Perioperative Care and Operating Room Management最新文献

{"title":"Comparative study of Thiopentone and Propofol for induction of anaesthesia in adult population- a randomized clinical trial","authors":"Abida Yousuf ,&nbsp;Shahid Ud Din Wani ,&nbsp;Suhail Ahmad Mir ,&nbsp;Tabassum Ali ,&nbsp;Ifat Jan ,&nbsp;Sehba Bader ,&nbsp;Hadi Mateen ,&nbsp;Bilquees Bhat ,&nbsp;Basharat Ahad ,&nbsp;Ghulam Nabi Bader","doi":"10.1016/j.pcorm.2025.100513","DOIUrl":"10.1016/j.pcorm.2025.100513","url":null,"abstract":"<div><h3>Background</h3><div>Modern medicine relies on general anesthesia. However, due to climate change and geopolitical instability, medicine shortages and supply chain disruptions are having a growing impact on the global healthcare environment. Applying high reliability organization (HRO) principles, healthcare systems must ensure consistent access to key anaesthetic agents. To assess clinical results and implications for sustainable anaesthetic procedures, this study compares thiopentone with propofol as a case study.</div></div><div><h3>Methods</h3><div>A Prospective, randomised, single-center cohort study. 190 adult patients in the age group of 18–70 years scheduled for different surgical procedures under general anaesthesia were carried out at a tertiary care hospital (Department of Anaesthesiology, SKIMS Medical College and Hospital, Srinagar). Patients were randomly assigned to either propofol or thiopentone to induce anesthesia. Along with qualitative markers such induction smoothness, recovery, and consciousness levels, hemodynamic data such as heart rate, systolic and diastolic blood pressure, and breathing rate were examined.</div></div><div><h3>Results</h3><div>Both drugs were clinically efficacious and safe. In terms of quicker induction, easier recovery, and general patient satisfaction, propofol performed better (90 % vs. 85 %). It dramatically lowered systolic blood pressure (from 129 ± 11 to 102 ± 9.9 mmHg) and heart rate (from 90 ± 15 to 80 ± 13 beats/min). On the other hand, thiopentone also decreased blood pressure and heart rate, but less significantly. Group differences in respiratory patterns revealed varying physiological reactions.</div></div><div><h3>Conclusion</h3><div>Although thiopentone and propofol both works well to induce anesthesia, propofol is more patient-acceptable and offers better hemodynamic stability. However, in environments with limited resources, thiopentone is a more practical choice due to its simpler availability and cheaper cost. To improve system resilience—a crucial quality of high reliability organizations functioning under the strains of global supply chain volatility—this case study emphasizes the need of preserving flexibility and redundancy in anesthesia protocols.</div></div><div><h3>Trial registration</h3><div>The trial was registered prospectively in the Clinical Trial Registry of India (CTRI/2023/02/049,428) registered on 03/02/2023. The first subject was recruited on 05/02/2023.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100513"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365531","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":"Ethical conundrum of CCTV in the operation theatre","authors":"Sathish Ayyappan ,&nbsp;Dr Daideepya Chandra Bhargava ,&nbsp;Dr Devendra Jadav ,&nbsp;Dr Vikas P Meshram ,&nbsp;Dr Tanuj Kanchan","doi":"10.1016/j.pcorm.2025.100509","DOIUrl":"10.1016/j.pcorm.2025.100509","url":null,"abstract":"<div><div>The installation of closed-circuit television (CCTV) in operation theatres (OTs) has not been a popular belief; however, its recent introduction in a few countries has generated intense ethical discussions. While CCTV enhances patient safety, procedural transparency, and accountability, it simultaneously raises concerns about privacy, autonomy, and possible exploitation of recorded data. As patients are in an unconscious state during the operation, they remain unaware of the extent of recording or the storage and utilisation of their data, further complicating informed consent protocols. On the other hand, Surgeons and OT staff often perceive surveillance as an intrusion, potentially fostering a culture of mistrust and inhibiting their professional autonomy. Transparent policies, restricted access, secure data management, and obtaining explicit consent are pivotal in addressing these dilemmas. The ethical challenge lies in balancing the benefits and respecting individual rights. This article critically explores the multifaceted ethical and legal challenges of CCTV in OTs.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100509"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470442","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 incidence of postoperative atelectasis following gastrointestinal procedures in pediatric population","authors":"Emi Yuki ,&nbsp;Sulpicio G. Soriano ,&nbsp;Miho Shibamura-Fujiogi ,&nbsp;Koichi Yuki","doi":"10.1016/j.pcorm.2025.100510","DOIUrl":"10.1016/j.pcorm.2025.100510","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative pulmonary complications including atelectasis are common complications after surgery. However, the incidence of postoperative atelectasis in pediatric surgical population is not yet well delineated.</div></div><div><h3>Methods</h3><div>Using electronic medical record, we identified pediatric patients who underwent gastrointestinal surgery from January 2016 to September 2019 and determined the presence or absence of postoperative atelectasis by postoperative X-ray read. Risk factor analysis of postoperative atelectasis was performed using logistic regression analysis.</div></div><div><h3>Results</h3><div>We found that 25.6 % of patients had radiographic evidence of postoperative atelectasis. Univariate and multivariate analyses demonstrated that the risk factors included lower weight, higher ASA class, emergency surgery, the use of higher peak airway pressure, lower lung compliance, and the lack of neuromuscular relaxant reversal agent use. In patients who received muscle relaxants, the lack of neuromuscular relaxant reversal agent use was associated with an increased risk of postoperative atelectasis (odds ratio 0.421, 95 % confidence interval 0.235–0.723, <em>p</em> &lt; 0.001).</div></div><div><h3>Discussion</h3><div>Postoperative atelectasis was frequently observed in pediatric patients undergoing gastrointestinal surgery. For cases where neuromuscular blockade is used, adequate reversal is critical.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100510"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338865","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":"A consideration before rapid remimazolam administration","authors":"Qian Huang,&nbsp;Yi Zou","doi":"10.1016/j.pcorm.2025.100511","DOIUrl":"10.1016/j.pcorm.2025.100511","url":null,"abstract":"","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100511"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338877","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":"Older adult patient satisfaction with brain health exams prior to surgery","authors":"Juliana S. Burt ,&nbsp;Yonah Joffe ,&nbsp;Bethany Kim ,&nbsp;Estefania Perera ,&nbsp;Benjamin A. Chapin ,&nbsp;Christoph N. Seubert ,&nbsp;Cynthia Wilson Garvan ,&nbsp;Catherine C. Price","doi":"10.1016/j.pcorm.2025.100507","DOIUrl":"10.1016/j.pcorm.2025.100507","url":null,"abstract":"<div><div>This study examines patient satisfaction with a novel preoperative neuropsychology program at the University of Florida Hospital (UF Health), the Perioperative Cognitive Anesthesia Network (PeCAN^SM). The PeCAN clinic serves patients 65 and older planning elective surgeries at UF Health by offering brain health exams to establish baseline functioning and to identify cognitive vulnerabilities preoperatively. Patient satisfaction with the program was assessed anonymously with two separate surveys: a brief PeCAN-specific mail-in survey and an electronic general behavioral health survey. Respondents rated their experience with PeCAN on both surveys and had the option to include comments. Mean survey ratings show that patients were satisfied (A- or B-rating on an A-to-F scale) with their overall care (95 %), scheduling experience (93 %), assessment experience (95 %), and clinician feedback recommendations (90 %). Comments were examined to determine general satisfaction with the PeCAN program as well as specific themes in patient experiences. Qualitative analyses indicated that the PeCAN visit was helpful, informative, and valuable to patients’ care.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100507"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614663","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":"Evaluation of hopelessness, decision regret and desire for retransplantation in patients with graft loss after kidney transplantation","authors":"Naile Akıncı ,&nbsp;Çağla Toprak","doi":"10.1016/j.pcorm.2025.100508","DOIUrl":"10.1016/j.pcorm.2025.100508","url":null,"abstract":"<div><h3>Aim</h3><div>In this descriptive study, it was aimed to evaluate hopelessness, decision regret, and desire to be transplanted again in patients who developed graft loss after kidney transplantation.</div></div><div><h3>Material and Method</h3><div>The study sample consisted of all patients who developed graft loss after kidney transplantation between January 2017 and February 2021 in a private hospital in XXX, who met the inclusion criteria and volunteered for the study. “Patient Information Form”, ‘Beck Hopelessness Scale’ and ‘Decision Regret Scale’ were used as data collection tools in the study.</div></div><div><h3>Findings</h3><div>It was determined that participants experienced a moderate level of hopelessness after graft rejection (13.370 ± 4.379) while the average scores on the decision regret scale were generally high (66.435 ± 18.213). Regarding the desire to be transplanted again, it was observed that the majority of the participants (52.2 %) did not want to be transplanted again. According to the results of the correlation analysis, there was a significant correlation between hopelessness and decision regret scores (<em>p</em>* &lt; 0.05) while there was no significant correlation with the desire to be transplanted again (<em>p</em> &gt; 0.05). In addition, hopelessness (<em>p</em> = 0.034) scores of individuals who were not employed were significantly higher than those who were employed, and both hopelessness (<em>p</em> = 0.000) and decision regret (<em>p</em> = 0.048) scores of those without religious belief were significantly higher than those with religious belief.</div></div><div><h3>Conclusion</h3><div>The findings of the study emphasize the critical importance of monitoring and psychological support processes before and after kidney transplantation. Understanding the emotional processes individuals experience after kidney transplant graft loss is important for the development of psychological support and intervention strategies.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100508"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335982","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":"A structured educational model to improve the education of nurses: Case-based learning","authors":"Aydanur Aydın","doi":"10.1016/j.pcorm.2025.100504","DOIUrl":"10.1016/j.pcorm.2025.100504","url":null,"abstract":"<div><h3>Background</h3><div>Case-based training is a crucial component of nursing education, providing students with opportunities to enhance clinical reasoning, critical thinking, and professional behavior. However, few studies integrate these constructs into measurable educational outcomes.</div></div><div><h3>Methods</h3><div>This study aims to look at the influence of online care training, which is based on case studies in surgical illnesses nursing, on students' care behaviors and self-efficacy levels. Participants were randomly assigned to undergo case-based education or traditional instruction. One hundred and four undergraduate nursing students from one university were chosen to participate. The structure is logical, with causal relationships between claims and a clear order of information. The researcher used an online platform to collect data from students in both groups before and three months after training. The introduction features form comprised the caring behavior scale (CBS) and questions to assess nursing students' self-efficacy.</div></div><div><h3>Results</h3><div>Before the training, there was no discernible difference in the levels of care exhibited by the participants or in their self-efficacy. Nevertheless, a notable alteration was observed in the CBS scores of the intervention group students following the training period. Their CBS and self-efficacy scores surpassed those of the control group. The results of the regression analysis indicated that age, gender, place of residence, and caring assessment scores did not exert a significant influence on the total score of the Caring Behavior Scale.</div></div><div><h3>Conclusion</h3><div>The findings of the research indicated that structured case-based nursing education was an effective method for fostering the development of caring behaviors among students.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100504"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270689","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":"An audit of theatre operating efficiency at a central hospital in South Africa","authors":"S. Nair ,&nbsp;F. Cotwall ,&nbsp;D. Basu ,&nbsp;K. Tshabalala","doi":"10.1016/j.pcorm.2025.100506","DOIUrl":"10.1016/j.pcorm.2025.100506","url":null,"abstract":"<div><h3>Background</h3><div>The South African health system functions within a resource-constraint environment. By improving the efficiency of theatre services, costs can be reduced alongside improvement in service delivery. This study aimed to assess theatre operating efficiency at a central hospital in Gauteng Province, South Africa.</div></div><div><h3>Objectives</h3><div>To assess theatre efficiency by determining the theatre utilization rate, theatre cancellation rate, and determining the causes of inefficiency.</div></div><div><h3>Methods</h3><div>An audit was conducted from 15 May 2023 to 19 May 2023, between the hours of 08h00 and 16h00, in 7 operating rooms. The 5-day audit was conducted to capture a snapshot of theatre efficiency to inform operational management decision making. Times were collected for each surgical case including the anaesthesia start and finish time, surgical start and finish time, and turnover time. Cancellations of cases were documented with reasons, additional delays observed were recorded.</div></div><div><h3>Results</h3><div>A total of 16 320 min were available for utilization for elective and emergency cases. A total of 63 elective and 6 emergency cases were performed. The theatre utilization rate accounted for 67,7 % (11 047 min) of block time. Surgical time was 40 % of the block time. Non-surgical time accounted for 60 % and included anaesthetic time (25 %), time lost due to early finish (10 %), turnover time (3 %), time lost due to late starts (4 %) and post-surgical time (3 %). The day of surgery cancellation rate was 39 %, with 40 elective cases cancelled of 103 elective cases booked. Hospital-related factors accounted for 90 % of all cases and 10 % were secondary to patient-related factors, illustrating a greater need to address hospital related factors to reduce day of surgery cancellations.</div></div><div><h3>Conclusions</h3><div>The theatre utilization rate did not meet standards reflected in literature. The day-of-surgery cancellation rates were higher than what is recommended. Causes of inefficiency need to be addressed to optimize theatre functions.</div></div><div><h3>Recommendations</h3><div>Key strategies include realistic scheduling of elective theatre cases, maximizing theatre availability, implementing staff rotations, enhancing professional communication and performing continuous theatre audits. These interventions aim to improve theatre utilization and reduce day of surgery cancellations, which will ultimately enhance patient outcomes.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100506"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296841","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":"Acute kidney injury amid a national shortage of intravenous fluids: A before-and-after study","authors":"Daniel A. Zapata-Pena ,&nbsp;Andres Zorrilla-Vaca,&nbsp;Angel E. Armas-Vazquez,&nbsp;Angela M Bader,&nbsp;Alexander Stone,&nbsp;Sergey Karamnov","doi":"10.1016/j.pcorm.2025.100505","DOIUrl":"10.1016/j.pcorm.2025.100505","url":null,"abstract":"<div><h3>Introduction</h3><div>Hurricane Helene in 2024 resulted in a sudden shortage of intravenous (IV) fluids across the US, activating hospital strategies to limit fluid utilization. The clinical impact of this shortage remains unclear. This study aims to describe the effect of fluid conservation strategies on acute kidney injury (AKI) rates during a hospital response.</div></div><div><h3>Methods</h3><div>This is a single-center retrospective study of patients undergoing major surgery during five weeks of IV fluid shortage from September to October 2024. Patients were categorized into groups per week, using the week before the IV fluid shortage as the control group (T1). The primary outcome was acute kidney injury (AKI) within seven days post-surgery, defined by KDIGO criteria. A multivariable logistic regression assessed the association between each phase and AKI, adjusting for confounders.</div></div><div><h3>Results</h3><div>The study had 503 patients in 5 weeks (T1: 108, T2: 127, T3: 92, T4: 99, T5:77). Baseline characteristics were similar across groups. AKI occurred in 2.8 % of T1, 3.9 % of T2 (OR 1.88, 95 % CI 0.40–8.89, <em>P</em> = 0.424), 6.5 % of T3 (OR 3.53, 95 % CI 0.77–16.3, <em>P</em> = 0.105), 5.1 % of T4 (OR 1.45, 95 % CI 0.31–6.84, <em>P</em> = 0.638), and 3.9 % of T5 (OR 1.36, 95 % CI 0.25–7.35, <em>P</em> = 0.720). All groups had a higher AKI rate than T1, suggesting a possible clinical difference without reaching statistical significance.</div></div><div><h3>Conclusions</h3><div>Emergency reduction strategies were associated with maintaining patient safety. While findings suggest an impact of fluid conservation measures on AKI incidence, it was not statistically significant. Extensive studies are needed to confirm these findings.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100505"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296842","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":"Factors influencing perioperative nurses' retention and turnover decisions: A qualitative analysis","authors":"Ada Xie ,&nbsp;Hui (Grace) Xu ,&nbsp;Jed Duff","doi":"10.1016/j.pcorm.2025.100503","DOIUrl":"10.1016/j.pcorm.2025.100503","url":null,"abstract":"<div><h3>Aim</h3><div>This study explored the factors influencing perioperative nurses' decisions to leave, stay, actual departure, or remain reluctantly.</div></div><div><h3>Background</h3><div>The perioperative nursing sector is crucial to surgical care and patient safety, yet its unique staffing dynamics remain underexplored. There is a noticeable gap in research addressing the staffing challenges within this sector. While many studies focus on either intention to leave or turnover, few have examined the broader staffing issues in perioperative nursing.</div></div><div><h3>Methods</h3><div>This qualitative analysis draws on open-ended responses from a nationwide online survey of perioperative nurses across Australia. Snowball sampling was conducted through relevant specialty associations. Data were analysed using both inductive and deductive thematic analysis, and the study adhered to the Standards for Reporting Qualitative Research (SRQR).</div></div><div><h3>Results</h3><div>This study found that workplace factors, rather than personal or family reasons, were the primary drivers of turnover intention and departure among perioperative nurses. A range of workplace issues—including excessive workload, staffing shortages, inflexible working schedules, poor collegial relationships, and lack of professional development opportunities—contributed to turnover intentions, but dysfunctional nursing management was the most influential factor. Factors influencing nurses to stay included strong collegial relationships, value of perioperative nursing work and patient care, and access to flexible schedules. Some participants remained despite high turnover intentions due to financial security, collegial bonds, and fear of job change.</div></div><div><h3>Conclusions</h3><div>This qualitative analysis identified nursing managers, workplace environment, workload, nursing shortages, scheduling, and professional growth as key factors influencing turnover decisions among perioperative nurses. It highlighted concerns about dysfunctional leadership styles and their limited efforts in retaining staff. Addressing these issues and promoting retention factors like the value of perioperative nursing and patient care, and positive collegial relationships are crucial for improving retention strategies.</div></div><div><h3>Implication for the organisation</h3><div>The study highlights the need for the human resource department’s involvement in the training and performance monitoring of nursing managers.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100503"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255496","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}