Journal of anesthesia & clinical research最新文献

{"title":"Dynamics of Elective Case Cancellation for Inpatient and Outpatient in an Academic Center.","authors":"Wei Xue,&nbsp;Zhe Yan,&nbsp;Rebecca Barnett,&nbsp;Lee Fleisher,&nbsp;Renyu Liu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Unexpected surgical cancellation is common and can have significant adverse effects. Cancellation rates vary because of a lack of a standard definition, different patient populations and study methodology. We hypothesized that case cancellation has a different pattern in a dedicated ambulatory surgical center compared to a general operating room (OR) setting in a large academic center without an anesthesia preoperative evaluation center necessitating evaluation by the various surgeons.</p><p><strong>Methods: </strong>Elective cases in general OR and in the ambulatory surgical center were included in this study. Elective cases are defined as the non-emergent cases scheduled before 8:00 am on the day of surgery. A cancelled case was defined as a scheduled procedure which is not performed on the scheduled procedure day. Case cancellation was monitored in real time using an electronic patient flow system (Navicare). As soon as the case is cancelled, the reason for the cancellation was obtained from the surgeon, the anesthesiologist, the OR coordinated nurses and/or the floor nurse. In the day surgical center, the cancelled cases were followed to determine whether/when they were rescheduled.</p><p><strong>Results: </strong>4261 elective cases were included in this investigation, including 2751 cases in the general OR and 1510 cases in the ambulatory surgical center. A total of 283 cases (6.6%) were cancelled which include 206 cases from the general OR and 77 from the ambulatory surgical center. The cancellation rate in the general OR was 7.5%, among which inpatients have the highest cancellation rate of 18.1%, followed by outpatients at 4.6%, and same day admission at the lowest cancellation rate of 2.0%. The top 3 reasons for cancellation in general OR werein adequate preoperative preparation 29.4 ± 4.5%, medical condition change 28.5 ± 10.2%; and scheduling issue 20.2 ± 7.1%. Most (59.2 ± 8.9%) of the cancellations was considered preventable, 12.3 ± 5.9% was considered potentially preventable, and 28.5 ± 10.2% were not preventable (such as patient condition changes). The cancellation rate in the ambulatory surgical center was 5.1%. The major reason for cancellation was patient no show 75.8 ± 5.2 %, 61% of those no show patients were rescheduled and the mean delay in surgery was 18 days (range from 1 day to 84 days).</p><p><strong>Conclusions: </strong>Case cancellation is not un-common in a large academic center without a preoperative evaluation clinic. The dynamics of case cancellation are different in an ambulatory surgical center as compared to the general OR. Inpatients have the highest cancellation rate associated with inadequate preoperative preparation and scheduling, this should be preventable via adopting proper systems of evaluation and preparation. Most of the case cancellations in the ambulatory surgical center are from patient no show, suggesting that administrative strategies to reduce this issue should ","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"4 5","pages":"314"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3839960/pdf/nihms508098.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31911626","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":"Capnography Primer for Oral and Maxillofacial Surgery: Review and Technical Considerations.","authors":"Sam E Farish,&nbsp;Paul S Garcia","doi":"10.4172/2155-6148.1000295","DOIUrl":"https://doi.org/10.4172/2155-6148.1000295","url":null,"abstract":"th century the histories of anesthesia and dentistry have been intertwined. However, office-based dental procedures which frequently involve analgesia, conscious sedation, and anesthesia vary from practice-to-practice with regard to respiratory monitoring. In modern oral and maxillofacial surgery, oxygenation is often emphasized over ventilation via usage of pulse oximetry (S p O 2 ). A recent Pubmed search using multiple appropriate Medical Subject Headings Terms (MeSH Terms) and following up on related citation trails results in a limited number of topic specific citations dating back to 1987. In this review, we summarize the literature that compares oximetry (S p O 2 and the less common P TC O 2 ) to ventilatory measurements, specifically capnometry (P ET CO 2 ) in the setting of oral and maxillofacial surgery and provide a comprehensive primer on the technological and respiratory considerations essential for a practitioner attempting to incorporate ventilatory monitoring. Anderson et al. [1] studied the combination of a capnograph (expired carbon dioxide (CO 2 ) monitor) and a transcutaneous oxygen monitor (P TC O 2 ) as a non-invasive system for monitoring of respiratory function in 10 ASA class I patients undergoing general anesthesia for removal of third molars. They concluded that the continuous display of the measured end tidal volume CO 2 (P ET CO 2 ), which the author’s state was measured via nasal prong sampling, proved to be a sensitive and accurate method for detecting apnea and airway obstruction. They further state that all episodes of apnea or obstruction were immediately detected as a dramatic decrease in the expired CO 2 level and that the P ET CO 2 values served as useful indicators of hypoventilation. Interestingly, during steady-state conditions of respiration, P TC O 2 correlated well with simultaneously measured partial pressure of oxygen in arterial blood (P a O 2 ) measured by blood gas technology. However, during any period when oxygenation was rapidly changing (step increase in FIO 2 , step decrease in FIO 2 , or apnea) the P TC O 2 lagged behind changes in P a O 2 even after a five-minute equilibration period, thereby not accurately reflecting the true state of oxygenation. They concluded that transcutaneous oxygen monitoring does not appear to be optimal as a respiratory monitor in the setting of ultralight general anesthesia where rapid, critical changes in oxygenation must be detected without delay [1]. Based on a randomly enrolled blind study of fifty-five patients, Bennet et al. [2] stated that in patients with nasal ventilatory exchange rates maintained throughout anesthesia, sampling of nasal P ET CO 2 was an effective way to monitor ventilation status or the respiratory system function. Respiratory depression or obstructive changes in ventilation were detected by capnography with a high sensitivity and low positive predictive value in detecting oxygen desaturation. They state that current technology did not sh","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"4 3","pages":"295"},"PeriodicalIF":0.0,"publicationDate":"2013-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897173/pdf/nihms510361.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32059973","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":"Epsilon-Aminocaproic Acid in Liver Transplantation: A Three-Year, Retrospective Review.","authors":"Joseph R Whiteley,&nbsp;William R Hand,&nbsp;Harrison L Plunkett,&nbsp;Jason M Taylor,&nbsp;W David Stoll,&nbsp;Bethany J Wolf","doi":"10.4172/2155-6148.1000328","DOIUrl":"https://doi.org/10.4172/2155-6148.1000328","url":null,"abstract":"The primary aim was to determine whether EACA affected transfusion requirements. Secondary outcomes were effect of EACA use on fibrinogen level, operative time, and hepatic artery or portal vein thrombus formation. We examined the association between EACA and RBC and FFP transfusion volume; factor 7 administrations, presence of thrombosis, mortality, change in fibrinogen levels, and MELD score. Chi-square tests and Fisher’s exact test were used for comparing categorical variables. Student’s t-test or Mann-Whitney U test was used to examine associations between EACA usage and all continuous outcomes. All analyses were conducted in SAS v. 9.3 (SAS Institute, Cary, NC).","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"4 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7272052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38010879","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":"An ICU Preanesthesia Evaluation Form Reduces Missing Preoperative Key Information.","authors":"Katherine Chuy,&nbsp;Zhe Yan,&nbsp;Lee Fleisher,&nbsp;Renyu Liu","doi":"10.4172/2155-6148.1000242","DOIUrl":"https://doi.org/10.4172/2155-6148.1000242","url":null,"abstract":"<p><strong>Background: </strong>A comprehensive preoperative evaluation is critical for providing anesthetic care for patients from the intensive care unit (ICU). There has been no preoperative evaluation form specific for ICU patients that allows for a rapid and focused evaluation by anesthesia providers, including junior residents. In this study, a specific preoperative form was designed for ICU patients and evaluated to allow residents to perform the most relevant and important preoperative evaluations efficiently.</p><p><strong>Methods: </strong>The following steps were utilized for developing the preoperative evaluation form: 1) designed a new preoperative form specific for ICU patients; 2) had the form reviewed by attending physicians and residents, followed by multiple revisions; 3) conducted test releases and revisions; 4) released the final version and conducted a survey; 5) compared data collection from new ICU form with that from a previously used generic form. Each piece of information on the forms was assigned a score, and the score for the total missing information was determined. The score for each form was presented as mean ± standard deviation (SD), and compared by unpaired <i>t</i> test. A <i>P</i> value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Of 52 anesthesiologists (19 attending physicians, 33 residents) responding to the survey, 90% preferred the final new form; and 56% thought the new form would reduce perioperative risk for ICU patients. Forty percent were unsure whether the form would reduce perioperative risk. Over a three month period, we randomly collected 32 generic forms and 25 new forms. The average score for missing data was 23 ± 10 for the generic form and 8 ± 4 for the new form (P = 2.58E-11).</p><p><strong>Conclusions: </strong>A preoperative evaluation form designed specifically for ICU patients is well accepted by anesthesia providers and helped to reduce missing key preoperative information. Such an approach is important for perioperative patient safety.</p>","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"3 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708313/pdf/nihms479759.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31580521","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":"Human μ Opioid Receptor Models with Evaluation of the Accuracy Using the Crystal Structure of the Murine μ Opioid Receptor.","authors":"Jose Manuel Perez-Aguilar,&nbsp;Jeffery G Saven,&nbsp;Renyu Liu","doi":"10.4172/2155-6148.1000218","DOIUrl":"https://doi.org/10.4172/2155-6148.1000218","url":null,"abstract":"<p><p>Models of the human μ opioid receptor were constructed using available G-protein-coupled receptor (GPCR) structures using homology (comparative) modeling techniques. The recent publication of a high-resolution crystal structure of a construct based on the murine μ opioid receptor offers a unique opportunity to evaluate the reliability of the homology models and test the relevance of introducing more templates (known structures) to increase the accuracy of the comparative models. In the first model two templates were used: the β₂ adrenergic and bovine rhodopsin receptors. For the second model, four templates were utilized: the β₂ adrenergic, bovine rhodopsin, β₁ adrenergic, and A_2A adenosine receptors. Including additional templates improved the accuracy of structural motifs and other features of the model when the same sequence alignment was used. The predicted structures were especially relevant in the case of important receptor regions such as the DRY motif, which has been associated with receptor activation. Additionally, this study showed that receptor sequence similarity is crucial in homology modeling, as indicated in the case of the highly diverse EC2 loop. This study demonstrates the reliability of the homology modeling technique in the case of the μ opioid receptor, a member of the rhodopsin-like family class of GPCRs. The addition of more templates improved the accuracy of the model. The findings regarding the modeling has significant implication to other GPCRs where the crystal structure is still unknown and suggest that homology modeling techniques can provide high quality structural models for interpreting experimental findings and formulating structurally based hypotheses regarding the activity of these important receptors.</p>","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"3 6","pages":"218"},"PeriodicalIF":0.0,"publicationDate":"2012-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3920553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32115384","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":"Memory Loss, Alzheimer's Disease and General Anesthesia: A Preoperative Concern.","authors":"Adam Thaler, Read Siry, Lufan Cai, Paul S García, Linda Chen, Renyu Liu","doi":"10.4172/2155-6148.1000192","DOIUrl":"10.4172/2155-6148.1000192","url":null,"abstract":"<p><strong>Background: </strong>The long-term cognitive effects of general anesthesia are under intense scrutiny. Here we present 5 cases from 2 academic institutions to analyze some common features where the patient's or the patient family member has made a request to address their concern on memory loss, Alzheimer's disease and general anesthesia before surgery.</p><p><strong>Methods: </strong>Records of anesthesia consultation separate from standard preoperative evaluation were retrieved to identify consultations related to memory loss and Alzheimer's disease from the patient and/or patient family members. The identified cases were extensively reviewed for features in common. We used Google® (http://www. google.com/) to identify available online information using \"anesthesia memory loss\" as a search phrase.</p><p><strong>Results: </strong>Five cases were collected as a specific preoperative consultation related to memory loss, Alzheimer's disease and general anesthesia from two institutions. All of the individuals either had perceived memory impairment after a prior surgical procedure with general anesthesia or had a family member with Alzheimer's disease. They all accessed public media sources to find articles related to anesthesia and memory loss. On May 2^nd, 2011, searching \"anesthesia memory loss\" in Google yielded 764,000 hits. Only 3 of the 50 Google top hits were from peer-reviewed journals. Some of the lay media postings made a causal association between general anesthesia and memory loss and/or Alzheimer's disease without conclusive scientific literature support.</p><p><strong>Conclusion: </strong>The potential link between memory loss and Alzheimer's disease with general anesthesia is an important preoperative concern from patients and their family members. This concern arises from individuals who have had history of cognitive impairment or have had a family member with Alzheimer disease and have tried to obtain information from public media. Proper preoperative consultation with the awareness of the lay literature can be useful in reducing patient and patient family member's preoperative anxiety related to this concern.</p>","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708317/pdf/nihms-387114.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31580520","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":"Interest in Anesthesia as Reflected by Keyword Searches using Common Search Engines.","authors":"Renyu Liu,&nbsp;Paul S García,&nbsp;Lee A Fleisher","doi":"10.4172/2155-6148.1000187","DOIUrl":"https://doi.org/10.4172/2155-6148.1000187","url":null,"abstract":"<p><strong>Background: </strong>Since current general interest in anesthesia is unknown, we analyzed internet keyword searches to gauge general interest in anesthesia in comparison with surgery and pain.</p><p><strong>Methods: </strong>The trend of keyword searches from 2004 to 2010 related to anesthesia and anaesthesia was investigated using Google Insights for Search. The trend of number of peer reviewed articles on anesthesia cited on PubMed and Medline from 2004 to 2010 was investigated. The average cost on advertising on anesthesia, surgery and pain was estimated using Google AdWords. Searching results in other common search engines were also analyzed. Correlation between year and relative number of searches was determined with p< 0.05 considered statistically significant.</p><p><strong>Results: </strong>Searches for the keyword \"anesthesia\" or \"anaesthesia\" diminished since 2004 reflected by Google Insights for Search (p< 0.05). The search for \"anesthesia side effects\" is trending up over the same time period while the search for \"anesthesia and safety\" is trending down. The search phrase \"before anesthesia\" is searched more frequently than \"preanesthesia\" and the search for \"before anesthesia\" is trending up. Using \"pain\" as a keyword is steadily increasing over the years indicated. While different search engines may provide different total number of searching results (available posts), the ratios of searching results between some common keywords related to perioperative care are comparable, indicating similar trend. The peer reviewed manuscripts on \"anesthesia\" and the proportion of papers on \"anesthesia and outcome\" are trending up. Estimates for spending of advertising dollars are less for anesthesia-related terms when compared to that for pain or surgery due to relative smaller number of searching traffic.</p><p><strong>Conclusions: </strong>General interest in anesthesia (anaesthesia) as measured by internet searches appears to be decreasing. Pain, preanesthesia evaluation, anesthesia and outcome and side effects of anesthesia are the critical areas that anesthesiologists should focus on to address the increasing concerns.</p>","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3707513/pdf/nihms-387107.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31580519","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":"Effect of n-Alkanols on G-Protein α Subunits.","authors":"Srinivas Pentyala,&nbsp;Kavita Tanguturi,&nbsp;Anas Sawas,&nbsp;Amulya Veerraju,&nbsp;Sandeep Annam,&nbsp;Laura Cipp,&nbsp;Mario Rebecchi","doi":"10.4172/2155-6148.1000153","DOIUrl":"https://doi.org/10.4172/2155-6148.1000153","url":null,"abstract":"<p><p>Guanine nucleotide binding (G)-proteins are GTP-driven allosteric proteins consisting of a single α subunit and a β and γ heterodimer. Gα subunits function as on/off switches based on the occupancy of the nucleotide-binding site, GTP or GDP, such that any alteration in nucleotide exchange modulates signal output. Our previous work has shown that haloalkanes and ethers inhibit GDP/GTP exchange on αi1, αi2 and αi3 subunits, but not the closely related αo. To test whether individual G-protein sensitivity correlates with n-alkanols potency and hydrophobicity, we studied the effects of n-alkanols of varied chain lengths on GDP/GTP exchange by Gαsubunits. n-alkanols (ethanol, butanol, pentanol, hexanol, heptanol, octanol and nonanol) showed differential effects on guanine nucleotide exchange by Gαi1, Gαi2 and Gαo. Based on our observations, we conclude that n-alkanols interact and modulate the activity of the G-α subunits to different extent, thereby uncoupling pathways known to modulate neuronal excitation.</p>","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"2 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3864364/pdf/nihms508088.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31970051","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":"Evaluation of a Computer Program Designed to Assess Psychomotor Recovery after Day Care Anesthesia-Comparison with Clinical Criteria","authors":"K. Sharma, Ajai Kumar Jain","doi":"10.4172/2155-6148.1000875","DOIUrl":"https://doi.org/10.4172/2155-6148.1000875","url":null,"abstract":"Background and aims: Day care surgery under general anesthesia offers a number of advantages to patients, health care providers and hospitals. A software program \"Computer Aided Psychomotor\" (CAP) test was designed by one of the authors for objective evaluation of cognitive and affective domains in patients recovering from anesthesia. \u0000Method: The CAP test was evaluated in 40 adult patients of ASA I or II recovering from general anesthesia after day care surgical procedures. Balanced anesthesia technique was administered to all the patients. A series of ten response time (RT) to the CAP test were recorded in the PAC, in the immediate preoperative period and at 30, 60, 90, 120, 180 and 240 minutes in the postoperative period. For comparison, recovery was also assessed by a clinical recovery score (CRS) at the same time interval. \u0000Result: Hierarchical ANOVA (F-test) was used to determine significance of difference between the observations recorded by CAP test and by the clinical method. At each time point, Dunnett's test was applied for comparison. Paired t–test was used for comparison of the two methods. The trends of recovery by the two methods of assessment were similar. However, at one hour and beyond in the recovery period, the CAP test was about 10% more sensitive than the clinical method. At 120, 180 and 240 minutes, the CAP test was able to detect an apparent state of \"supernormal\" recovery which was not detectable by clinical method. \u0000Conclusion: The CAP test is an alternate method for assessment of recovery of psychomotor skills after day care anesthesia. It is a simple bedside test that can be performed in patients recovering from anesthesia. The CAP test is an objective assessment as against high level of subjective bias that could occur with the clinical method of assessment.","PeriodicalId":89794,"journal":{"name":"Journal of anesthesia & clinical research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2155-6148.1000875","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70279079","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}