世界危重病急救学杂志(英文版)最新文献

{"title":"Low T3 <i>vs</i> low T3T4 euthyroid sick syndrome in septic shock patients: A prospective observational cohort study.","authors":"Mirza Kovacevic, Visnja Nesek-Adam, Semir Klokic, Ekrema Mujaric","doi":"10.5492/wjccm.v13.i3.96132","DOIUrl":"https://doi.org/10.5492/wjccm.v13.i3.96132","url":null,"abstract":"<p><strong>Background: </strong>Both phases of euthyroid sick syndrome (ESS) are associated with worse prognosis in septic shock patients. Although there are still no indications for supplementation therapy, there is no evidence that both phases (initial and prolonged) are adaptive or that only prolonged is maladaptive and requires supplementation.</p><p><strong>Aim: </strong>To analyze clinical, hemodynamic and laboratory differences in two groups of septic shock patients with ESS.</p><p><strong>Methods: </strong>A total of 47 septic shock patients with ESS were divided according to values of their thyroid hormones into low T3 and low T3T4 groups. The analysis included demographic data, mortality scores, intensive care unit stay, mechanical ventilation length and 28-day survival and laboratory with hemodynamics.</p><p><strong>Results: </strong>The Simplified Acute Physiology Score II score (<i>P</i> = 0.029), dobutamine (<i>P</i> = 0.003) and epinephrine requirement (<i>P</i> = 0.000) and the incidence of renal failure and multiple organ failure (MOF) (<i>P</i> = 0.000) were significantly higher for the low T3T4. Hypoalbuminemia (<i>P</i> = 0.047), neutrophilia (<i>P</i> = 0.038), lymphopenia (<i>P</i> = 0.013) and lactatemia (<i>P</i> = 0.013) were more pronounced on T2 for the low T3T4 group compared to the low T3 group. Diastolic blood pressure at T0 (<i>P</i> = 0.017) and T1 (<i>P</i> = 0.007), as well as mean arterial pressure at T0 (<i>P</i> = 0.037) and T2 (<i>P</i> = 0.033) was higher for the low T3 group.</p><p><strong>Conclusion: </strong>The low T3T4 population is associated with higher frequency of renal insufficiency and MOF, with worse laboratory and hemodynamic parameters. These findings suggest potentially maladaptive changes in the chronic phase of septic shock.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"13 3","pages":"96132"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302142","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":"Early clinical outcomes of two regimens of prophylactic antibiotics in cardiac surgical patients with delayed sternal closure.","authors":"Mahmoud Ismail Allam Eissa, Rasha Kaddoura, Danial Hassan, Cornelia S Carr, Samy Hanoura, Yasser Shouman, Abdulwahid Almulla, Amr Salah Omar","doi":"10.5492/wjccm.v13.i3.92658","DOIUrl":"https://doi.org/10.5492/wjccm.v13.i3.92658","url":null,"abstract":"<p><strong>Background: </strong>Delayed sternal closure (DSC) can be a lifesaving approach for certain patients who have undergone cardiac surgery. The value of the type of prophylactic antibiotics in DSC is still debatable.</p><p><strong>Aim: </strong>To investigate clinical outcomes of different prophylactic antibiotic regimens in patients who had DSC after cardiac surgery.</p><p><strong>Methods: </strong>This was a retrospective observational single-center study. Fifty-three consecutive patients who underwent cardiac surgery and had an indication for DSC were included. Patients were subjected to two regimens of antibiotics: Narrow-spectrum and broad-spectrum regimens.</p><p><strong>Results: </strong>The main outcome measures were length of hospital and intensive care unit (ICU) stay, duration of mechanical ventilation, and mortality. Of the 53 patients, 12 (22.6%) received narrow-spectrum antibiotics, and 41 (77.4%) received broad-spectrum antibiotics. The mean age was 59.0 ± 12.1 years, without significant differences between the groups. The mean duration of antibiotic use was significantly longer in the broad-spectrum than the narrow-spectrum group (11.9 ± 8.7 <i>vs</i> 3.4 ± 2.0 d , <i>P</i> < 0.001). The median duration of open chest was 3.0 (2.0-5.0) d for all patients, with no difference between groups (<i>P</i> = 0.146). The median duration of mechanical ventilation was significantly longer in the broad-spectrum group [60.0 (Δ interquartile range (IQR) 170.0) h <i>vs</i> 50.0 (ΔIQR 113.0) h, <i>P</i> = 0.047]. Similarly, the median length of stay for both ICU and hospital were significantly longer in the broad-spectrum group [7.5 (ΔIQR 10.0) d <i>vs</i> 5.0 (ΔIQR 5.0) d, <i>P</i> = 0.008] and [27.0 (ΔIQR 30.0) d <i>vs</i> 19.0 (ΔIQR 21.0) d, <i>P</i> = 0.031]. Five (9.8%) patients were readmitted to the ICU and 18 (34.6%) patients died without a difference between groups.</p><p><strong>Conclusion: </strong>Prophylactic broad-spectrum antibiotics did not improve clinical outcomes in patients with DSC post-cardiac surgery but was associated with longer ventilation duration, length of ICU and hospital stays <i>vs</i> narrow-spectrum antibiotics.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"13 3","pages":"92658"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302140","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":"Optic nerve sheath diameters in nontraumatic brain injury: A scoping review and role in the intensive care unit.","authors":"Madhura Bhide, Deven Juneja, Omender Singh, Shakya Mohanty","doi":"10.5492/wjccm.v13.i3.97205","DOIUrl":"10.5492/wjccm.v13.i3.97205","url":null,"abstract":"<p><strong>Background: </strong>Neuromonitoring in medical intensive care units is challenging as most patients are unfit for invasive intracranial pressure (ICP) modalities or unstable to transport for imaging. Ultrasonography-based optic nerve sheath diameter (ONSD) is an attractive option as it is reliable, repeatable and easily performed at the bedside. It has been sufficiently validated in traumatic brain injury (TBI) to be incorporated into the guidelines. However, currently the data for non-TBI patients is inconsistent for a scientific recommendation to be made.</p><p><strong>Aim: </strong>To compile the existing evidence for understanding the scope of ONSD in measuring ICP in adult non-traumatic neuro-critical patients.</p><p><strong>Methods: </strong>PubMed, Google Scholar and research citation analysis databases were searched for studies in adult patients with non-traumatic causes of raised ICP. Studies from 2010 to 2024 in English languages were included.</p><p><strong>Results: </strong>We found 37 articles relevant to our search. The cutoff for ONSD in predicting ICP varied from 4.1 to 6.3 mm. Most of the articles used cerebrospinal fluid opening pressure followed by raised ICP on computed tomography/magnetic resonance imaging as the comparator parameter. ONSD was also found to be a reliable outcome measure in cases of acute ischaemic stroke, intracerebral bleeding and intracranial infection. However, ONSD is of doubtful utility in septic metabolic encephalopathy, dysnatremias and aneurysmal subarachnoid haemorrhage.</p><p><strong>Conclusion: </strong>ONSD is a useful tool for the diagnosis of raised ICP in non-traumatic neuro-critically ill patients and may also have a role in the prognostication of a subset of patients.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"13 3","pages":"97205"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302143","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":"Remimazolam in intensive care unit: Potential applications and considerations.","authors":"Praveen Reddy Elmati, Teja Nagaradona, Gowthami Sai Kogilathota Jagirdhar, Salim Surani","doi":"10.5492/wjccm.v13.i3.96877","DOIUrl":"https://doi.org/10.5492/wjccm.v13.i3.96877","url":null,"abstract":"<p><p>This manuscript explores the potential use of Remimazolam in the intensive care unit (ICU) and critical care units, considering its pharmacological characteristics, clinical applications, advantages, and comparative effectiveness over current sedatives and anesthetics. We reviewed existing PubMed and Google Scholar literature to find relevant studies on Remimazolam in ICU. We created search criteria using a combination of free text words, including Remimazolam, critical care, intensive care, sedation, anesthesia, pharmacokinetics, and pharmacodynamics. Relevant articles published in the English language were analyzed and incorporated. Remimazolam is an ultra-short-acting benzodiazepine derivative promising for sedation and anesthesia. It is a safer option for hemodynamically unstable, elderly, or liver or kidney issues. It also has comparable deep sedation properties to propofol in the ICU. Furthermore, it reduces post-procedural delirium and patient comfort and reduces the need for additional sedatives in pediatric patients. In conclusion, Remimazolam is an excellent alternative to current sedatives and anesthetics in the ICU. Its cost is comparable to that of current medications. Further research on its long-term safety in the ICU and its broader application and incorporation into routine use is necessary.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"13 3","pages":"96877"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302146","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":"Antimicrobial and synergistic effects of lemongrass and geranium essential oils against <i>Streptococcus mutans</i>, <i>Staphylococcus aureus</i>, and <i>Candida</i> spp.","authors":"Patrícia Michelle Nagai de Lima, Thaís Cristine Pereira, Lara Steffany de Carvalho, Letícia Ferreira Dos Santos, Carlos Eduardo Rocha Oliveira, Lucas de Paula Ramos, Maria Cristina Marcucci, Amjad Abu Hasna, Luciane Dias de Oliveira","doi":"10.5492/wjccm.v13.i3.92531","DOIUrl":"https://doi.org/10.5492/wjccm.v13.i3.92531","url":null,"abstract":"<p><strong>Background: </strong>The oral cavity harbors more than 700 species of bacteria, which play crucial roles in the development of various oral diseases including caries, endodontic infection, periodontal infection, and diverse oral diseases.</p><p><strong>Aim: </strong>To investigate the antimicrobial action of <i>Cymbopogon Schoenanthus</i> and <i>Pelargonium graveolens</i> essential oils against <i>Streptococcus mutans, Staphylococcus aureus, Candida albicans, Ca. dubliniensis</i>, and <i>Ca. krusei</i>.</p><p><strong>Methods: </strong>Minimum microbicidal concentration was determined following Clinical and Laboratory Standards Institute documents. The synergistic antimicrobial activity was evaluated using the Broth microdilution checkerboard method, and the antibiofilm activity was evaluated with the 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide assay. Data were analyzed by one-way analysis of variance followed by the Tukey post-hoc test (<i>P</i> ≤ 0.05).</p><p><strong>Results: </strong><i>C. schoenanthus</i> and <i>P. graveolens</i> essential oils were as effective as 0.12% chlorhexidine against <i>S. mutans</i> and <i>St. aureus</i> monotypic biofilms after 24 h. After 24 h <i>P. graveolens</i> essential oil at 0.25% was more effective than the nystatin group, and <i>C. schoenanthus</i> essential oil at 0.25% was as effective as the nystatin group.</p><p><strong>Conclusion: </strong><i>C. schoenanthus</i> and <i>P. graveolens</i> essential oils are effective against <i>S. mutans, St. aureus, Ca. albicans, Ca. dubliniensis</i>, and <i>Ca. krusei</i> at different concentrations after 5 min and 24 h.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"13 3","pages":"92531"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302138","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":"Diagnosis and management of severe pulmonary and extrapulmonary tuberculosis in critically ill patients: A mini review for clinicians.","authors":"Dominic Ti Ming Tan, Kay Choong See","doi":"10.5492/wjccm.v13.i2.91435","DOIUrl":"10.5492/wjccm.v13.i2.91435","url":null,"abstract":"<p><p>Among critically ill patients, severe pulmonary and extrapulmonary tuberculosis has high morbidity and mortality. Yet, it is a diagnostic challenge given its nonspecific clinical symptoms and signs in early stages of the disease. In addition, management of severe pulmonary and extrapulmonary tuberculosis is complicated given the high risk of drug-drug interactions, drug-disease interactions, and adverse drug reactions. To help clinicians acquire an up-to-date approach to severe tuberculosis, this paper will provide a narrative review of contemporary diagnosis and management of severe pulmonary and extrapulmonary tuberculosis in critically ill patients.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"13 2","pages":"91435"},"PeriodicalIF":0.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297337","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":"Future of neurocritical care: Integrating neurophysics, multimodal monitoring, and machine learning.","authors":"Bahadar S Srichawla","doi":"10.5492/wjccm.v13.i2.91397","DOIUrl":"10.5492/wjccm.v13.i2.91397","url":null,"abstract":"<p><p>Multimodal monitoring (MMM) in the intensive care unit (ICU) has become increasingly sophisticated with the integration of neurophysical principles. However, the challenge remains to select and interpret the most appropriate combination of neuromonitoring modalities to optimize patient outcomes. This manuscript reviewed current neuromonitoring tools, focusing on intracranial pressure, cerebral electrical activity, metabolism, and invasive and noninvasive autoregulation monitoring. In addition, the integration of advanced machine learning and data science tools within the ICU were discussed. Invasive monitoring includes analysis of intracranial pressure waveforms, jugular venous oximetry, monitoring of brain tissue oxygenation, thermal diffusion flowmetry, electrocorticography, depth electroencephalography, and cerebral microdialysis. Noninvasive measures include transcranial Doppler, tympanic membrane displacement, near-infrared spectroscopy, optic nerve sheath diameter, positron emission tomography, and systemic hemodynamic monitoring including heart rate variability analysis. The neurophysical basis and clinical relevance of each method within the ICU setting were examined. Machine learning algorithms have shown promise by helping to analyze and interpret data in real time from continuous MMM tools, helping clinicians make more accurate and timely decisions. These algorithms can integrate diverse data streams to generate predictive models for patient outcomes and optimize treatment strategies. MMM, grounded in neurophysics, offers a more nuanced understanding of cerebral physiology and disease in the ICU. Although each modality has its strengths and limitations, its integrated use, especially in combination with machine learning algorithms, can offer invaluable information for individualized patient care.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"13 2","pages":"91397"},"PeriodicalIF":0.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297405","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":"Point-of-care ultrasonography spotlight: Could venous excess ultrasound serve as a shared language for internists and intensivists?","authors":"Anosh Aslam Khan, Hasham Saeed, Ibtehaj Ul Haque, Ayman Iqbal, Doantrang Du, Abhilash Koratala","doi":"10.5492/wjccm.v13.i2.93206","DOIUrl":"10.5492/wjccm.v13.i2.93206","url":null,"abstract":"<p><p>Point-of-care ultrasonography (POCUS), particularly venous excess ultrasound (VExUS) is emerging as a valuable bedside tool to gain real-time hemodynamic insights. This modality, derived from hepatic vein, portal vein, and intrarenal vessel Doppler patterns, offers a scoring system for dynamic venous congestion assessment. Such an assessment can be crucial in effective management of patients with heart failure exacerbation. It facilitates diagnosis, quantification of congestion, prognostication, and monitoring the efficacy of decongestive therapy. As such, it can effectively help to manage cardiorenal syndromes in various clinical settings. Extended or eVExUS explores additional veins, potentially broadening its applications. While VExUS demonstrates promising outcomes, challenges persist, particularly in cases involving renal and liver parenchymal disease, arrhythmias, and situations of pressure and volume overload overlap. Proficiency in utilizing spectral Doppler is pivotal for clinicians to effectively employ this tool. Hence, the integration of POCUS, especially advanced applications like VExUS, into routine clinical practice necessitates enhanced training across medical specialties.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"13 2","pages":"93206"},"PeriodicalIF":0.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297408","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":"Ten misconceptions regarding decision-making in critical care.","authors":"Tara Ramaswamy, Jamie L Sparling, Marvin G Chang, Edward A Bittner","doi":"10.5492/wjccm.v13.i2.89644","DOIUrl":"10.5492/wjccm.v13.i2.89644","url":null,"abstract":"<p><p>Diagnostic errors are prevalent in critical care practice and are associated with patient harm and costs for providers and the healthcare system. Patient complexity, illness severity, and the urgency in initiating proper treatment all contribute to decision-making errors. Clinician-related factors such as fatigue, cognitive overload, and inexperience further interfere with effective decision-making. Cognitive science has provided insight into the clinical decision-making process that can be used to reduce error. This evidence-based review discusses ten common misconceptions regarding critical care decision-making. By understanding how practitioners make clinical decisions and examining how errors occur, strategies may be developed and implemented to decrease errors in Decision-making and improve patient outcomes.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"13 2","pages":"89644"},"PeriodicalIF":0.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297413","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":"Critical care specialists, the missing link in organ procurement for transplantation.","authors":"Francisca Del Rocio Gonzalez Cohens, Fernando M Gonzalez","doi":"10.5492/wjccm.v13.i2.90274","DOIUrl":"10.5492/wjccm.v13.i2.90274","url":null,"abstract":"<p><p>The procurement process for organ donation begins with the identification of potential organ donors in emergency or critical care units (CCU), followed by their clinical evaluation, diagnostic procedures, and therapeutic interventions, mostly conducted in CCUs. It concludes with the request for organ donation and, if accepted, the retrieval of organs. Despite most interventions occurring in detection units, there has been a neglect of the strategic role played by critical care specialists (CCS) in managing and caring for brain-dead or near-brain-death patients. Questions arise: Are they willing to undertake this responsibility? Do they fully comprehend the nature of organ procurement? Are they aware of the specific interventions required to maintain possible organ donors in optimal physiological condition? Our objective is to examine the role of CCS in organ procurement and propose ways to enhance it, ultimately aiming to increase and enhance organ donation rates.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"13 2","pages":"90274"},"PeriodicalIF":0.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297336","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}