Journal of Anesthesia, Analgesia and Critical Care (Online)最新文献

{"title":"Abstracts of the ICARE 2026 80th SIAARTI National Congress.","authors":"","doi":"10.1186/s44158-026-00440-5","DOIUrl":"https://doi.org/10.1186/s44158-026-00440-5","url":null,"abstract":"","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"6 Suppl 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225473","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":"Ventilation-perfusion imaging: what are we trying to improve?","authors":"Lorenzo Ball, Denise Battaglini, Nicolò Patroniti","doi":"10.1186/s44158-026-00465-w","DOIUrl":"10.1186/s44158-026-00465-w","url":null,"abstract":"","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"6 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198201","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":"Postoperative muscle mass depletion in older patients undergoing major elective surgery.","authors":"Francesca Moretto, Agnese Siani, Martina Fracazzini, Anna Carmen Leonetti, Teresa Esposito, Lorenza Scotti, Cristina Rigamonti, Sergio Gentilli, Raffaele Romito, Alessandro Volpe, Alessandro Carriero, Rosanna Vaschetto","doi":"10.1186/s44158-026-00466-9","DOIUrl":"10.1186/s44158-026-00466-9","url":null,"abstract":"<p><p>In older patients, the impact of surgery and postoperative recovery on skeletal muscle parameters remains poorly investigated. We aimed to assess changes in skeletal muscle parameters after major elective surgery and explore factors associated with total psoas index (TPI) reduction. This retrospective, post hoc analysis included 51 patients aged 70 years or older who underwent major elective general or urologic surgery and had preoperative and postoperative computed tomography (CT) scans available. The primary endpoint was the change in TPI between preoperative and postoperative CT. At postoperative CT follow-up, TPI decreased by 14% (mean [SD] paired difference -0.51 [0.77] cm²/m²) and muscle attenuation by 15% (both p < 0.001). The prevalence of low TPI increased from 13 patients preoperatively to 24 postoperatively. Preoperative low TPI was not significantly associated with postoperative outcomes, while greater TPI reduction was associated with longer hospital length of stay and intensive care unit admission in univariable analyses, but these associations were not confirmed after multivariable adjustment. These findings might suggest a postoperative decrease in skeletal muscle parameters in older adults, although their clinical relevance requires further investigation.</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"6 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186595","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":"What is the significance of intra-operative oliguria with regard to post-operative acute kidney injury? A physiology-informed framework for intra-operative oliguria management.","authors":"Lachlan Blackwood","doi":"10.1186/s44158-026-00433-4","DOIUrl":"10.1186/s44158-026-00433-4","url":null,"abstract":"<p><strong>Background: </strong>Intra-operative oliguria is frequently interpreted as a surrogate for hypovolaemia or impaired renal perfusion, often prompting reflexive and potentially harmful fluid administration. However, urine output during anaesthesia is influenced by a complex interplay of neurohormonal activation, surgical stress, and positive pressure ventilation, which can decouple diuresis from actual renal blood flow. This perspective articles critically appraises the evidence linking intra-operative oliguria to acute kidney injury (AKI) and explores the physiological pitfalls of interpreting urine output as an isolated haemodynamic target.</p><p><strong>Results: </strong>Recent high-level evidence confirms a significant correlation between intra-operative oliguria and post-operative AKI, yet also highlights substantial heterogeneity in the thresholds and durations used across clinical practice. To address this, we propose a conceptual, physiology-informed framework that categorises reduced urine output into four distinct clinical phenotypes: adaptive (a physiologic neurohormonal response to stress), haemodynamic (potentially reversible hypoperfusion), high-risk/complex (occurring in major surgery or vulnerable patients), and injury-associated (established renal damage). In one highly selected high-risk population, a single randomised trial reported that targeting supranormal, urine-guided hydration was associated with a lower incidence of AKI. These findings are hypothesis-generating only and should not be generalised, but they raise the possibility that oliguria in narrowly defined contexts may represent a potentially modifiable signal warranting further prospective study rather than passive observation. Bedside adjuncts, such as ultrasound assessment of cardiac output or venous congestion, may assist in differentiating these phenotypes, although their intra-operative validation remains limited. This framework is intended as a hypothesis-generating conceptual aid to clinical reasoning, not as a validated clinical algorithm or practice recommendation.</p><p><strong>Conclusion: </strong>Interpreting intra-operative oliguria requires a fundamental shift from binary thresholds to context-dependent phenotyping. Effective management must prioritise individualised assessment-integrating surgical risk, baseline patient vulnerability, and dynamic monitoring-rather than responding to isolated urine output triggers.</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"6 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186617","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":"Extended recovery room as a strategy to reduce inappropriate ICU admissions: an Italian hospital experience.","authors":"Melissa Sederino, Stefano Bambi, Vittorio Pavoni, Iacopo Cappellini","doi":"10.1186/s44158-026-00430-7","DOIUrl":"10.1186/s44158-026-00430-7","url":null,"abstract":"<p><p>The limited operational hours of Recovery Rooms (RR) frequently result in potentially avoidable intensive care unit (ICU) admissions for intermediate-risk surgical patients. \"Project Futura,\" implemented at Santo Stefano Hospital (Prato, Italy) in March 2024, extended RR hours into the evening (until 24:00) and holidays by reorganizing existing ICU nursing staff without additional resources. This retrospective before-after study compared October-December 2023 (pre-intervention) with October-December 2024 (post-intervention). During the post-intervention period, 362 of 1519 surgical patients (23.83%) received extended RR monitoring; only 18 (1.18%) required subsequent ICU/intermediate care unit admission. ICU occupancy decreased from 91.79 to 73.78% (p < 0.0001), extraordinary emergency RR activations dropped from 22 to 0, estimated ICU costs decreased by 35.7%, and nursing on-call hours were reduced by 91.7%. These preliminary findings suggest that extending RR operational hours may represent a safe, cost-efficient strategy to improve the appropriateness of postoperative ICU utilization.</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"6 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083014","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":"Phenotype-based appropriateness of IGM-enriched polyclonal immunoglobulin use in critical illness: report of an expert consensus.","authors":"Irene Coloretti, Elena Giovanna Bignami, Stefano Busani, Daniela Clerici, Antonio Corcione, Alberto Corona, Abele Donati, Gennaro De Pascale, Francesco Giuseppe De Rosa, Francesco Forfori, Salvatore Grasso, Francesco Imperatore, Giorgia Montrucchio, Pinna Simone Mornese, Erik Roman Pognuz, Maria Francesca Rubulotta, Gianluca Paternoster, Thomas Pellis, Antonio Siniscalchi, Carlo Tascini, Luigi Tritapepe, Massimo Girardis","doi":"10.1186/s44158-026-00459-8","DOIUrl":"10.1186/s44158-026-00459-8","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Sepsis and septic shock result from a dysregulated host response to infection, encompassing both hyperinflammatory and immunosuppressed phenotypes. Although immunomodulatory adjunctive therapies have been extensively investigated over the past decades, none have demonstrated consistent clinical efficacy. In contrast, low circulating immunoglobulin levels are common in septic patients and are associated with greater disease severity and poorer outcomes, providing a biological rationale for the use of polyclonal intravenous immunoglobulins (IVIg) as phenotype-targeted adjunctive therapies. This expert consensus sought to systematically evaluate the appropriateness of IVIg therapy across predefined and clinically relevant scenarios in critically ill patients and deliver pragmatic, phenotype-oriented guidance. A multidisciplinary Italian panel comprising experts in intensive care, infectious diseases, transplant medicine, and oncology applied a modified RAND/UCLA Appropriateness Method. The process integrated a structured literature review (PubMed, EMBASE, and the Cochrane Library) with anonymous 9-point Likert scale ratings. Indications were classified according to the median score as appropriate (7-9), uncertain (4-6), or inappropriate (1-3), and interpanel disagreement was assessed using the Interpercentile Range Adjusted for Symmetry. The expert panel evaluated seven phenotypes that were identified as the most clinically relevant and extensively addressed in the available literature. IVIg use was judged appropriate without formal disagreement in severe community-acquired pneumonia with hyperinflammation plus shock (median 8), low IgM &lt; 60 mg/dL (median 8), or prior immunosuppression (median 8), whereas hyperinflammation without shock was uncertain (median 6). Appropriateness was also supported for abdominal infection with endotoxaemic shock, immune suppression/paralysis, or low IgM (all median 8); sepsis in solid-organ transplant recipients (median 7), particularly with low IgM (median 8), while prophylaxis in high-risk transplant recipients was uncertain (median 5). IVIg was rated appropriate for overwhelming septic shock with severe hyperinflammation (median 8), especially with low IgM (median 8) and toxin-mediated syndromes (median 9); for post-cardiac surgery sepsis with immune suppression (median 7) but not clearly for hyperinflammation (uncertain, median 6); for multidrug-resistant pathogen sepsis with immune suppression (median 7-8); and in haematologic malignancies, as prophylaxis or treatment primarily when immunoglobulins are low (medians 7-8), with prophylaxis otherwise uncertain. Across all phenotypes, IgM-enriched preparations were consistently preferred (median 8-9). Available evidence suggests no major safety signals, although adverse events are likely to be underreported. Overall, the consensus supports personalised, phenotype-oriented consideration of IgM-enriched IVIg as an adjunctive strategy to optimise standard care, wh","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"6 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139774","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":"Comparison of bag-valve-device ventilation and volume-controlled ventilation with laryngeal tube evo in intra-arrest ventilation-a prospective randomized study in human body donors.","authors":"Cornelius Christopher Falk, Beate Brand-Saberi, Eckart Förster, Tamar Gelashvili, Harald Genzwürker, Jochen Hinkelbein, Annika Hoyer, Amy Thomasseck, Justin Trenkel, Jens Tiesmeier, Lydia Johnson Kolaparambil Varghese, Gerrit Jansen","doi":"10.1186/s44158-026-00458-9","DOIUrl":"10.1186/s44158-026-00458-9","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the effects of the new supraglottic airway device known as laryngeal tube evo on target parameters of ventilation therapy during mechanical chest compressions in intra-arrest ventilation with bag-valve-device ventilation vs. volume-controlled ventilation.</p><p><strong>Methods: </strong>Thiel-embalmed human body donors were included in a standardized resuscitation scenario. Ventilation was performed in a randomized order using the laryngeal tube evo for bag-valve-device ventilation and volume-controlled ventilation during mechanical cardiopulmonary resuscitation. Expiratory (Vt_e) and expiratory tidal volumes per kg body weight (Vt_e/kgBW); delta tidal volume (difference between ideal and expiratory tidal volume; ΔVt); leakage volume (V_leak); peak (P_peak); mean (P_mean) and plateau (P_plat) pressures and respiratory rates were recorded. The primary efficacy endpoint was Vt_e.</p><p><strong>Results: </strong>Five body donors were included. Although one donor (20%) was successfully ventilated with all ventilation modes, three could only be ventilated with one of the modes (bag-valve-device ventilation = 20%; volume-controlled ventilation = 40%). One donor (20%) could not be sufficiently ventilated with any of the modes. Mean Vt_e was 91.73 ± 66.3 ml with bag-valve-device ventilation versus 142.93 ± 115.05 ml with volume-controlled ventilation. The comparison of both ventilation modes revealed higher Vt_e (50.27 ml; 95% confidence interval (CI): 7.56 to 92.97; p = 0.02), Vt_e/kgBW (0.8 ml; 95% CI: 0.05 to 1.56; p = 0.04), P_mean (5.23 mbar; 95% CI: 4 to 6.47; p < 0.0001) and P_plat (10.36 mbar; 95% CI: 8.08 to 12.64; p < 0.0001), but lower ∆Vt (- 50.3 ml; 95% CI: - 93 to - 7.59; p = 0.02) and respiratory rates (- 10.83/min; 95% CI: - 17.29 to - 4.36; p = 0.001) for volume-controlled ventilation.</p><p><strong>Conclusions: </strong>Comparing volume-controlled ventilation with bag-valve-device ventilation for asynchronous ventilation during mechanical cardiopulmonary resuscitation using the laryngeal tube evo, volume-controlled ventilation resulted in higher Vt_e and Vt_e/kgBW, but lower ∆Vt and respiratory rates. Future studies should evaluate laryngeal tube evo in prehospital use during mechanical cardiopulmonary resuscitation. When doubts regarding its effectiveness are present, synchronous ventilation (30:2) should be performed.</p><p><strong>Trial registration: </strong>German Clinical Trials Register; unique identifier: DRKS00037836. Registered on September 09, 2025 [1].</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"6 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042523","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":"Safety and tolerability study of clonidine for sedation in mechanically ventilated adult patients.","authors":"Huub L A van den Oever, Marieke Zeeman, Eline Klaas, Polina Nassikovker, Carmen Bles, Arthur R de Meijer, Arriette Kruisdijk-Gerritsen, Maurits E Arbouw","doi":"10.1186/s44158-026-00447-y","DOIUrl":"10.1186/s44158-026-00447-y","url":null,"abstract":"<p><strong>Background: </strong>Clonidine is used as an adjunct sedative in mechanically ventilated ICU patients, but prospective data on the safety and tolerability of higher intravenous doses remain limited.</p><p><strong>Methods: </strong>This secondary analysis used data from a prospective pharmacokinetic study in 32 critically ill adults. Patients were consecutively enrolled into four dose groups (0, 600, 1200 or 1800 μg/day, 8 per group) and received continuous intravenous clonidine added to standard sedation for up to seven days. Half of the patients in the clonidine groups underwent a four-hour loading phase during which the infusion rate was tripled. Serious adverse events (SAEs), a predefined set of adverse events (AEs), and outcome parameters were recorded. The relatedness of SAEs to clonidine was assessed using the WHO-UMC causality classification system. Patients were monitored for 48 h after clonidine discontinuation.</p><p><strong>Results: </strong>Ten SAEs were reported (3, 3, 3 and 1 in the 0, 600, 1200 and 1800 μg/day dose groups, respectively; Bayes factor (BF) 0.23). Seven SAEs were considered unrelated to clonidine, while three were judged possibly related. No SAEs occurred during the loading phase. No dose-dependent relationship was observed between clonidine dose and bradycardia or hypotension (BF 0.39 and 0.40, respectively). Pleural effusions were more frequent in the control group than in the clonidine groups (BF 12.9). Days on sedation, duration of mechanical ventilation, days in ICU and hospital mortality did not differ between groups. No clinically meaningful tachycardia or hypertension suggestive of clonidine withdrawal was observed.</p><p><strong>Conclusion: </strong>Clonidine was well tolerated within the studied dose range when used as an adjunct to standard sedation in our cohort of non-bradycardic, mechanically ventilated, critically ill adults. No clear dose-dependent increase in predefined adverse events was observed within the studied dose range. These findings provide support for further prospective evaluation of clonidine at doses up to 1800 µg/day in future efficacy studies.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT02466373.</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"6 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018933","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":"Reply to \"Addressing challenges for virtual reality applications in the ICU\": from feasibility to clinically meaningful implementation.","authors":"Ian Buckley, Joanne Dowds, Cristiano Pargana, Seán McEntagart, Emily Naylor, Christopher Soraghan, Ignacio Martin-Loeches","doi":"10.1186/s44158-026-00455-y","DOIUrl":"10.1186/s44158-026-00455-y","url":null,"abstract":"<p><p>Virtual reality (VR) is increasingly explored as an adjunct to rehabilitation in critically ill patients, but its clinical role, optimal application, and safety assessment remain incompletely defined. Our pilot study evaluated whether immersive VR could be integrated into routine cycle-based rehabilitation in selected, awake, consenting ICU patients without clinically relevant physiological instability and with acceptable tolerability, usability, and satisfaction. VR-assisted rehabilitation should not be considered a homogeneous intervention, as its effects are likely to depend on patient selection, neurological and functional status, characteristics of the immersive environment, physical workload, interaction intensity, duration, frequency, and cumulative exposure. Future studies should distinguish pragmatic evaluation from mechanistic investigation. Standard physiological monitoring remains appropriate for bedside feasibility studies, whereas electroencephalography, heart-rate variability, electrodermal activity, and other biosignals may help characterize autonomic and neurocognitive responses in hypothesis-driven research. Standardized assessment of cybersickness, adverse events, premature session termination, workflow, staff burden, device reliability, infection prevention, and governance will also be essential. Our findings provide preliminary, hypothesis-generating evidence that VR-assisted cycling is feasible and potentially safe in carefully selected ICU patients. Multicentre studies should now determine whether this approach improves rehabilitation engagement, functional recovery, patient experience, and other clinically meaningful outcomes.</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"6 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921994","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":"Addressing challenges for virtual reality applications in the ICU.","authors":"Marco Cascella","doi":"10.1186/s44158-026-00446-z","DOIUrl":"10.1186/s44158-026-00446-z","url":null,"abstract":"","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"6 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842394","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}