Annals of Cardiac Anaesthesia最新文献

{"title":"Cerebral Oxygenation-Guided Indexed-Flow Normothermic Cardiopulmonary Bypass with Vasopressor-Sparing Pressure Management: A Retrospective Descriptive Cohort Study.","authors":"Nikita Chibisov, Andrey Kornienko, Anatoly Malyshev, Evgeny Rodionov, Igor Glushenko, Mikhail Shtrymov","doi":"10.4103/aca.aca_170_26","DOIUrl":"10.4103/aca.aca_170_26","url":null,"abstract":"<p><strong>Context: </strong>Mean arterial pressure targets during cardiopulmonary bypass remain debated; vasopressor-driven pressure augmentation may not improve oxygen delivery.</p><p><strong>Aims: </strong>The aim of the paper is to describe clinical outcomes and physiologic markers during normothermic cardiopulmonary bypass managed with indexed flow, cerebral oximetry, calculated indexed oxygen delivery (DO2i), and vasopressor-sparing pressure management.</p><p><strong>Settings and design: </strong>Single-center retrospective descriptive cohort study at a cardiac surgery center.</p><p><strong>Material and methods: </strong>Consecutive adults undergoing elective or urgent cardiac surgery with normothermic cardiopulmonary bypass from June 2023 to December 2025 were included if complete anesthesia-perfusion, regional cerebral oxygen saturation (rSO2), circuit-derived venous oxygen saturation (SvO2), DO2i, and early outcome data were available. Circulatory arrest was excluded. Indexed pump flow was 2.2-2.4 L/min/m². Mean arterial pressure was interpreted with indexed flow, rSO2, SvO2, DO2i, hemoglobin, acid-base status, venous return, and surgical context. Baseline rSO2 was recorded before ventilation on room air; maximal relative decrease during bypass was recorded.</p><p><strong>Statistical analysis used: </strong>Descriptive statistics and Wilson 95% confidence intervals were used. No comparative testing or causal modeling was performed.</p><p><strong>Results: </strong>Two hundred patients were analyzed. Operating-room extubation was achieved in 172 patients (86.0%). Stroke occurred in six (3.0%), acute kidney injury in two (1.0%), and venoarterial extracorporeal membrane oxygenation was required in six (3.0%). Baseline right and left rSO2 were 57.5 ± 11.2% and 58.5 ± 11.3%; maximal relative rSO2 decrease was 28.5 ± 3.4%; circuit-derived SvO2 was 67.4 ± 5.9%; and calculated DO2i was 611 ± 74 mL/min/m².</p><p><strong>Conclusions: </strong>This flow-oriented, cerebral oximetry-guided, oxygen-delivery-aware strategy was accompanied by favorable early recovery. Because the study was retrospective and noncomparative, the findings are hypothesis-generating.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 4","pages":"587-593"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164896","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":"Mesocardia: Imaging and Implications.","authors":"Neeti Makhija, Mohanish Rajendra Badge, Praveen Peri, V Bharath","doi":"10.4103/aca.aca_10_26","DOIUrl":"10.4103/aca.aca_10_26","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 4","pages":"671-673"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Intranasal Dexmedetomidine on Hemodynamic Responses during Double-Lumen Tube Insertion: A Randomized Controlled Trial.","authors":"Roys P Gilbert, Suda N Kumar, Ilangovan Panchanathan, Anu K Thomas, Kishorkumar Dhanaboopathy, Balaji Kuppuswamy, Santhosh R Benjamin, Korah T Kuruvila, Vinay M Rao, Nishok David","doi":"10.4103/aca.aca_52_26","DOIUrl":"10.4103/aca.aca_52_26","url":null,"abstract":"<p><strong>Background: </strong>Thoracic surgeries require controlled lung collapse for optimal visualization, achieved through Double-Lumen Tube (DLT) intubation for one-lung ventilation (OLV). DLT insertion triggers significant sympathetic activation, potentially causing cardiovascular complications and cerebrovascular events. This study aimed to investigate the efficacy of intranasally administered Dexmedetomidine in attenuating hemodynamic perturbations associated with laryngoscopy and DLT placement.</p><p><strong>Methods: </strong>This randomized controlled study was done in a tertiary care center in South India. Patients coming for thoracic surgery requiring DLT insertion were recruited and randomized into Group A and Group B (n = 25). Group A received 1 mcg/kg Intranasal Dexmedetomidine, and Group B received Intranasal Normal saline 45 minutes prior to induction of anaesthesia using a mucosal atomizer device. Hemodynamic parameters, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR), were recorded at different time points up to 30 minutes after intubation.</p><p><strong>Results: </strong>Patients in the dexmedetomidine group had a lower heart rate before intubation (84.92 ± 0.0349) than those in the placebo group (96.48 ± 0.0349). A statistically significant reduction in heart rate was observed in Group A at intubation (T0) and at subsequent time points (T1, T2, T3, T20, T25, and T30). SBP and DBP decreased before intubation, after which subsequent readings showed a statistically significant difference (P = 0.000). Patients in Group A required significantly less Propofol to maintain BP within 20% of baseline.</p><p><strong>Conclusion: </strong>Administering a single dose of intranasal dexmedetomidine at 1 mcg/kg before induction effectively manages the hemodynamic response during laryngoscopy.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 4","pages":"510-515"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163930","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":"Comparison of Effectiveness of Caudal Dexmedetomidine vs. Caudal Fentanyl with Bupivacaine during Pediatric Cardiac Surgery with regards to Hemodynamic Fluctuations and Postoperative Pain.","authors":"Roshani Nitin Manwani, Dhawal Wadaskar, Prasad Panbude, Shrilekh Mankhair, Shilpa Kanakam","doi":"10.4103/aca.aca_42_25","DOIUrl":"10.4103/aca.aca_42_25","url":null,"abstract":"<p><strong>Background: </strong>Optimum analgesia, reflecting into attenuation of stress response, is pertinent in pediatric cardiac surgery. Narcotics are still the mainstay in providing analgesia, and they are a common adjunct in caudal epidural analgesia. Unwanted effects of narcotics warrant a constant search for nonopioid analgesics.</p><p><strong>Objective: </strong>To compare dexmedetomidine vs. fentanyl as an adjuvant in caudal anesthesia in pediatric cardiac surgery.</p><p><strong>Materials and methods: </strong>Sixty patients, 1 to 8 years of age, with acyanotic congenital heart disease were divided into two groups randomly: group A received caudal dexmedetomidine 0.5 µg/kg with 2 mg/kg bupivacaine diluted to 1.6 ml/kg with normal saline. Group B received caudal fentanyl 1 µg/kg with 2 mg/kg bupivacaine diluted to 1.6 ml/kg with normal saline.</p><p><strong>Results: </strong>Stress response assessed by surge in heart rate and blood pressure after induction was significantly lower in group A (Dexmedetomidine group). The mean time to successful discontinuation of mechanical ventilation was significantly lower in the dexmedetomidine group (1.2 ± 0.4 vs. 1.73 ± 0.58 h). Children in the dexmedetomidine group had lower FLACC pain scores at 4 hours postextubation (2.93 ± 1.04 vs. 3.83 ± 0.83), implying better pain control. The time to need for rescue analgesia was longer in the dexmedetomidine group (6.1 ± 1.21 vs. 3.96 ± 0.96 h).</p><p><strong>Conclusion: </strong>Caudal dexmedetomidine gave better control of hemodynamic parameters when compared with fentanyl and was associated with earlier extubation postoperatively. It also has superior and prolonged analgesia compared to caudal fentanyl as an adjunct.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 4","pages":"594-599"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164292","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":"Emergent Cervical Laminoplasty in a Patient with Chronic Thromboembolic Pulmonary Hypertension.","authors":"Ahmed K Awad, Jacob Chen, Gustavo A Heresi, Nakul S Kumar, Andrej Alfirevic, Anand Mehta, Haytham Elgharably","doi":"10.4103/aca.aca_274_25","DOIUrl":"10.4103/aca.aca_274_25","url":null,"abstract":"<p><strong>Abstract: </strong>Patients with chronic thromboembolic pulmonary hypertension (CTEPH) present with a variable degree of pulmonary hypertension (PH), right ventricular dysfunction, and hypoxia. It is challenging if the patient requires an emergent surgical procedure other than pulmonary endarterectomy. Herein, we present a unique case of cervical laminoplasty for symptomatic cervical spinal cord compression in a patient with CTEPH and severe PH.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 4","pages":"614-617"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164277","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":"Three-Point Bedside Congestion Score (IJV Collapsibility + IVC Collapsibility + Central Venous Pressure) in Elective Mitral Valve Surgery: A Prospective Observational Study.","authors":"Manisha Sharma, Venuthurupalli S P Rajesh, K S RamKiran, Visharad Trivedi, Vartika Kanjani, Kaushal Patel, Himani Pandya","doi":"10.4103/aca.aca_138_26","DOIUrl":"10.4103/aca.aca_138_26","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Systemic venous congestion and right-ventricular (RV) dysfunction are key drivers of postoperative hemodynamic instability, prolonged ventilation, and acute kidney injury (AKI) after mitral valve surgery. Comprehensive echocardiography is informative but may be impractical in high-throughput pre-anesthesia workflows. We evaluated a pragmatic three-point bedside congestion score combining internal jugular vein (IJV) collapsibility, inferior vena cava (IVC) collapsibility, and invasively measured central venous pressure (CVP) for preoperative risk stratification.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this prospective, observational, single-center study, 100 consecutive adults (&gt;18 years) undergoing elective mitral valve surgery for mitral stenosis were enrolled. A bedside ultrasound was performed in the preoperative area with patients in a 45° head-elevated position during quiet, spontaneous respiration. One point was assigned for each abnormal component (IJV collapsibility &lt;18%, IVC collapsibility &lt;25%, and CVP &gt;12 mmHg), yielding a total score of 0 to 3. Tricuspid annular plane systolic excursion (TAPSE) was dichotomized at 17 mm. Outcomes included vasoactive-inotropic score (VIS), ventilation duration, intensive care unit (ICU) and hospital length of stay, AKI, and in-hospital mortality. Discrimination for AKI and mortality was evaluated using a 5-fold cross-validated receiver operating characteristic (ROC) area under the curve (AUC) with bootstrap 95% confidence intervals. Calibration was assessed using recalibration intercept and slope, and decision curve analysis was used to explore clinical net benefit across threshold probabilities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The observed score distribution concentrated at 0 to 2 and 3; therefore, patients were analyzed as low score (0 to 2; n = 50) versus high score (3; n = 50). Compared with low-score patients, high-score patients had higher postoperative VIS (median 18.0 vs 10.0), longer ventilation (31.5 vs 22.0 hours), longer ICU stay (10.0 vs 5.5 days), and longer hospital stay (23.0 vs 12.5 days). AKI occurred in 40% versus 20%, and mortality in 10% versus 2% in high- versus low-score groups. In the combined 2 × 2 stratification, low score with normal TAPSE had no AKI or mortality, whereas high score with abnormal TAPSE had AKI in 55.6% and mortality in 14.8%. The combined score + TAPSE model showed moderate discrimination (AUC 0.77 for AKI; AUC 0.782 for mortality) with near-ideal calibration in this dataset. Decision curve analysis suggested a higher net benefit for the combined model than single-predictor models across threshold probabilities of approximately 0.05 to 0.30.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A simple three-point bedside congestion score stratifies postoperative risk after elective mitral valve surgery. Incorporating TAPSE into preoperative assessment provided a rapid and reliable means of excluding significant RV dysfunction, thereby reinforcing t","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 4","pages":"528-537"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164042","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":"Impact of Erector Spinae Block on Postoperative Analgesia and Hospital Recovery in Coronary Artery Bypass Surgery: A Systematic Review with Meta-analysis, Meta-Regression, and Sequential Trial Analysis.","authors":"João Paulo Aureliano de Carvalho, Helen Dos Reis Requião, Rodrigo Mascarenhas Vieira, Pablo de Sousa Ferreira, Elias Batista da Silva Neto, Liana Maria Tôrres de Araújo Azi, Norma Sueli Pinheiro Módolo, Rodrigo Leal Alves","doi":"10.4103/aca.aca_17_26","DOIUrl":"10.4103/aca.aca_17_26","url":null,"abstract":"<p><strong>Abstract: </strong>The erector spinae plane block (ESPB) is a promising regional technique for cardiac surgery. We evaluated the efficacy of ESPB regarding analgesia and in-hospital outcomes in patients undergoing coronary artery bypass grafting (CABG). We conducted a systematic review and meta-analysis comparing ESPB versus control in adults undergoing CABG (CRD42025645045). Primary outcomes were opioid consumption (24 h/48 h) and pain intensity. Secondary outcomes included extubation time and intensive care unit (ICU) length of stay. Data were pooled using random-effects models. Meta-regression and trial sequential analysis (TSA) were used to assess sources of heterogeneity and robustness, respectively, while the Grading of Recommendations, Assessment, Development, and Evaluations framework provided the certainty of the evidence for each outcome. Twelve studies (704 patients) were analyzed. ESPB significantly reduced the morphine milligram equivalent consumption at 24 h (mean difference (MD) -19.05 mg; 95% confidence interval (CI) [-22.50 to -15.61]; P < 0.001; high certainty) and 48 h (MD -19.42 mg; 95% CI [-28.75 to -10.09]; P < 0.001; moderate certainty). Pain scores, by the Numerical Rating Scale, were lower within 12 h (MD -0.93; P < 0.001; moderate certainty) and at 24 h (MD -0.58; P = 0.016; low certainty). ESPB shortened extubation time (MD -2.50 h; high certainty) and ICU stay (MD -12.55 h; moderate certainty). TSA confirmed robust evidence for opioid reduction, early pain relief, and extubation benefits. ESPB provides effective early analgesia, reduces perioperative opioid requirements, and accelerates recovery in CABG, representing a fundamental complement to conventional isolated intravenous analgesia. Future research should investigate continuous techniques.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 4","pages":"481-493"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164283","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":"Reframing Blood Conservation in Left Ventricular Assist Device Implantation as Physiology-Guided Hemostatic Resuscitation.","authors":"Liang Yan, Andi Guo","doi":"10.4103/aca.aca_101_26","DOIUrl":"10.4103/aca.aca_101_26","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 4","pages":"674-675"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163963","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":"Comment on \"The Intricacies of Cardiac Venous Drainage: Implications for Coronary Sinus Lactate\".","authors":"Sanjula Virmani, Sukhdev Garg, Indira Malik, Abhas Chandra Dash, Sayyed Ehtesham Hussain Naqvi, Rachna Wadhwa, Harpreet Singh","doi":"10.4103/aca.aca_13_26","DOIUrl":"10.4103/aca.aca_13_26","url":null,"abstract":"","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 4","pages":"659-660"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164249","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":"Incidence and Predictors of Acute Kidney Injury Among Postoperative Cardiac Surgery Patients in Tanzania.","authors":"Nai K Kipuyo, Salehe Mrutu, Atala Jongo, Respicious Boniface","doi":"10.4103/aca.aca_38_26","DOIUrl":"10.4103/aca.aca_38_26","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac surgery-associated acute kidney injury (CSA-AKI) is a severe postoperative complication linked to increased morbidity and mortality. Data on the incidence and predictors of CSA-AKI in sub-Saharan Africa, including Tanzania, are limited. This study aimed to determine the incidence and predictors of AKI in patients who underwent cardiac surgery at Tanzania's National Cardiac Institute.</p><p><strong>Methods: </strong>This prospective study included 177 patients. AKI was defined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria based on serum creatinine (SCr) changes at 24, 48, and 72 h postoperatively. The patients' clinical profiles were collected and analyzed using SPSS version 27.0 (IBM Corp., Armonk, NY, USA). Chi-square tests and modified Poisson regression were used to identify associated factors at 95% confidence intervals (CIs), with P < 0.05.</p><p><strong>Results: </strong>The prevalence of postoperative AKI was 53%, with the majority of patients presenting with AKI stage I (72.9%). In the multivariable analysis, diabetes mellitus (Adjusted Prevalence Ratio (aPR )1.32, 95% CI 1.02-1.70; P = 0.038), American Society of Anesthesiologists (ASA) IV status (aPR 1.39, 95% CI 1.10-1.76; P = 0.007), blood transfusion (transfusion: aPR 3.63, 95% CI 1.15-11.41; P = 0.027), triple components (aPR 3.41, 95% CI 1.08-10.78; P = 0.037), and prolonged cardiopulmonary bypass (CPB) time of 181-240 min (aPR 3.53, 95% CI 1.51-8.25; P = 0.004) and > 240 min (aPR 3.80, 95% CI 1.57-9.18; P = 0.003) were independent predictors of AKI. Female sex was independently associated with a lower prevalence of AKI (aPR 0.66, 95% CI 0.50-0.88; P = 0.004). Patients who developed AKI had significantly longer stays in the intensive care unit (ICU) (aPR 2.39, 95% CI 1.39-4.12; P = 0.002).</p><p><strong>Conclusion: </strong>The prevalence of CSA-AKI is remarkably high in this setting, posing a significant clinical burden. Key preoperative and intraoperative predictors were also identified. These results reinforce the importance of perioperative patient optimization, strategies to minimize CPB exposure, transfusion practice optimization, and surveillance of high-risk patients.</p>","PeriodicalId":7997,"journal":{"name":"Annals of Cardiac Anaesthesia","volume":"29 4","pages":"538-545"},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164418","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}