CHEST critical care最新文献

{"title":"Associations Among Skeletal Muscle Health, Disability, and Self-Reported Physical Function in Survivors of Critical Illness","authors":"Kimberly F. Rengel MD, MSCI ,&nbsp;Jo Ellen Wilson MD, MPH, PhD ,&nbsp;Heidi J. Silver RD, PhD ,&nbsp;Emma Hollingsworth MPH ,&nbsp;Onur M. Orun MS ,&nbsp;James C. Jackson PsyD ,&nbsp;Matthew F. Mart MD ,&nbsp;Christopher G. Hughes MD ,&nbsp;E. Wesley Ely MD, MPH ,&nbsp;Nathan E. Brummel MD, MSCI, ATSF","doi":"10.1016/j.chstcc.2024.100115","DOIUrl":"10.1016/j.chstcc.2024.100115","url":null,"abstract":"<div><h3>Background</h3><div>Factors associated with disability after critical illness are incompletely understood. Lower pre-existing muscle mass and muscle density on CT imaging are associated with greater mortality resulting from critical illness. Their relationship with disability and physical function in survivors of critical illness is unclear.</div></div><div><h3>Research Question</h3><div>We sought to understand the relationship between muscle mass and muscle density before critical illness and disability and self-reported physical function after surviving a critical illness.</div></div><div><h3>Study Design and Methods</h3><div>We conducted a nested cohort study of 125 survivors of critical illness with abdominal imaging between 6 months before and 4 days after ICU admission. We measured skeletal muscle cross-sectional area at the L3 vertebra, indexed by height, to obtain the skeletal muscle mass index and measured skeletal muscle density by calculating the mean Hounsfield units of the muscles. We recorded discharge location and, at 3 and 12 months after hospital discharge, assessed for disability with basic activities of daily living, instrumental activities of daily living, and self-reported physical function. We used multivariable regression to assess the relationship between baseline skeletal muscle mass index or density and outcomes.</div></div><div><h3>Results</h3><div>We found no association between skeletal muscle mass index and discharge to a facility or disability. However, lower skeletal muscle density was associated with greater odds of discharge to a facility, but not with disability at either time point.</div></div><div><h3>Interpretation</h3><div>A substantial percentage of participants (40%) demonstrated low muscle mass on abdominal imaging before seeking treatment for a critical illness. We did not find muscle mass or density to be associated with long-term disability or physical function after critical illness, although lower density was associated with increased risk of discharge to a facility. Further work is needed to understand the relationship between muscle health and physical recovery after critical illness.</div></div><div><h3>Trial Registry</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>; No.: NCT00392795; URL: <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span></div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100115"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143815889","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":"A Descriptive Qualitative Study of Religion and Spirituality’s Role in Critical Illness Decision-Making Among Black and White Family Caregivers","authors":"Oluwatumilara F. Akeke MPH ,&nbsp;Dingyue Wang BSN ,&nbsp;Deborah Ejem PhD ,&nbsp;Kimberly S. Johnson MD ,&nbsp;Sharron L. Docherty PhD, RN ,&nbsp;Christopher E. Cox MD, MPH ,&nbsp;Katelyn Dempsey MPH ,&nbsp;Laura Fish MPH, PhD ,&nbsp;Sirajbir Sodhi BS ,&nbsp;Devika Shenoy BS ,&nbsp;Nidhi Charan BS ,&nbsp;Muhammed S. Bah BA ,&nbsp;Deepshikha C. Ashana MD","doi":"10.1016/j.chstcc.2024.100113","DOIUrl":"10.1016/j.chstcc.2024.100113","url":null,"abstract":"<div><h3>Background</h3><div>Spiritual beliefs and spiritual support from clinicians can affect medical decision-making and coping during times of serious illness.</div></div><div><h3>Research Question</h3><div>How do religion and spirituality affect the critical illness experience of Black and White family caregivers of patients who are critically ill?</div></div><div><h3>Study Design and Methods</h3><div>Twenty-one semistructured interviews were conducted with Black and White family caregivers of patients admitted to ICUs in a southeastern United States health system between January 3, 2023, and May 11, 2023. Eligible family caregivers either reported unmet spiritual needs or a high degree of importance of spirituality in their lives. Participants were asked how spirituality affected medical decision-making and coping while their loved ones were seriously ill. Coders were masked to participant race during thematic analysis.</div></div><div><h3>Results</h3><div>Of 21 family caregivers, 9 caregivers (42.9%) were Black and 12 caregivers (57.1%) were White. Black and White family caregivers generally were middle-aged (mean [SD]: 50.6 [13.6] years and 61.7 [10.7] years, respectively) and female (n = 7 [77.8%] and n = 9 [75.0%], respectively). We observed that clinicians showed less engagement about spirituality with Black compared with White family caregivers in this sample. Black family caregivers felt more comfortable discussing their spirituality with members of their community, such as pastors or friends. A common belief among all family caregivers in this sample was that God, rather than the medical team, was in control of their loved one’s outcome. This was accompanied by a shared desire for accessible spiritual spaces in the ICU and proactive clinician engagement in their spirituality.</div></div><div><h3>Interpretation</h3><div>Although spirituality served as an important coping mechanism for all family caregivers in this sample, racial differences in spiritual support offered to family caregivers were identified. Ensuring that multidisciplinary critical care teams are prepared to deliver culturally competent spiritual care is a priority.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 1","pages":"Article 100113"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444657","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":"Association of P0.1 With Duration of Ventilation and Mortality in Patients With COVID-19 ARDS","authors":"Else A.M.D. ter Haar MD ,&nbsp;Maurits H. Renes MD ,&nbsp;Hendrik W. Zijlstra MD ,&nbsp;Salvador J. Recinos MD ,&nbsp;Peter Dieperink MD ,&nbsp;Walter M. van den Bergh MD, PhD ,&nbsp;Joep M. Droogh MD, PhD ,&nbsp;Judith M. Vonk PhD ,&nbsp;Janesh Pillay MD, PhD","doi":"10.1016/j.chstcc.2024.100112","DOIUrl":"10.1016/j.chstcc.2024.100112","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 1","pages":"Article 100112"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453331","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":"Improvements in Vasopressor Requirements With Venovenous Extracorporeal Membrane Oxygenation","authors":"Mazen F. Odish MD ,&nbsp;Travis Pollema DO ,&nbsp;Alex Ignatyev BS ,&nbsp;Jerry Lipinski MD ,&nbsp;Cassia Yi MSN ,&nbsp;Michelle Parrett BSN ,&nbsp;Khang Tong MS ,&nbsp;Lin Liu PhD ,&nbsp;Atul Malhotra MD ,&nbsp;Robert L. Owens MD","doi":"10.1016/j.chstcc.2024.100111","DOIUrl":"10.1016/j.chstcc.2024.100111","url":null,"abstract":"<div><h3>Background</h3><div>Venovenous extracorporeal membrane oxygenation (ECMO) is used increasingly for severe respiratory failure. Some ECMO clinicians may view concurrent vasopressors as a contraindication for venovenous ECMO. However, we noted improved vasopressor requirements after venovenous ECMO cannulation.</div></div><div><h3>Research Question</h3><div>How does venovenous ECMO affect vasopressor requirements in patients with respiratory failure?</div></div><div><h3>Methods</h3><div>This was a retrospective review of all venovenous ECMO initiations from December 2016 through December 31, 2023, at a large-volume ECMO center. The changes in norepinephrine equivalent dose and number of continuous IV vasopressors were determined immediately before and 24 hours after venovenous ECMO cannulation. This change was assessed by Wilcoxon signed-rank tests, and their associations with potential predictor variables (pH, Pa<span>co</span>₂, Pa<span>o</span>₂, and positive end-expiratory pressure) were examined by linear regressions.</div></div><div><h3>Results</h3><div>Two hundred five patients received venovenous ECMO during this time, with 108 patients taking vasopressors at ECMO cannulation and included in this analysis. The mean (SD) norepinephrine equivalent dose at ECMO initiation, 0.23 (0.29) μm/kg/min, to 24 hours after ECMO, 0.14 (0.23) μm/kg/min, decreased significantly (<em>P</em> &lt; .001). The mean (SD) number of pressors at ECMO initiation, 1.69 (0.92), to 24 hours later, 1.29 (1.04), decreased significantly (<em>P</em> &lt; .001). A significant decrease in positive end-expiratory pressure, mean airway pressure, and Pa<span>co</span>₂ with a significant increase in pH and Pa<span>o</span>₂ was found (<em>P</em> ≤ .001 for all). The changes in pH (<em>P</em> &lt; .001) were associated with changes in norepinephrine equivalent dose and number of vasopressors after adjusting for baseline outcomes. Twenty-seven patients (25%) had received a norepinephrine equivalent dose of ≥ 0.3 μm/kg/min at ECMO initiation; of these, 16 patients (59.3%) survived to hospital discharge (compared with 51.9% survival among those with a lower norepinephrine equivalent dose at ECMO initiation; <em>P</em> = .66).</div></div><div><h3>Interpretation</h3><div>Our results show that patients’ vasopressor requirements significantly decreased 24 hours after venovenous ECMO initiation, with a change in pH weakly associated with vasopressor improvement. The requirement of vasopressors, even norepinephrine equivalent dose of ≥ 0.3 μm/kg/min at the time of ECMO consideration, is not a clear contraindication to ECMO candidacy.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 1","pages":"Article 100111"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444659","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":"Analytical Accuracy of a Continuous Glucose Monitor in Adult Diabetic Ketoacidosis","authors":"Nathan L. Haas MD ,&nbsp;Lynn Ang MD ,&nbsp;Nazanene H. Esfandiari MD ,&nbsp;Ahsan M. Khan MBBS ,&nbsp;James A. Cranford PhD ,&nbsp;Ashley Cohen MD ,&nbsp;Jordan Sell MD ,&nbsp;Mostafa Abdel-Hamid MD ,&nbsp;Kevin E. Romanchik BSN, RN ,&nbsp;Frederick K. Korley MD, PhD","doi":"10.1016/j.chstcc.2024.100109","DOIUrl":"10.1016/j.chstcc.2024.100109","url":null,"abstract":"<div><h3>Background</h3><div>Management of diabetic ketoacidosis (DKA) requires frequent point-of-care blood glucose (POCBG) measurements, often necessitating ICU admission and incurring substantial costs. Replacing hourly POCBG measurements with continuous glucose monitoring (CGM) could optimize DKA management by minimizing resource use and detecting hypoglycemic events earlier. However, the accuracy of CGM in DKA is not well established.</div></div><div><h3>Research Question</h3><div>What is the clinical and analytical accuracy of CGM in adults with DKA?</div></div><div><h3>Study Design and Methods</h3><div>This was a prospective observational study at a single academic medical center emergency department. Adults older than 18 years with DKA were included. Glucose was measured every 5 minutes via Dexcom G6 CGM and compared with hourly POCBG measurements until resolution of DKA. The primary outcome was proportion of paired CGM and POCBG values in Clarke error grid zones A and B. Additional outcomes included level of agreement via Bland-Altman plot, mean absolute relative difference, and time of first detection of glucose &lt; 150 mg/dL.</div></div><div><h3>Results</h3><div>Twenty adult patients with DKA were studied. Mean age was 42 years, 60% were female, 70% had type I diabetes, and mean presenting pH was 7.17. Three hundred thirty-four paired measurements from CGM and POCBG measurements were analyzed. Clarke error grid analysis revealed 97.0% of readings to be within zones A and B. Bland-Altman analysis showed the average difference between CGM and POCBG measurement was 26.0 mg/dL (95% limits of agreement, –70.7 to 122.6). Mean absolute relative difference was 28.6% (95% CI, 26.5%-30.6%). The first incidence of glucose &lt; 150 mg/dL (n = 14) was detected 28.9 minutes earlier by CGM than POCBG measurements.</div></div><div><h3>Interpretation</h3><div>In this study, CGM provided accurate measurements of blood glucose and identified missed opportunities for earlier intervention in adults with DKA. Future interventional trials can assess the impact of CGM-guided DKA management on patient outcomes, patient experience, and resource use.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 1","pages":"Article 100109"},"PeriodicalIF":0.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143351003","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":"Best Practices for Intensivists Planning and Opening Hospital-Based Deceased Organ Donor Care Units","authors":"Emily A. Vail MD ,&nbsp;Rita N. Bakhru MD ,&nbsp;Ashley C. McGinity MD ,&nbsp;Todd Sarge MD ,&nbsp;Julie K. Heimbach MD ,&nbsp;Allison J. Tompeck MD ,&nbsp;Thomas M. Leventhal MD ,&nbsp;Devang K. Sanghavi MBBS, MD ,&nbsp;George W. Williams III MD ,&nbsp;Rishi Kumar MD ,&nbsp;Philip Sommer MD ,&nbsp;Niels D. Martin MD ,&nbsp;Samuel T. Windham MD ,&nbsp;Varun K. Goyal MD ,&nbsp;Donor Care Unit Network for Optimizing Recovery Group","doi":"10.1016/j.chstcc.2024.100110","DOIUrl":"10.1016/j.chstcc.2024.100110","url":null,"abstract":"<div><div>Over the past 2 decades, clinical management and recovery of organs from deceased donors in the United States increasingly have been centralized into specialty donor care units. Intensivists who lead or practice in donor care units colocated with hospitals (or hospital-based donor care units) are well positioned to offer operational experience, to deliver evidence-based clinical donor management, and to leverage hospital resources to facilitate research and education efforts to improve access to transplantable organs. In this How I Do It article, intensivist leaders of 11 US donor care units collaborating in the Donor Care Unit Network for Optimizing Recovery group describe the benefits and limitations of hospital-based donor care units and collate resources and shared experiences to inform planning and opening of other hospital-based donor care units.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 1","pages":"Article 100110"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394764","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":"Long-Term Outcomes of Patients With COVID-19 Who Are Critically Ill","authors":"Katelyn A. Mazzochi MD ,&nbsp;Sheraya De Silva BSc(Hon) ,&nbsp;Nicholas L.M. Chan MD ,&nbsp;Erin McGann MPhysio ,&nbsp;Tayla L. Robertson MPhysioPrac ,&nbsp;Tahnee R. Hellings MPhysioPrac ,&nbsp;Carol L. Hodgson PhD ,&nbsp;Alisa M. Higgins PhD","doi":"10.1016/j.chstcc.2024.100108","DOIUrl":"10.1016/j.chstcc.2024.100108","url":null,"abstract":"<div><h3>Background</h3><div>Survivors of critical illness are susceptible to long-term functional impairments after admission to an ICU. During the COVID-19 pandemic, the number of patients admitted to an ICU with SARS-CoV-2 infection surged. The long-term consequences of critical illness resulting from COVID-19 illness remain unclear.</div></div><div><h3>Research Question</h3><div>What are the long-term outcomes of adult patients admitted to an ICU for COVID-19?</div></div><div><h3>Study Design and Methods</h3><div>We searched Ovid MEDLINE and EMBASE using subject heading and free-text terms related to long-term outcomes of critically ill patients with COVID-19. We included all articles that reported original data on outcomes from 90 days onward for adult patients admitted to an ICU for COVID-19. Data extracted included study details, patient characteristics, outcomes reported, measurement tools used, and timing of assessment.</div></div><div><h3>Results</h3><div>A total of 14,882 studies were screened, from which 134 studies fulfilled the selection criteria. Follow-up time points ranged from 90 days to 2 years after critical illness. Mortality after hospitalization was the most reported outcome (n = 60), with the general ICU cohort having an aggregate mortality rate of 35.5% (95% CI, 34.7%-36.2%) at 90 days and 31.6% (95% CI, 30.9%-32.4%) at 6 months. A plethora of other outcomes were assessed, including psychologic function and mental health (n = 49), persistent symptoms (n = 47), quality of life (n = 47), physical function (n = 33), and cognitive function (n = 31). For each outcome, different measurement tools were used, making data synthesis across studies difficult.</div></div><div><h3>Interpretation</h3><div>Important evidence gaps remain regarding the long-term health outcomes and health care needs for survivors of critical COVID-19 illness. This review found that mortality was the most reported long-term outcome. Significant heterogeneity was evident across studies in terms of outcomes assessed, measurement instruments used, and the duration of follow-up. Future research requires increased consistency in outcomes assessed and measurement tools to inform clinical practice.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 1","pages":"Article 100108"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465574","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":"Management of Asthma and COPD Exacerbations in Adults in the ICU","authors":"Stephen A. Mein MD,&nbsp;Michael C. Ferrera MD","doi":"10.1016/j.chstcc.2024.100107","DOIUrl":"10.1016/j.chstcc.2024.100107","url":null,"abstract":"<div><div>Severe, life-threatening asthma and COPD exacerbations are managed commonly in the ICU and are associated with significant morbidity and mortality. It is important to understand the commonalities and differences in the diagnosis and management of these obstructive lung diseases to improve patient outcomes via evidence-based care. In this review, we first outline triggers of acute asthma and COPD exacerbations and an initial diagnostic evaluation and severity assessment. We then review the pathophysiologic features of asthma and COPD exacerbations and create a framework for the management of exacerbations in critically ill adult patients aimed at reducing airway inflammation, reversing bronchospasm, and, in severe cases, supporting patients with mechanical ventilation or advanced therapies until clinical improvement is achieved.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 1","pages":"Article 100107"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479911","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":"Silent Burdens","authors":"Cassiano Teixeira MD, PhD","doi":"10.1016/j.chstcc.2024.100106","DOIUrl":"10.1016/j.chstcc.2024.100106","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"2 4","pages":"Article 100106"},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700607","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":"Prevalence of Inpatient Pulse Oximetry in Operative and Nonoperative Settings","authors":"Nicholas A. Bosch MD ,&nbsp;Anica C. Law MD ,&nbsp;Ashraf Fawzy MD, MPH ,&nbsp;Theodore J. Iwashyna MD, PhD","doi":"10.1016/j.chstcc.2024.100104","DOIUrl":"10.1016/j.chstcc.2024.100104","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"2 4","pages":"Article 100104"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700608","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}