Regional Anesthesia and Pain Medicine最新文献

{"title":"The five-in-two (FIT) ankle block for outpatient foot surgery: a proof-of-concept anatomical and observational study.","authors":"Lucas Deffontis, Matthias Herteleer, Corentin Roger, Olivier Choquet, Mathieu Capdevila, Wayan Hebrard, Anne Gourari, Aurélien Bonnal, Sophie Bringuier, Xavier Capdevila","doi":"10.1136/rapm-2026-108097","DOIUrl":"https://doi.org/10.1136/rapm-2026-108097","url":null,"abstract":"<p><strong>Introduction: </strong>Regional anesthesia for foot surgery commonly relies on a five-injection ankle block, a technique associated with technical complexity and patient discomfort. We developed an ultrasound-guided five-in-two (FIT) ankle block based on an anatomical rationale, to provide complete foot anesthesia with only two punctures.</p><p><strong>Methods: </strong>A dual-injection ankle block technique was defined through an anatomical study, consisting of a mid-calf injection targeting the superficial and deep fibular nerves and a distal transverse injection 5 cm above the medial malleolus targeting the tibial, saphenous, and sural nerves. The technique was assessed in a bicentric prospective observational study of adult patients undergoing outpatient foot surgery, with surgical anesthesia as the primary outcome. Secondary outcomes assessed block performance, perioperative pain intensity, 24-hour rescue analgesic consumption, patient-reported experience, and block-related safety.</p><p><strong>Results: </strong>80 patients received a FIT ankle block, with successful surgical anesthesia achieved in 77 cases (96%). Median sensory and motor block durations were 554 (420-758) and 600 (444-882) minutes, respectively. Pain was minimal, with median Visual Analogue Scale scores of 0 (0-7) during block placement and 0 (0-4) on arrival in the post-anesthesia care unit. Intravenous rescue analgesia was required in 5% of patients. The median Echelle du Vécu de l'Anesthésie LocoRégionale global score was 88 (80-97), and the complication rate was 0% (95% CI 0 to 3.75%).</p><p><strong>Conclusions: </strong>The anatomically guided FIT ankle block is an effective proximal motor-sparing regional anesthesia technique for outpatient foot surgery, providing reliable anesthesia, excellent analgesia, and well-tolerated perioperative outcomes.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiparameter urine reagent strips for bedside identification of cerebrospinal fluid in epidural catheter aspirates: a proof-of-concept observation.","authors":"Rajangam Hariharan, Hemanth Kumar V R, Sekar Loganathan, Iriventi Sar Chandra Sarma","doi":"10.1136/rapm-2026-108280","DOIUrl":"https://doi.org/10.1136/rapm-2026-108280","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glutamatergic neurons in the nucleus accumbens represent a distinct functional population that gates pain.","authors":"Tian-En Si, Zhi-Xiao Li, Yingying Zhang, Wei Meng, Jing Cao, Weidong Zang","doi":"10.1136/rapm-2026-107870","DOIUrl":"https://doi.org/10.1136/rapm-2026-107870","url":null,"abstract":"<p><strong>Background: </strong>The nucleus accumbens (NAc) integrates affective and sensory information crucial for pain processing. While canonically viewed as a predominantly GABAergic structure, the potential existence and function of non-canonical excitatory populations remain poorly understood. We hypothesized that a distinct subpopulation of vesicular glutamate transporter 2 (VGluT2) neurons in the NAc exists and actively drives inflammatory pain and related anxiety behaviors.</p><p><strong>Methods: </strong>In this controlled laboratory in vivo study using male mice, we identified and characterized NAc VGluT2 neurons using patch-clamp electrophysiology. A persistent inflammatory pain model was established via intraplantar complete Freund's adjuvant (CFA) injection. To determine functionality, we used viral-mediated chemogenetics to selectively inhibit these neurons. Main outcome measures included mechanical paw withdrawal frequency (PWF), thermal paw withdrawal latency (PWL), and pain-related anxiety evaluated via the open field test (OFT) and elevated plus maze (EPM).</p><p><strong>Results: </strong>NAc VGluT2 neurons constitute a unique, non-GABAergic population, with >90% displaying intrinsic burst-firing. These neurons became significantly hyperexcitable under CFA-induced inflammatory pain conditions. Chemogenetic inhibition of NAc VGluT2 neurons successfully alleviated pain hypersensitivity. Furthermore, modulating this neuronal population bidirectionally regulated pain-related anxiety-like behaviors.</p><p><strong>Conclusions: </strong>VGluT2 neurons in the NAc represent a functionally distinct, burst-firing population that critically gates inflammatory pain and comorbid anxiety. Inhibiting this specific microcircuit provides a novel, precise target for treating persistent pain.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limited predictive utility of spinal cord stimulation trial pain metrics for post-implant outcomes.","authors":"Alexander David Keith, Jason S Kilgore, David Anthony Provenzano","doi":"10.1136/rapm-2026-108028","DOIUrl":"https://doi.org/10.1136/rapm-2026-108028","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the predictive value of pain outcomes reported during spinal cord stimulation (SCS) trialing for short-term, intermediate-term, and long-term post-implantation pain relief, and whether baseline patient characteristics modify these relationships.</p><p><strong>Methods: </strong>A retrospective review identified 124 patients who underwent SCS trial and implantation between 2015 and 2022 with a minimum of 6-months follow-up. Pain outcomes included numeric rating scale pain score (NRS), patient-reported percent pain relief (PR-PPR), and calculated percent pain relief (C-PPR) post-trial and at short-term (ST) 1-6 months (>1 to ≤6 months), intermediate term (IT) 6-15 months (>6 to ≤15 months), long-term (LT) 15-24 months (>15 to ≤24 months), and extended long-term (ELT) 24-36 months (>24 to ≤36 months) post-implantation. Univariable linear and logistic regression assessed predictive value, while Bland-Altman analysis and Lin's concordance correlation coefficient (CCC) evaluated agreement between PR-PPR and C-PPR. Interaction modeling assessed effect modification of baseline covariates.</p><p><strong>Results: </strong>Patients experienced significant pain reduction following trial (∆NRS 4.7; 95% CI 4.3 to 5.2), with sustained, but attenuating, benefit through 36 months. ∆NRS demonstrated the strongest predictive value (peak R²=0.32 at 15-24 months), though overall explanatory power was modest. In adjusted models, post-trial NRS was the strongest predictor of achieving ≥50% long-term pain relief (OR 0.70, p=0.002). Bland-Altman analysis showed a mean difference of 10 percentage points between PR-PPR and C-PPR (95% limits of agreement -36% to +56%) with poor overall agreement (CCC=0.36). Greater than 50% PR-PPR was maintained in 81.5% at 1-6 months and 70.2% at 24-36 months, with no significant differences between high and moderate trial responders. Covariate interaction modeling did not identify any consistent patient-specific modifiers.</p><p><strong>Conclusions: </strong>Trial-phase pain metrics demonstrated limited utility in explaining short, intermediate, and long-term pain relief. NRS-based measures showed the most consistent predictive value, while disagreement between PR-PPR and C-PPR raises concerns regarding the reproducibility of percentage-based metrics. These findings emphasize the need for refinement of reliable SCS trial predictors for post-implant pain relief outcomes.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood trauma history and response to behavioral treatments for chronic low back pain.","authors":"Samsuk Kim, Dokyoung Sophia You, Sean Mackey, Beth D Darnall","doi":"10.1136/rapm-2026-108047","DOIUrl":"10.1136/rapm-2026-108047","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of epinephrine on ropivacaine pharmacokinetics in TAP blocks: a randomized controlled trial.","authors":"Romain Rozier, Yann Le Guennec, Xavier Capdevila, Eric Le Louarn, Juliette Balbo, Thibaud Lavrut, Patrick Baque, Olivier Perus, Alexandre Destere, Axel Maurice-Szamburski","doi":"10.1136/rapm-2025-106500","DOIUrl":"10.1136/rapm-2025-106500","url":null,"abstract":"<p><strong>Background: </strong>Ropivacaine is commonly used in abdominal wall blocks due to its safety profile, and the addition of epinephrine is hypothesized to prolong analgesic duration and reduce systemic absorption. However, previous studies have been limited by non-weight-adjusted dosing and potential pharmacokinetic interactions, and inadequate investigation of the free form of ropivacaine.</p><p><strong>Objective: </strong>To characterize and compare the pharmacokinetics of total and free ropivacaine administered at a weight-adjusted dose of 1 mg/kg in Transversus Abdominis Plane (TAP) blocks, with and without epinephrine (1:200 000; 5 µg/mL).</p><p><strong>Methods: </strong>In this randomized controlled trial, 40 patients undergoing laparoscopic colectomy received bilateral TAP blocks with ropivacaine alone (TAP/E-) or ropivacaine with epinephrine (TAP/E+). Pharmacokinetic parameters, including maximum plasma concentration (Cmax), time to Cmax (Tmax), and area under the concentration-time curve, were assessed over 240 min. Secondary outcomes included α₁-acid glycoprotein (AGP), analgesia, safety, and mean plasma concentration (Cmean).</p><p><strong>Results: </strong>The mean Cmax in the TAP/E+ group (0.531±0.245 µg/mL) was not significantly different from that in the TAP/E- group (0.746±0.428 µg/mL). Epinephrine significantly prolonged Tmax (165 vs 55.9 min in TAP/E-, p<0.001) and reduced Cmean (p=0.005). No serious adverse events occurred, though QT interval prolongation was observed in both groups.</p><p><strong>Conclusion: </strong>This study demonstrates that adding epinephrine did not alter the Cmax of ropivacaine in TAP blocks, but did prolong the time to reach Cmax. These findings support the routine inclusion of epinephrine in TAP blocks and provide a basis for multimodal analgesia strategies.</p><p><strong>Trial registration number: </strong>NCT04959123.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"911-917"},"PeriodicalIF":4.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of chronic postsurgical pain after cardiac surgery and the effect of bilateral erector spinae plane block: a randomized controlled trial.","authors":"Burhan Dost, Elif Sarıkaya Ozel, Cengiz Kaya, Esra Turunc, Deniz Karakaya, Mustafa Kemal Demirag, Sezgin Bilgin, Alessandro De Cassai, Hesham Elsharkawy","doi":"10.1136/rapm-2025-106591","DOIUrl":"10.1136/rapm-2025-106591","url":null,"abstract":"<p><strong>Background: </strong>The effects of the erector spinae plane (ESP) block on chronic postsurgical pain (CPSP) after cardiac surgery remain unclear. This study evaluated the efficacy of bilateral ESP block in reducing the incidence and severity of CPSP after cardiac surgery.</p><p><strong>Methods: </strong>This prospective, randomized, controlled, single-blind trial included 63 patients aged 18-80 years with American Society of Anesthesiologists physical status II-III, scheduled for elective cardiac surgery via median sternotomy. Participants received a bilateral ultrasound-guided ESP block or standard care without regional anesthesia. The primary outcome was the Brief Pain Inventory (BPI) score at 3 months postoperatively. Secondary outcomes included morphine consumption in the first 24 hours; Numerical Rating Scale (NRS) scores during rest/activity at 0, 3, 6, 12, and 24 hours; BPI scores at 6 months postoperatively; and Douleur Neuropathique 4 (DN4) and Hospital Anxiety and Depression Scale (HADS) scores at 3 and 6 months postoperatively.</p><p><strong>Results: </strong>The BPI scores of the two groups did not differ significantly at 3 months postoperatively (median (IQR): 0(26) vs 12 (31), p=0.166). However, 24 hours postoperative morphine consumption (8 mg vs 10.5 mg, p<0.001) and NRS scores at multiple time points were significantly lower in the ESP block group. No significant differences were observed between the groups in terms of the BPI, DN4, or HADS scores at three or 6 months.</p><p><strong>Conclusions: </strong>The ESP block effectively reduced acute pain and opioid consumption; however, it had no significant effect on the incidence or severity of CPSP at 3 and 6 months.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"878-885"},"PeriodicalIF":4.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global usage of spinal cord stimulation therapy for chronic pain syndromes: a systematic review and meta-analysis.","authors":"Peter D Vu, Noushad Mamun, Lei Feng, Kathryn J Krause, Billy Huh, Ryan S D'Souza, Saba Javed","doi":"10.1136/rapm-2025-106806","DOIUrl":"10.1136/rapm-2025-106806","url":null,"abstract":"<p><strong>Background/importance: </strong>Spinal cord stimulation (SCS) is an established therapy for chronic pain conditions when conventional treatments fail. However, global research implementation varies significantly due to patient demographics, healthcare infrastructure, and economic factors, creating disparities in access that directly impact patient care and public health outcomes.</p><p><strong>Objective: </strong>To evaluate the global landscape of SCS research by analyzing patient demographics, geographic distribution, funding sources, and pain conditions treated across chronic pain populations aged 18 years and older, with primary focus on associations between geographic regions and patient age demographics.</p><p><strong>Evidence review: </strong>We conducted a systematic literature review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, searching five major databases through October 2024. Studies from 2000 onward reporting SCS in adults with chronic pain lasting 3 months or longer were included. We included randomized trials, comparative studies, and case series with at least 10 patients, excluding commentaries, reviews, and insurance databases.</p><p><strong>Findings: </strong>Analysis of 187 studies revealed heterogeneity in age distributions across geographic regions, with Asian studies showing higher mean ages compared to North America, while European showed lower mean ages. Research concentration was predominantly in high-income regions, with 57% of studies receiving industry funding and significant associations between funding source and geographic origin. Post-surgical pain syndrome-thoracolumbar emerged as the most prevalent condition globally, representing 44.9% of cases.</p><p><strong>Conclusions: </strong>Significant associations exist between geographic regions and patient demographics in SCS research, with notable disparities in research concentration highlighting the need for broader investigation in underrepresented areas to optimize global application of this chronic pain management therapy.</p><p><strong>Prospero registration number: </strong>CRD42025635147.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"959-970"},"PeriodicalIF":4.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tale of two approaches to ultrasound-guided interscalene brachial plexus block: a pro-con.","authors":"Robert Loren Owen, Beth A VanderWielen, Adam W Amundson, Rebecca L Johnson","doi":"10.1136/rapm-2025-106624","DOIUrl":"10.1136/rapm-2025-106624","url":null,"abstract":"<p><p>The interscalene brachial plexus block is a well-described and widely used peripheral nerve block effective for regional anesthesia and analgesia in orthopedic surgical procedures of the shoulder, upper arm, and clavicle. Conventionally, an in-plane ultrasound-guided approach has been the technique of choice, while the out-of-plane approach, though less described, has been gaining anecdotal momentum among a growing number of proceduralists. This pro-con discussion highlights the out-of-plane approach's goal of avoiding needle injuries to nerves that course through the middle scalene muscle and the in-plane approach's benefit of whole-shaft needle visualization and increased distance away from the plexus on entry. We aim to provide a comprehensive comparison to guide proceduralists in their clinical decision-making.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"985-988"},"PeriodicalIF":4.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of local anesthetic volume for popliteal plexus block on motor nerve conduction and muscle function in the leg: a randomized clinical trial in healthy volunteers.","authors":"Johan Kløvgaard Sørensen, Ulrik Grevstad, Erisela Qerama, Line Stenholt Bruun, Lone Nikolajsen, Charlotte Runge","doi":"10.1136/rapm-2025-106557","DOIUrl":"10.1136/rapm-2025-106557","url":null,"abstract":"<p><strong>Background and objectives: </strong>Popliteal plexus block (PPB) has shown moderate improvements in multimodal analgesia following total knee arthroplasty (TKA) while preserving motor function. However, the optimal analgesic volume for PPB remains unknown, and concerns exist regarding potential volume-dependent motor nerve involvement. This study investigates whether increasing the volume of local anesthetic for PPB affects muscle function and motor nerve involvement.</p><p><strong>Methods: </strong>In this randomized, controlled, blinded trial, 40 healthy volunteers received one active nerve block and one sham block in each leg. Participants were randomized into three PPB groups receiving 10 mL, 20 mL, or 30 mL of 1% lidocaine, with 20 observations per group. Additionally, 10 femoral nerve blocks and 10 sciatic nerve blocks were included as reference groups to confirm motor nerve involvement. The primary outcome was relative changes in maximum voluntary isometric contraction (MVIC) of ankle plantar- and dorsiflexion. Secondary outcomes included relative changes in MVIC of knee extension, relative changes in compound muscle action potential of the gastrocnemius, anterior tibial, vastus medialis, and vastus lateralis muscles and frequency of saphenous nerve involvement.</p><p><strong>Results: </strong>There were no significant differences in motor function between the three PPB groups for any MVIC measures (p≥0.1). Compound muscle action potential changes did not indicate clinically relevant motor nerve involvement across PPB groups. Saphenous nerve involvement was inconsistent, affecting 40% (10 mL), 40% (20 mL), and 60% (30 mL) of cases (p=0.3), suggesting ineffective sensory block of the femoral nerve's medial knee contributions.</p><p><strong>Conclusion: </strong>Increasing the volume of local anesthetic for PPB does not impair muscle function or significantly involve motor nerves, supporting its motor-sparing efficacy. PPB inconsistently affects the femoral nerve's sensory contributions to the knee, emphasizing its role as an adjunct to femoral triangle or adductor canal blocks in clinical practice. Concerns of muscle impairment should not hinder future clinical trials from exploration of the optimal analgesic volume for PPB.</p><p><strong>Trial registration number: </strong>NCT05464862.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":"924-930"},"PeriodicalIF":4.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}