the analgesic efficacy and safety of two different doses of dexmedetomidine in continuous epidural for postoperative analgesia.\u0000 \u0000 \u0000 \u0000 Patients undergoing lower limb surgeries were divided randomly into two groups: Group I (n = 36) received an epidural infusion of 0.1% ropivacaine + 0.5 μg/kg/24 h of dexmedetomidine and Group II (n = 36) received epidural infusion 0.1% ropivacaine + 1 μg/kg/24 h of dexmedetomidine. Both groups received epidural infusion at the rate of 5 ml/h over 48 h postoperatively. Pain scores, demand for rescue analgesics, hemodynamic parameters, and sedation scores were compared between the groups. Statistical analysis was done using an independent t-test and Chi-square test.\u0000 \u0000 \u0000 \u0000 1 μg/kg group (Group II) had a significantly reduced pain score at all time intervals and less demand for rescue analgesia (P = 0.03). The severity of pain was more in the 0.5 μg/kg group (Group I), at all times (P = 0.000). Incidence hypotension was higher in Group II. Bradycardia was seen in two patients in Group II and none in Group I.\u0000 \u0000 \u0000 \u0000 Dexmedetomidine in a dose of 1 μg/kg/24 h with 5 ml of 0.1% ropivacaine through epidural infusion provides better analgesia with a safe hemodynamic profile.\u0000 \u0000 Key message: Epidural dexmedetomidine can cause profound hypotension. The optimum, safe dose of dexmedetomidine is not known. In our study, we observed that continuous epidural infusion of 1 μg/kg/24 h dexmedetomidine provides better analgesia with acceptable hemodynamic variations.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"5 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139853802","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":"Anesthetic management for aortopexy in an infant with tracheomalacia","authors":"Neha Goyal, Sweta Bharadiya, Deepanshu Dang, Manoj Kamal, Rakesh Kumar","doi":"10.4103/joacp.joacp_110_22","DOIUrl":"https://doi.org/10.4103/joacp.joacp_110_22","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"11 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139854501","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":"The effect of addition of ultra-low dose of naloxone to fentanyl–bupivacaine mixture on the incidence of pruritis after spinal anesthesia for cesarean delivery: Randomized clinical study","authors":"Sameh A. Ahmed, A. Amer, H. Lotfy, R. F. Mansour","doi":"10.4103/joacp.joacp_14_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_14_23","url":null,"abstract":"\u0000 \u0000 \u0000 The use of intrathecal opioids is associated with high risk of pruritis and this may be decreased by adding a low dose of naloxone. This study evaluated the effect of the addition of 20 μg of naloxone to fentanyl–bupivacaine mixture on the incidence of pruritis in pregnant females scheduled for cesarean section (CS).\u0000 \u0000 \u0000 \u0000 Eighty pregnant patients scheduled for CS under spinal anesthesia were randomized to receive either 10 mg of 0.5% hyperbaric bupivacaine (2 ml) plus 25 μg fentanyl (group F) or 10 mg of 0.5% hyperbaric bupivacaine (2 ml) plus 25 μg fentanyl and 20 μg naloxone (group FN). The incidence, onset, duration, site, and severity of pruritis were measured. Furthermore, the postoperative numerical rating scale (NRS) score, the total tramadol rescue analgesia, and the time for the first request of rescue analgesia were recorded.\u0000 \u0000 \u0000 \u0000 Compared to the F group, the FN group showed a significant decrease in the incidence of pruritis (P = 0.022), prolongation of the onset of pruritis (P = 0.006), shortening of the duration of pruritis (P = 0.029), and decrease in the severity of pruritis (P = 0.039). Furthermore, the postoperative pain score, the rescue analgesic consumption, and the time for the first request of rescue analgesia were comparable between the two groups (P > 0.05).\u0000 \u0000 \u0000 \u0000 The addition of an ultra-low dose of naloxone (20 μg) to fentanyl–bupivacaine mixture in spinal anesthesia for pregnant females scheduled for CS significantly reduced the incidence of pruritis without having a significant effect on the postoperative analgesia.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"20 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139597288","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":"Comparative evaluation of insertion characteristics of PLMA using different techniques in the pediatric age group","authors":"Suman Tiwari, Anita Seth","doi":"10.4103/joacp.joacp_258_22","DOIUrl":"https://doi.org/10.4103/joacp.joacp_258_22","url":null,"abstract":"\u0000 \u0000 \u0000 The laryngeal mask airway ProSeal (PLMA) insertion should be easy, fast, and atraumatic. Most studies have been done on adults who cannot be considered as the reflection of pediatric patients. In this study, we compared the first attempt success rate of three techniques of PLMA insertion: introducer, 90° rotation, and pharyngoscopy technique in the pediatric population.\u0000 \u0000 \u0000 \u0000 In this prospective comparative randomized study, a total of 135 patients of American Society of Anesthesiology grade I and II, aged three to eleven years, with normal airways scheduled for elective surgery, were randomly allocated into three groups: introducer, 90° rotation, and pharyngoscopy group. Parameters evaluated were: first attempt insertion success rate, insertion time, ease of insertion score, hemodynamic parameters, oropharyngeal seal pressure, manipulations, PLMA blood staining, postoperative sore throat, and hoarseness.\u0000 \u0000 \u0000 \u0000 First attempt insertion success rate was higher in the 90° rotation (97.78%) and pharyngoscopy (97.78%) group as compared to the introducer group (93.33%). But the result was not statistically significant. PLMA insertion time was the least in the rotation group, followed by the pharyngoscopy and introducer group (P < 0.0001). Mean arterial pressure and heart rate were significantly raised in the pharyngoscopy versus rotation group and the introducer versus 90° rotation group after PLMA insertion. Oropharyngeal seal pressure was significantly higher in the introducer as compared to the rotation group (P = 0.007).\u0000 \u0000 \u0000 \u0000 All three techniques had a high first-attempt insertion success rate. As the rotation technique had the best result in insertion time and hemodynamic response, it may be considered a good alternative to pharyngoscopy and introducer technique in pediatric patients of age three to eleven years with a normal airway.\u0000 \u0000 \u0000 \u0000 Several studies on PLMA insertion technique in adults are present, but few in the pediatric population. Introducer, pharyngoscopy, and 90° rotation technique were compared. The rotation technique was better in terms of insertion time and hemodynamic stability.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"14 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139597505","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":"Leucoglycemic index predicts post-operative vasopressor-inotropic requirement after adult cardiac surgery (LEUCOGLYPTICS): A retrospective single-center study","authors":"R. Magoon, Armaanjeet Singh, R. Kashav, Jasvinder K Kohli, Iti Shri, N. Bansal, Vijay Grover","doi":"10.4103/joacp.joacp_100_22","DOIUrl":"https://doi.org/10.4103/joacp.joacp_100_22","url":null,"abstract":"\u0000 \u0000 \u0000 Cardiac surgery often necessitates considerable post-operative vasoactive-inotropic support. Given an encouraging literature on the prognostic potential of leucoglycemic index (LGI) [serum glucose (mg/dl) × total leucocytes count (cells/mm3)/1000], we aimed to evaluate whether intensive care unit (ICU)-admission LGI can predict post-operative vasopressor-inotropic requirements following cardiac surgery on cardio-pulmonary bypass (CPB).\u0000 \u0000 \u0000 \u0000 The data of patients undergoing cardiac surgery at our tertiary care center between January 2015 and December 2020 was retrospectively reviewed. The vasopressor-inotropic requirement was estimated using the VIS (vasoactive-inotropic score) values over the first post-operative 72 hrs. Subsequently, VISi (indexed VIS) was computed as maxVIS[0-24hrs] + maxVIS[24-48hrs] +2 × maxVIS[48-72hrs]/10), and the study participants were divided into h-VISi (VISi ≥3) and l-VISi (VISi <3).\u0000 \u0000 \u0000 \u0000 Out of 2138 patients, 479 (22.40%) patients categorized as h-VISi. On univariate analysis: LGI, age, European System for Cardiac Operative Risk Evaluation score (EuroSCORE II), left-ventricle ejection fraction, prior congestive heart failure (CHF), chronic renal failure, angiotensin-converting enzyme inhibitors, combined surgeries, CPB and aortic cross-clamp (ACC) duration, blood transfusion, and immediate post-operative glucose were significant h-VISi predictors. Subsequent to multi-variate analysis, the predictive performance of LGI (OR: 1.09; 95% CI: 1.03–1.14; P = 0.002) prior CHF (OR: 2.35; 95% CI: 1.44–3.82; P = 0.001), CPB time (OR: 1.08; 95% CI: 1.02–1.14; P = 0.019), ACC time (OR: 1.03; 95% CI: 1.02–1.04; P = 0.008), and EuroSCORE II (OR: 1.14; 95% CI: 1.06–1.21; P < 0.001) remained significant. With 1484.75 emerging as the h-VISi predictive cut-off, patients with LGI ≥ 1484.75 also had a higher incidence of vasoplegia, low-cardiac output syndrome, new-onset atrial fibrillation, acute kidney injury, and mortality. LGI additionally exhibited a significant positive correlation with duration of mechanical ventilation and ICU stay (R = 0.495 and 0.564, P value < 0.001).\u0000 \u0000 \u0000 \u0000 An elevated LGI of greater than 1484.75 independently predicted a VISindex ≥3 following adult cardiac surgery on CPB.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"19 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139595948","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":"Comparison of ultrasound-guided suprainguinal fascia iliaca compartment block and pericapsular nerve group block for postoperative analgesia and associated cognitive dysfunction following hip and proximal femur surgery","authors":"Vijetha Gonabal, Shipra Aggarwal, Divya Rani, Mamta Panwar","doi":"10.4103/joacp.joacp_230_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_230_23","url":null,"abstract":"Hip and proximal femur fractures in any age group require surgical reduction and fixation. Various regional techniques are popular for lower limb surgeries but adequate analgesia from these blocks is variable depending upon the type of surgery. We conducted a study to compare ultrasound-guided suprainguinal fascia iliaca compartment (SFIC) block and pericapsular nerve group (PENG) block for postoperative analgesia and cognitive dysfunction in patients undergoing hip and proximal femur surgery. Sixty-six patients, aged 18–65 years, American Society of Anaesthesiologists I and II undergoing hip and proximal femur surgery were randomized into two groups, group F for SFIC block (n = 33) and group P for PENG block (n = 33). After completion of surgery, an ultrasound-guided SFIC or PENG block was given. Visual analogue scale (VAS) score on movement and rest, muscle power (quadriceps strength), time to first rescue analgesia, total analgesic requirement, and postoperative cognitive dysfunction in the first 24 h were observed. A total of 66 patients participated in the study and 30 in each group were analyzed. VAS score at movement was significantly lower (P = 0.018) with better quadriceps muscle strength (P = 0.001) in the PENG block compared to the SFIC block group at 24 h postoperatively. Total opioid consumption in morphine equivalents (P = 0.03) was lower in the PENG block than in the SFIC block group for 24 h (28.5% vs. 71.4%). Cognitive impairment was comparable in both groups (3.3% vs. 16.7%, P = 0.097). PENG block is better than SFIC block for postoperative analgesia with lesser opioid consumption, whereas postoperative cognitive dysfunction was comparable in both groups.","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"4 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139182369","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":"Effect of video distraction on preoperative anxiety scores in pediatric patients undergoing general anesthesia in ophthalmic daycare procedures: A randomized controlled trial","authors":"Soumily Bandyopadhyay, Manpreet Kaur, R. Sinha, Thilaka Muthiah, Arshad Ayub, Rajeshwari Subramaniam","doi":"10.4103/joacp.joacp_236_22","DOIUrl":"https://doi.org/10.4103/joacp.joacp_236_22","url":null,"abstract":"Parental separation, fear, and exposure to the operating room environment lead to stress and anxiety in pediatric patients. This study aims to identify the research gaps in the effect of video distraction on pediatric patients of Indian origin. We hypothesized that video distraction along with parental presence would reduce preoperative anxiety in pediatric patients undergoing ophthalmic procedures under general anesthesia compared with parental presence alone. In this prospective randomized trial, 145 patients aged 2–8 years, ASA I-II, with at least one functional eye undergoing elective ophthalmic daycare procedures were enrolled. They were randomly allocated to two Groups: Group V had distraction by watching a video/playing a video game together with parental presence, whereas control Group C had parental presence alone without any video distraction. The primary objective of the study was to compare preoperative anxiety using the Modified Yale Preoperative Anxiety score (mYPAS) and heart rate (HR), whereas the secondary objective was to compare child fear, emergence delirium, and parental satisfaction between the two groups. The three time points for intergroup comparisons were the preoperative holding area 10 min before induction (T0), transport of the child to the operating room (T1), and face mask introduction (T2). There was a statistically significant difference between mYPAS score in groups V and C at all time points (P = 0.036, P = 0.0001, P = 0.0000), parental satisfaction score at all three time points (P = 0.0049, P = 0.0000, P = 0.0000), and Child Fear Score at T1 and T2 (P = 0.0001, P = 0.0001, respectively). However, there was no statistically significant difference in the emergence of delirium between the two groups. Video distraction together with parental presence has a promising role for implementation in hospitals with heavy workload settings where pharmacological intervention would not be feasible, to alleviate preoperative anxiety in children. However, preoperative anxiety may not translate into increased postoperative emergence delirium as was earlier believed.","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139182301","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":"Anesthetic management of a patient with post-thyroidectomy tracheal fistula for repair","authors":"K. Lakshman, Gowry Rajendran, Balligavi Hanumanthappa Arathi, Veera Bhadra Gowda","doi":"10.4103/joacp.joacp_218_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_218_23","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"66 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139182791","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":"Ultrasound-guided quadratus lumborum block: Posterior versus anterior approach in paediatrics undergoing laparoscopic inguinal hernia repair","authors":"D. A. El Malla, M. E. El Mourad","doi":"10.4103/joacp.joacp_366_22","DOIUrl":"https://doi.org/10.4103/joacp.joacp_366_22","url":null,"abstract":"Regional anaesthesia has gained popularity in managing post-operative pain in paediatric patients. Quadratus lumborum block (QLB) is recognised as one of the peri-operative pain management techniques used during abdominal surgeries. However, no consensus about the best approach has been reached. Sixty paediatric patients with ages ranging from 1 to 6 as well as classification I and II of the American Society of Anesthesiologists, scheduled for laparoscopic inguinal hernia, were allocated to receive either a posterior approach (Group I) or an anterior approach (Group II) QLB. Twenty four-hour morphine consumption, the face, legs, activity, cry, and consolability (FLACC) score, duration of analgesia, performance time, and block-related complications were recorded. Group II showed significantly lower morphine consumption as well as a longer duration of analgesia (P = 0.039*, 0.020*, respectively), with an equivalent period for block performance being reported in the two groups (P = 0.080). At 2, 4, 6, and 12 hours post-operatively, the FLACC scores were substantially diminished in Group II compared to Group I (P = 0.001*, 0.012*, 0.002*, 0.028*, respectively). However, at twenty-four hours, comparable pain scores were observed between both groups (P = 0.626). In addition, there were no block-related complications. In paediatric patients scheduled for laparoscopic inguinal hernia repair, the ultra-sound-guided anterior approach of the QLB was associated with significantly reduced post-operative morphine consumption, a lower FLACC score, and a longer analgesia duration when compared to the posterior approach.","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"278 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139183046","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}