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

{"title":"Technical aspects of neuraxial analgesia during labor and maternity care: an updated overview.","authors":"Antonio Coviello, Carmine Iacovazzo, Maria Grazia Frigo, Marilena Ianniello, Dario Cirillo, Giuseppe Tierno, Andrea Uriel de Siena, Pasquale Buonanno, Giuseppe Servillo","doi":"10.1186/s44158-025-00224-3","DOIUrl":"10.1186/s44158-025-00224-3","url":null,"abstract":"<p><p>Labor analgesia is increasingly widespread throughout the world with a rate ranging from 10 to 60%. The benefits regarding clinical and non-clinical maternal-fetal outcomes are currently discussed in international scientific literature. Even stage of labor needs a different and appropriate approach to control the pain; however, different techniques are reported in literature. The following study intends to give a brief overview of the characteristics of the different neuraxial and non-neuraxial techniques currently available and the non-technical skills necessary for effective assistance to pregnant women, providing insights on the topic to understand critical issues at the same time. After bibliographic research since 2018 to 2023, many randomized controlled trials, literature reviews, systematic reviews, and metanalysis were evaluated to create this brief overview. The following pharmacological and non-pharmacological approaches were assessed: spinal techniques, such as epidural analgesia (EA), combined spinal-epidural (CSE), dural puncture epidural (DPE), and continuous spinal anesthesia (CSA); pharmacological administration of nitrous oxide (N₂O) and systemic opioids (morphine, fentanyl, and pethidine); as the third one transcutaneous electric nerve stimulation (TENS), acupressure/acupuncture, aromatherapy, and breathing exercises. All the assessed approaches are relatively safe and effective, but the association of technical and non-technical skills is needed to improve the maternal and fetus outcome. More studies are needed to clarify what is the best approach to labor analgesia.</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"5 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069975","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":"Neuromuscular monitoring and incidence of postoperative residual neuromuscular blockade: a prospective observational study.","authors":"Alessandra Piersanti, Rossella Garra, Fabio Sbaraglia, Miryam Del Vicario, Rosa Lamacchia, Marco Rossi","doi":"10.1186/s44158-025-00226-1","DOIUrl":"10.1186/s44158-025-00226-1","url":null,"abstract":"<p><strong>Background: </strong>Neuromuscular blocking agents (NMBAs) are routinely used in anesthesia practice. An undetected, incomplete recovery of neuromuscular function at the end of surgery potentially exposes patients to clinical deterioration in the postoperative period. The aim of this study was to investigate the incidence of postoperative residual neuromuscular blockade (RNMB) in a cohort of patients receiving NMBAs.</p><p><strong>Methods: </strong>We enrolled 90 spontaneously breathing adult patients admitted to the recovery room (RR) after completion of surgeries having received at least 1 dose of NMBA. Anesthesia management, the dosage of NMBA used, and whether monitoring of neuromonitoring function was employed or if a reversal agent was administered were all at the discretion of the attending anesthesiologist, who was unaware that neuromuscular function was going to be monitored in the RR. The primary objective of this study was to determine the incidence of RNMB (defined as a train-of-four ratio ≤ 0.9). The secondary objectives were the number of postoperative adverse respiratory events and, for exploratory purposes, the estimation of potential risk factors through logistic regression analysis.</p><p><strong>Results: </strong>RNMB occurred in 5 (5%) patients who had received only one dose of NMBA at induction of anesthesia. Two patients with RNMB (40%) required O₂ supplementation during monitoring in the RR, compared to 11 patients in the rest of the sample (13%). Additionally, 2 of these patients (2%) required O₂ supplementation before hospital discharge due to O₂ desaturation < 92%. None of the patients with RNMB had received a reversal of neuromuscular blockade at the end of surgery. The association between RNMB and potential risk factors, assessed through multivariable logistic regression did not yield significant results for any of the considered variables.</p><p><strong>Conclusions: </strong>RNMB can occur even when a single dose of NMBAs is administered. Despite decades of extensive literature on the risks of RNMB and recent guidelines, routine monitoring of neuromuscular function and pharmacologic reversal of NMBA is still substandard. Routine monitoring of neuromuscular function is strongly advocated to enhance the level of patient care.</p><p><strong>Trial registration: </strong>The study was registered at ClinicalTrials.gov ( NCT06193213 , date of registration: 05/01/2024).</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"5 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061564","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":"Single center experience with Hypotension Prediction Index (HPI) during cytoreductive surgery with Hyperthermic Intraperitoneal Chemotherapy (HIPEC).","authors":"Camilla L'Acqua, Luciano Frassanito, Shigeki Kusamura, Franco Valenza","doi":"10.1186/s44158-025-00225-2","DOIUrl":"10.1186/s44158-025-00225-2","url":null,"abstract":"","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"5 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025929","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":"Neuromodulation in chronic pain management: addressing persistent doubts in spinal cord stimulation.","authors":"Giuliano Lo Bianco, Adnan Al-Kaisy, Silvia Natoli, Alaa Abd-Elsayed, Georgios Matis, Alfonso Papa, Leonardo Kapural, Peter Staats","doi":"10.1186/s44158-024-00219-6","DOIUrl":"https://doi.org/10.1186/s44158-024-00219-6","url":null,"abstract":"","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"5 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959830","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":"One-year outcome and quality of life of patients with subarachnoid hemorrhage admitted to intensive care unit: a single-center retrospective pilot study.","authors":"Carlo Bergamini, Etrusca Brogi, Sara Salvigni, Michele Romoli, Giovanni Bini, Alessandra Venditto, Elvis Lafe, Marcello D'Andrea, Luigino Tosatto, Maria Ruggiero, Vanni Agnoletti, Emanuele Russo","doi":"10.1186/s44158-024-00223-w","DOIUrl":"10.1186/s44158-024-00223-w","url":null,"abstract":"<p><p>Patients admitted to intensive care unit (ICU) after non-traumatic subarachnoid hemorrhage (SAH) represent a group with distinctive characteristics and few data are available on long-term outcome in this population. We conducted a single-center retrospective study in an Italian intensive care unit. All patients with non-traumatic SAH (ICD-9-CM Diagnosis Code 430) admitted to ICU were included. Disability and quality of life were evaluated via telephone interview after 12-15 months after initial bleeding using GOSE and EuroQoL, respectively. Baseline and clinical course characteristics were analyzed to evaluate relation with poor outcome defined as GOSE ≤ 3. Final population consisted of 38 patients. Twenty-four patients (63.2%) had favorable outcome (GOSE ≥ 4). Among 29 patients (76.3%) who survived at 1 year, median EQ-5D Index was 0.743 (IQR 0.287), while median EQ-VAS was 74.79 (IQR 18.5). Median EQ-5D Index and median EQ-VAS were higher among patients with favorable outcome (EQ-5D Index p = 0.037, EQ-VAS p = 0.003). Among baseline characteristics, only HH scale showed a significant relation with disability at one year (p = 0.033). Between complications occurred during ICU-stay only early HICP was related with unfavorable outcome (p = 0.028). Higher HH scale and early HICP were related with unfavorable outcome. Among patients with unfavorable outcome, quality of life has a broad range of variability, and this result should be taken into account when reporting patient-centered outcomes.</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"5 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928828","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":"Ciltius, Altius, Fortius! Our Olympic games: simulation training for potential casualties massive influx during Paris 2024!","authors":"Myriam Lamamri, Raphaëlle David, Emmanuel Weiss, Mathilde Holleville","doi":"10.1186/s44158-024-00220-z","DOIUrl":"10.1186/s44158-024-00220-z","url":null,"abstract":"","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"5 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928806","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":"Analgosedation in patients with acute respiratory failure on noninvasive ventilation: is it truly safe?","authors":"Manuel Alberto Guerrero-Gutiérrez, Rafael Alfonso Reyes-Monge, Ignacio Rodríguez-Guevara, Diego Escarramán-Martínez, Orlando Rubén Pérez-Nieto","doi":"10.1186/s44158-024-00221-y","DOIUrl":"10.1186/s44158-024-00221-y","url":null,"abstract":"","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"4 1","pages":"84"},"PeriodicalIF":0.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873602","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":"Intraoperative extracorporeal support for lung transplant: a systematic review and network meta-analysis.","authors":"Tommaso Pettenuzzo, Honoria Ocagli, Nicolò Sella, Alessandro De Cassai, Francesco Zarantonello, Sabrina Congedi, Maria Vittoria Chiaruttini, Elisa Pistollato, Marco Nardelli, Martina Biscaro, Mara Bassi, Giordana Coniglio, Eleonora Faccioli, Federico Rea, Dario Gregori, Paolo Navalesi, Annalisa Boscolo","doi":"10.1186/s44158-024-00214-x","DOIUrl":"10.1186/s44158-024-00214-x","url":null,"abstract":"<p><strong>Background: </strong>In the last decades, veno-arterial extracorporeal membrane oxygenation (V-A ECMO) has been gaining in popularity for intraoperative support during lung transplant (LT), being advocated for routinely use also in uncomplicated cases. Compared to off-pump strategy and, secondarily, to traditional cardiopulmonary bypass (CPB), V-A ECMO seems to offer a better hemodynamic stability and oxygenation, while data regarding blood product transfusions, postoperative recovery, and mortality remain unclear. This systematic review and network meta-analysis aims to evaluate the comparative efficacy and safety of V-A ECMO and CPB as compared to OffPump strategy during LT.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across multiple databases (PubMed Embase, Cochrane, Scopus) and was updated in February 2024. A Bayesian network meta-analysis (NMA), with a fixed-effect approach, was performed to compare outcomes, such as intraoperative needing of blood products, invasive mechanical ventilation (IMV) duration, intensive care unit (ICU) length of stay (LOS), surgical duration, needing of postoperative ECMO, and mortality, across different supports (i.e., intraoperative V-A (default (d) or rescue (r)) ECMO, CPB, or OffPump).</p><p><strong>Findings: </strong>Twenty-seven observational studies (6113 patients) were included. As compared to OffPump surgery, V-A ECMOd, V-A ECMOr, and CPB recorded a higher consumption of all blood products, longer IMV durations, prolonged ICU LOS, surgical duration, and higher mortalities. Comparing different extracorporeal supports, V-A ECMOd and, secondarily, V-A ECMOr overperformed CPB in nearly all above mentioned outcomes, except for RBC transfusions. The lowest rate of postoperative ECMO was recorded after OffPump surgery, while no differences were found comparing different extracorporeal supports. Finally, older age, male gender, and body mass index ≥ 25 kg/m² negatively impacted on RBC transfusions, ICU LOS, surgical duration, need of postoperative ECMO, and mortality, regardless of the intraoperative extracorporeal support investigated.</p><p><strong>Interpretation: </strong>This comparative network meta-analysis highlights that OffPump overperformed ECMO and CPB in all outcomes of interest, while, comparing different extracorporeal supports, V-A ECMOd and, secondarily, V-A ECMOr overperformed CPB in nearly all above mentioned outcomes, except for RBC transfusions. Older age, male gender, and higher BMI negatively affect several outcomes across different intraoperative strategies, regardless of the intraoperative extracorporeal support investigated. Future prospective studies are necessary to optimize and standardize the intraoperative management of LT.</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"4 1","pages":"81"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856940","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":"Amitriptyline-perphenazine therapy for persistent idiopathic facial pain: translational perspectives from a retrospective study.","authors":"Maurizio Marchesini, Giulia Topi, Cesare Bonezzi, Laura Demartini","doi":"10.1186/s44158-024-00217-8","DOIUrl":"10.1186/s44158-024-00217-8","url":null,"abstract":"<p><strong>Background: </strong>Persistent idiopathic facial pain (PIFP) can be challenging, both in its diagnosis, which appears to be purely exclusionary, and in its treatment, which currently lacks a gold standard. Amitriptyline is considered a first-line therapy, although not always effective. Recent insights into the role of dopamine in facial pain suggest that a novel therapeutic approach could target the dopamine system.</p><p><strong>Methods: </strong>This study aimed to retrospectively evaluate the efficacy of treatment with amitriptyline-perphenazine association in patients with severe PIFP. Thirty-one patients were given a regimen dose of amitriptyline-perphenazine at dosages ranging between 10/2 and 20/4 mg and were then retrospectively analyzed. We evaluated the following outcomes, referred to the last week prior to follow-up visits: NRS score for pain intensity (minimum, maximum, and average), the number of attacks, and SF-36 questionnaire for quality of life. Comparisons were made between pre- and post-treatment.</p><p><strong>Results: </strong>Thirty-one patients over 35 were screened. At baseline, average NRS was 5 ± 0.93 (CI 95%: 4.6-5.3), and the median number of breakthrough episodes over last week was 5 ± 1.57 (CI 95%: 4-6) with a maximum NRS = 9 ± 0.89 (CI 95%: 8-9). After treatment, average NRS was 4.1 ± 0.93 (CI 95%: 3.8-4.5; p < 0.001), maximum NRS was 6.1 ± 1.60 (CI 95%: 5.5-6.6), and the median number of attacks was 4 ± 0.99 (IC 95%: 3-4) (p < 0.001). Regarding SF-36 questionnaire, the most improved parameters were quality of life related to pain (25.89 ± 12.48 vs 31.19 ± 13.44; p < 0.001) and physical function (69.56 ± 17.84 vs 84.17 ± 20.99; p < 0.001).</p><p><strong>Conclusion: </strong>Despite limitations, the pain scores, the frequency of the attacks, and quality of life were found to be significantly improved after treatment. Although results are not broad based given the small sample size, the combination of amitriptyline and perphenazine may be an effective and well-tolerated treatment in patients with PIFP. It is abundantly clear that dopaminergic pathways play a key role in pain modulation, yet the underlying mechanisms have not been fully understood, requiring further investigation.</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"4 1","pages":"83"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856916","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":"Analgesic efficacy and safety of erector spinae plane block versus serratus anterior plane block in breast surgery-a meta-analysis and systematic review of randomized controlled trials.","authors":"Samiullah Shaikh, Umm E Salma Shabbar Banatwala, Paranshi Desai, Muhammad Arham Khan, Rimsha Bint-E-Hina, Sidra Samad, Muhammad Hamza Sikandari, Ali Nawaz, Rana Ijaz, Shayan Asmat, Abeer Fatima, Harim Mirza, Noor Mahal Azam, Qurat Ul Ain Muhammad, Satesh Kumar, Mahima Khatri","doi":"10.1186/s44158-024-00218-7","DOIUrl":"10.1186/s44158-024-00218-7","url":null,"abstract":"<p><strong>Background: </strong>Mastectomy and breast-conserving surgery are key interventions for breast cancer, a leading cause of cancer-related mortality in women. Many undergoing breast surgery experience postoperative pain compromising their functionality and quality of life. While multiple pain management strategies are available, evidence comparing the erector spinae (ESPB) and serratus anterior plane blocks (SAPB) for improving post-surgical pain management in breast cancer surgery patients is limited. Therefore, we investigated the efficacy and safety of these two regional anesthesia techniques.</p><p><strong>Methods: </strong>After PROSPERO registration, we systematically searched PubMed, Google Scholar, and Cochrane Library until May 2024. Risk ratios (RR) were calculated for dichotomous outcomes and standard mean differences (SMD) or mean differences (MD) were computed for continuous data. RevMan Review Manager 5.4.1 was used for the data analysis and generation of forest plots as well as funnel plots. The Cochrane Risk of Bias tool 2.0 (18) and Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) guidelines were used to appraise and evaluate the evidence (19).</p><p><strong>Results: </strong>A total of 9 randomized control trials enrolling 550 patients were included. Static pain scores at 0, 6, 8, 12, and 24 h after surgery, dynamic pain scores computed at 0, 8, 12, and 24 h after surgery and area under the curve (AUC) static pain score at all time points between 0 and 24 h (SMD (HKSJ 95% CI) - 0.27 [- 0.99, 0.45]) did not significantly vary with either plane block. Postoperative morphine consumption in the first 24 h and the number of patients requesting analgesia were significantly greater in those receiving SAPB [MD: - 1.41 (95% C.I. - 2.70, - 0.13), p = 0.03] and [RR: 1.28 (95% C.I. 1.00, 1.63), p = 0.05], respectively. The time to first postoperative analgesic use was significantly greater among those administered ESPB [MD: 1.55 h, (95% C.I. 1.02, 2.09), p < 0.01]. Patient satisfaction scores and the incidence of nausea and vomiting were similar across both groups.</p><p><strong>Conclusions: </strong>While pain scores with either block are comparable, ESPB reduces postoperative morphine consumption and may be the favorable option in breast cancer patients undergoing surgery.</p>","PeriodicalId":73597,"journal":{"name":"Journal of Anesthesia, Analgesia and Critical Care (Online)","volume":"4 1","pages":"82"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856921","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}