Archives of Surgery最新文献

{"title":"Postoperative mortality after surgery for brain tumors by patient insurance status in the United States.","authors":"Eric N Momin,&nbsp;Hadie Adams,&nbsp;Russell T Shinohara,&nbsp;Constantine Frangakis,&nbsp;Henry Brem,&nbsp;Alfredo Quiñones-Hinojosa","doi":"10.1001/archsurg.2012.1459","DOIUrl":"https://doi.org/10.1001/archsurg.2012.1459","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether being uninsured is associated with higher in-hospital postoperative mortality when undergoing surgery in the United States for a brain tumor.</p><p><strong>Design: </strong>Retrospective cohort study using the Nationwide Inpatient Sample, January 1, 1999, through December 31, 2008.</p><p><strong>Setting: </strong>The Nationwide Inpatient Sample contains all inpatient records from a stratified sample of 20% of hospitals in 37 states.</p><p><strong>Patients: </strong>A total of 28,581 patients, aged 18 to 65 years, who underwent craniotomy for a brain tumor. Three groups were studied: Medicaid recipients and privately insured and uninsured patients.</p><p><strong>Main outcome measure: </strong>The main outcome measure was in-hospital postoperative death. Associations between this outcome and insurance status were examined within the full cohort and within the subset of patients with no comorbidity using Cox proportional hazards models. These models were stratified by hospital to control for any clustering effects that could arise from differing access to care.</p><p><strong>Results: </strong>In the unadjusted analysis, the mortality rate for privately insured patients was 1.3% (95% CI, 1.1%-1.4%) compared with 2.6% for uninsured patients (95% CI, 1.9%-3.3%; P < .001) and 2.3% for Medicaid recipients (95% CI, 1.8%-2.8%; P < .001). After adjusting for patient characteristics and stratifying by hospital in patients with no comorbidity, uninsured patients still had a higher risk of experiencing in-hospital death (hazard ratio, 2.62; 95% CI, 1.11-6.14; P = .03) compared with privately insured patients. In this adjusted analysis, the disparity was not conclusively present in Medicaid recipients (hazard ratio, 2.03; 95% CI, 0.97-4.23; P = .06).</p><p><strong>Conclusions: </strong>Uninsured patients who underwent craniotomy for a brain tumor experienced the highest in-hospital mortality. Differences in overall health do not fully account for this disparity.</p>","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"1017-24"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archsurg.2012.1459","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31062093","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":"Hyperoxia and traumatic brain injury: comment on \"early hyperoxia worsens outcomes after traumatic brain injury\".","authors":"H Gill Cryer","doi":"10.1001/archsurg.2012.1641","DOIUrl":"https://doi.org/10.1001/archsurg.2012.1641","url":null,"abstract":"injured patients. J Neurosurg. 2001;94(3):403-411. 14. Valadka AB, Gopinath SP, Contant CF, Uzura M, Robertson CS. Relationship of brain tissue PO2 to outcome after severe head injury. Crit Care Med. 1998; 26(9):1576-1581. 15. Sahuquillo J, Poca MA, Garnacho A, et al. Early ischaemia after severe head injury: preliminary results in patients with diffuse brain injuries. Acta Neurochir (Wien). 1993;122(3-4):204-214. 16. Rangel-Castillo L, Lara LR, Gopinath S, Swank P, Valadka A, Robertson C. Cerebral hemodynamic effects of acute hyperoxia and hyperventilation after severe brain injury. J Neurotrauma. 2010;27(10):1853-1863. 17. Bostek CC. Oxygen toxicity: an introduction. AANA J. 1989;57(3):231237. 18. Ahn ES, Robertson CL, Vereczki V, Hoffman GE, Fiskum G. Synthes Award for Resident Research on Brain and Craniofacial Injury: normoxic ventilatory resuscitation after controlled cortical impact reduces peroxynitrite-mediated protein nitration in the hippocampus. Clin Neurosurg. 2005;52:348-356. 19. Li J, Gao X, Qian M, Eaton JW. Mitochondrial metabolism underlies hyperoxic cell damage. Free Radic Biol Med. 2004;36(11):1460-1470. 20. Doppenburg EM, Zauner A, Watson JC, Bullock R. Determination of the ischemic threshold for brain oxygen tension. Acta Neurochir Suppl (Wien). 1998; 71:166-169.","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"1046"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archsurg.2012.1641","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30765900","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":"Image of the month. PNET of the pancreas.","authors":"Antonio Pio Tortorelli,&nbsp;Sergio Alfieri,&nbsp;Alejandro Martin Sanchez,&nbsp;Fausto Rosa,&nbsp;Giovanni Battista Doglietto","doi":"10.1001/archsurg.2011.1620b","DOIUrl":"https://doi.org/10.1001/archsurg.2011.1620b","url":null,"abstract":"","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"1063-4"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31062097","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":"Association between early hyperoxia and worse outcomes after traumatic brain injury.","authors":"Megan Brenner,&nbsp;Deborah Stein,&nbsp;Peter Hu,&nbsp;Joseph Kufera,&nbsp;Matthew Wooford,&nbsp;Thomas Scalea","doi":"10.1001/archsurg.2012.1560","DOIUrl":"https://doi.org/10.1001/archsurg.2012.1560","url":null,"abstract":"<p><p>OBJECTIVE To investigate the relationship between oxygenation and short-term outcomes in patients with traumatic brain injury (TBI). DESIGN Logistic regression analysis was used to determine whether average high (&gt;200 mm Hg) or low (&lt;100 mm Hg) PaO2 levels within the first 24 hours of hospital admission correlated with patient outcomes relative to patients with average PaO2 levels between 100 and 200 mm Hg. SETTING Level 1 trauma center. PATIENTS We retrospectively reviewed 1547 consecutive patients with severe TBI who survived past 12 hours after hospital admission. MAIN OUTCOME MEASURES We measured mortality, intensive care unit length of stay, hospital length of stay, and discharge Glasgow Coma Scale (GCS) score. RESULTS Of the 1547 patients, 77% were male and 89% sustained blunt trauma. Mean (SD) age, admission GCS score, and Injury Severity Score were 41.3 (20.6) years, 8.3 (4.7), and 31.9 (12.5), respectively. Mean (SD) intensive care unit length of stay and hospital length of stay were 8.7 (10.5) days and 13.8 (13.7) days, respectively. Mean (SD) discharge GCS score was 10.1 (4.7). The mortality rate was 28%. After controlling for age, sex, Injury Severity Score, mechanism of injury, and admission GCS score, patients with high PaO2 levels had significantly higher mortality and lower discharge GCS scores than patients with a normal PaO2 (P &lt; .05). Patients with low PaO2 levels also had increased mortality (P &lt; .05). CONCLUSIONS Hyperoxia within the first 24 hours of hospitalization is associated with worse short-term functional outcomes and higher mortality after TBI. Although the mechanism for this has not been completely elucidated, it may involve hyperoxia-induced oxygen-free radical toxicity with or without vasoconstriction. Hyperoxia and hypoxia were found to be equally detrimental to short-term outcomes in patients with TBI. A narrower therapeutic window for oxygenation may improve mortality and functional outcomes.</p>","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"1042-6"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archsurg.2012.1560","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30766158","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 race on intraoperative parathyroid hormone kinetics: an analysis of 910 patients undergoing parathyroidectomy for primary hyperparathyroidism.","authors":"Robin M Cisco,&nbsp;Jennifer H Kuo,&nbsp;Lauren Ogawa,&nbsp;Anouk Scholten,&nbsp;Michael Tsinberg,&nbsp;Quan-Yang Duh,&nbsp;Orlo H Clark,&nbsp;Jessica E Gosnell,&nbsp;Wen T Shen","doi":"10.1001/archsurg.2012.1476","DOIUrl":"https://doi.org/10.1001/archsurg.2012.1476","url":null,"abstract":"<p><p>HYPOTHESIS African American patients exhibit different intraoperative parathyroid hormone (IOPTH) profiles than non-African American patients. DESIGN Retrospective review. SETTING University medical center. PATIENTS Nine hundred ten patients who underwent parathyroidectomy for primary hyperparathyroidism between July 2005 and August 2010. INTERVENTIONS All patients underwent preoperative imaging with ultrasonography and sestamibi; operative exploration; and IOPTH measurement at 2 points preexcision and 5 and 10 minutes postexcision. MAIN OUTCOME MEASURES Preexcision and postexcision IOPTH measurements. RESULTS Of the 910 patients, 734 self-reported their race as white (81%); 91, Latino/other (10%); 56, Asian (6%); and 28, African American (3%). African American patients had significantly higher initial preexcision IOPTH levels compared with white patients (348 vs 202 pg/mL; P = .048) and significantly higher 5-minute postexcision IOPTH levels (151 vs 80 pg/mL; P = .01). The 10-minute postexcision IOPTH levels were similar between the 2 groups (52 vs 50 pg/mL). A similar percentage of white and African American patients had a 50% drop in IOPTH level at 10 minutes postexcision. No differences in IOPTH kinetics were observed in the other racial groups examined. CONCLUSIONS African American patients with primary hyperparathyroidism exhibit significantly higher preincision and 5-minute postexcision IOPTH values when compared with white patients. The 10-minute postexcision IOPTH values did not differ between races. The altered IOPTH kinetics identified in African American patients may reflect the severity of biochemical disease but may also be related to genetically predetermined differences in parathyroid hormone metabolism.</p>","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"1036-40"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archsurg.2012.1476","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30765949","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":"Comparative effectiveness of unfractionated and low-molecular-weight heparin for prevention of venous thromboembolism following bariatric surgery.","authors":"Nancy J O Birkmeyer,&nbsp;Jonathan F Finks,&nbsp;Arthur M Carlin,&nbsp;David L Chengelis,&nbsp;Kevin R Krause,&nbsp;Abdelkader A Hawasli,&nbsp;Jeffrey A Genaw,&nbsp;Wayne J English,&nbsp;Jon L Schram,&nbsp;John D Birkmeyer","doi":"10.1001/archsurg.2012.2298","DOIUrl":"https://doi.org/10.1001/archsurg.2012.2298","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness and safety of 3 predominant venous thromboembolism (VTE) prophylaxis strategies among patients undergoing bariatric surgery.</p><p><strong>Design: </strong>Cohort study.</p><p><strong>Setting: </strong>The Michigan Bariatric Surgery Collaborative, a statewide clinical registry and quality improvement program.</p><p><strong>Patients: </strong>Twenty-four thousand seven hundred seventy-seven patients undergoing bariatric surgery between 2007 and 2012.</p><p><strong>Interventions: </strong>Unfractionated heparin preoperatively and postoperatively (UF/UF), UF heparin preoperatively and low-molecular-weight heparin postoperatively (UF/LMW), and LMW heparin preoperatively and postoperatively (LMW/LMW).</p><p><strong>Main outcome measures: </strong>Rates of VTE, hemorrhage, and serious hemorrhage (requiring >4 U of blood products or reoperation) occurring within 30 days of surgery.</p><p><strong>Results: </strong>Overall, adjusted rates of VTE were significantly lower for the LMW/LMW (0.25%; P < .001) and UF/LMW (0.29%; P = .03) treatment groups compared with the UF/UF group (0.68%). While UF/LMW (0.22%; P = .006) and LMW/LMW (0.21%; P < .001) were similarly effective in patients at low risk of VTE (predicted risk <1%), LMW/LMW (1.46%; P = .10) seemed more effective than UF/LMW (2.36%; P = .90) for high-risk (predicted risk ≥1%) patients. There were no significant differences in rates of hemorrhage or serious hemorrhage among the treatment strategies.</p><p><strong>Conclusion: </strong>Low-molecular-weight heparin is more effective than UF heparin for the prevention of postoperative VTE among patients undergoing bariatric surgery and does not increase rates of bleeding.</p>","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"994-8"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archsurg.2012.2298","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31062089","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":"Association of postdischarge complications with reoperation and mortality in general surgery.","authors":"Hadiza S Kazaure,&nbsp;Sanziana A Roman,&nbsp;Julie A Sosa","doi":"10.1001/2013.jamasurg.114","DOIUrl":"https://doi.org/10.1001/2013.jamasurg.114","url":null,"abstract":"<p><strong>Objectives: </strong>To describe procedure-specific types, rates, and risk factors for postdischarge (PD) complications occurring within 30 days after 21 groups of inpatient general surgery procedures.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>American College of Surgeons National Surgical Quality Improvement Program 2005 through 2010 Participant Use Data Files.</p><p><strong>Patients: </strong>A total of 551,510 adult patients who underwent one of 21 groups of general surgery procedures in the inpatient setting.</p><p><strong>Main outcome measures: </strong>Postdischarge complications, reoperation, and mortality.</p><p><strong>Results: </strong>Of 551,510 patients (mean age, 54.6 years), 16.7% experienced a complication; 41.5% occurred PD. Of the PD complications, 75.0% occurred within 14 days PD. Proctectomy (14.5%), enteric fistula repair (12.6%), and pancreatic procedures (11.4%) had the highest PD complication rates. Breast, bariatric, and ventral hernia repair procedures had the highest proportions of complications that occurred PD (78.7%, 69.4%, and 62.0%, respectively). For all procedures, surgical site complications, infections, and thromboembolic events were the most common. Occurrence of an inpatient complication increased the likelihood of a PD complication (12.5% vs 6.2% without an inpatient complication; P < .001). Compared with patients without a PD complication, those with a PD complication had higher rates of reoperation (4.6% vs 17.9%, respectively; P < .001) and death (2.0% vs 6.9%, respectively; P < .001) within 30 days after surgery; those whose PD complication was preceded by an inpatient complication had the highest rates of reoperation (33.7%) and death (24.7%) (all P < .001). After adjustment, PD complications were associated with procedure type, American Society of Anesthesiologists class higher than 3, and steroid use.</p><p><strong>Conclusions: </strong>The PD complication rates vary by procedure, are commonly surgical site related, and are associated with mortality. Fastidious, procedure-specific patient triage at discharge as well as expedited patient follow-up could improve PD outcomes.</p>","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"1000-7"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/2013.jamasurg.114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31062091","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":"Shifting surgical paradigms for cholecystectomy in mild gallstone pancreatitis: comment on \"early laparoscopic cholecystectomy for mild gallstone pancreatitis\".","authors":"Michael A West","doi":"10.1001/archsurg.2012.1637","DOIUrl":"https://doi.org/10.1001/archsurg.2012.1637","url":null,"abstract":"creases hospital stay in patients with mild gallstone pancreatitis: a randomized prospective study. Ann Surg. 2010;251(4):615-619. 7. Kelly TR, Wagner DS. Gallstone pancreatitis: a prospective randomized trial of the timing of surgery. Surgery. 1988;104(4):600-605. 8. Taylor E, Wong C. The optimal timing of laparoscopic cholecystectomy in mild gallstone pancreatitis. Am Surg. 2004;70(11):971-975. 9. Papachristou GI, Muddana V, Yadav D, et al. Comparison of BISAP, Ranson’s, APACHE-II, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis. Am J Gastroenterol. 2010;105(2):435-441, quiz 442. 10. Dambrauskas Z, Gulbinas A, Pundzius J, Barauskas G. Value of the different prognostic systems and biological markers for predicting severity and progression of acute pancreati t is. Scand J Gastroenterol . 2010;45(7-8):959970. 11. Yaghoubian A, Aboulian A, Chan T, et al. Use of clinical triage criteria decreases monitored care bed utilization in gallstone pancreatitis. Am Surg. 2010;76(10): 1147-1149.","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"1035"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archsurg.2012.1637","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30766601","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":"Irreversible electroporation for the ablation of liver tumors: are we there yet?","authors":"Kevin P Charpentier","doi":"10.1001/2013.jamasurg.100","DOIUrl":"https://doi.org/10.1001/2013.jamasurg.100","url":null,"abstract":"<p><strong>Objective: </strong>To explore irreversible electroporation (IRE) as a novel, nonthermal form of tissue ablation using high-voltage electrical current to induce pores in the lipid bilayer of cells, resulting in cell death.</p><p><strong>Data sources: </strong>PubMed searches were performed using the keywords electroporation, IRE, and ablation. The abstracts for the 2012 meetings of both the American Hepato-Pancreato-Biliary Association and the Society for Interventional Radiology were also searched. All articles and abstracts with any reference to electroporation were identified and reviewed.</p><p><strong>Study selection: </strong>All studies and abstracts pertaining to electroporation.</p><p><strong>Data extraction: </strong>All data pertaining to the safety and efficacy of IRE were extracted from preclinical and clinical studies. Preclinical data detailing the theory and design of IRE systems were also extracted.</p><p><strong>Data synthesis: </strong>Preclinical studies have suggested that IRE may have advantages over conventional forms of thermal tumor ablation including no heat sink effect and preservation of the acellular elements of tissue, resulting in less unwanted collateral damage. The early clinical experience with IRE demonstrates safety for the ablation of human liver tumors. Short-term data regarding oncologic outcome is now emerging and appears encouraging.</p><p><strong>Conclusion: </strong>Irreversible electroporation is likely to fill a niche void for the ablation of small liver tumors abutting a major vascular structure and for ablation of tumors abutting a major portal pedicle where heat sink and collateral damage must be avoided for maximum efficacy and safety. Studies are still needed to define the short-term and long-term oncologic efficacy of IRE.</p>","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"1053-61"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/2013.jamasurg.100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31062095","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":"Another club in the bag: comment on \"Irreversible electroporation for the ablation of liver tumors\".","authors":"Steven D Colquhoun","doi":"10.1001/jamasurg.2013.493","DOIUrl":"https://doi.org/10.1001/jamasurg.2013.493","url":null,"abstract":"","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"1061"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/jamasurg.2013.493","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31062096","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}