Revista espanola de anestesiologia y reanimacion最新文献

{"title":"The effect of structured proctoring and hypotension prediction index teaching on incidence and duration of intraoperative hypotension in patients undergoing major abdominal surgery: A comparative study of two monitoring systems.","authors":"J Ripollés-Melchor, P Fernández-Valdés-Bango, D García-López, M Olvera-García, J L Tomé-Roca, C A Vargas-Berenjeno, A Ruiz-Escobar, A B Adell-Pérez, L Carrasco-Sánchez, A Abad-Gurumeta, J V Lorente, A V Espinosa, I Jiménez-López, M A Valbuena-Bueno, M I Monge-García","doi":"10.1016/j.redare.2025.501803","DOIUrl":"10.1016/j.redare.2025.501803","url":null,"abstract":"<p><strong>Introduction: </strong>Intraoperative hypotension (IOH) is a commonly observed phenomenon during major abdominal surgery. The severity and duration of IOH have been identified as crucial factors in the development of these complications.</p><p><strong>Methods: </strong>The study compares two groups of adult patients undergoing major abdominal surgery: one group received standard hemodynamic management using the Edwards Flotrac device, while the second group received hypotension prediction index duration, and severity of intraoperative hypotension in high-risk patients (HPI)-guided hemodynamic management, with anesthesiologists trained via a structured proctoring program. We retrospective analized prospectively gathered anonymized data from 6 Spanish centers during 2021-2022. The primary outcome measure was the time-weighted average of mean arterial pressure < 65 mmHg (MAP) during surgery (TWA MAP 65 mmHg). The secondary outcome measures included incidence of hypotensive episodes, total time with hypotension, and percentage of time spent in hypotension during surgery.</p><p><strong>Results: </strong>A total of 607 patients were analyzed, 270 in the pre-proctoring group vs 337 in the post-proctoring group. The median TWA MAP 65 mmHg was 0.09 mm Hg (interquartile range (IQR), 0.00-0.31 mm Hg) post-proctoring group vs 0.37 mmHg (IQR, 0.08-1.01 mm Hg) in the pre-proctoring group, for a median difference of 0.19 mmHg (95% CI, 0.13-0.27 mmHg; P < .001), whereas the median TWA MAP < 55 mmHg was 0.00 mmHg (IQR, 0.00-0.01 mmHg) post-proctoring group vs 0.00 mmHg (IQR, 0.00-0.07 mm Hg) in the pre-proctoring group, 0 mmHg (95% CI, 0.0-0.02 mm Hg; P < .001).</p><p><strong>Conclusions: </strong>A structured program in hemodynamic training based on the intraoperative use of the hemodynamic prediction index decreases the incidence.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501803"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145139","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 comparative study of optic nerve sheath diameter and Lung Ultrasound score in healthy and preeclampsia parturients.","authors":"A Nagpal, M Pandey, N Kumar","doi":"10.1016/j.redare.2025.501773","DOIUrl":"10.1016/j.redare.2025.501773","url":null,"abstract":"<p><strong>Background: </strong>Complications of preeclampsia include cerebral and pulmonary edema which strongly correlate with optic nerve sheath diameter (ONSD) and lung ultrasound score (LUSS) respectively. This study was conducted to compare ONSD and LUSS in healthy and preeclamptic parturients.</p><p><strong>Methods: </strong>In this prospective observational analytical study, 35 healthy pregnant women and preeclamptic women each underwent ultrasound assessment for ONSD and LUSS (12 region lung technique). Severity of preeclampsia was noted. ROC analysis was performed to obtain a cutoff value for both ONSD and LUSS to predict complications of preeclampsia. A p-value of <0.05 was considered significant.</p><p><strong>Results: </strong>Mean ONSD and LUSS were higher in preeclamptic compared to healthy parturients [5.06 ± 0.46 vs 4.24 ± 0.38 mm (p < 0.0001) and [5 (1-12) vs 0 (0-1.5); p value <0.0001], respectively. Mean ONSD in severe pre-eclampsia (5.36 ± 0.32 mm) was significantly higher as compared to mild pre-eclampsia (4.71 ± 0.35 mm; p < 0.0001). Women with severe preeclampsia had a higher LUSS as compared to the mild preclamptics and healthy parturients. However, no difference in ONSD and LUSS between mild preeclamptics and healthy parturients was observed. A mean ONSD of >4.65 mm and LUSS of >2 could predict preeclampsia with a sensitivity of 77.14% and 68.57% and specificity of 91.43% and 85.71% with an AUC of 0.907 and 0.806 respectively.</p><p><strong>Conclusion: </strong>Both ONSD and LUSS can be used to assess severity and complications of preeclampsia. Early detection can be used to treat, guide fluid therapy and monitor response to treatment.</p><p><strong>Ctri registration: </strong>CTRI/2019/12/022243 (https://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=37940&EncHid=&userName=). IEC: LHMC/IEC/Thesis/2019/116 dated 29/10/2019.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501773"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145209","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":"Paraparetic variant of Guillain-Barré syndrome after epidural anaesthesia.","authors":"F Garvayo Fernández, A López Olid, M Pascual Salas, A Sánchez López, L M Jiménez Rodriguez, F J Redondo Calvo","doi":"10.1016/j.redare.2025.501775","DOIUrl":"10.1016/j.redare.2025.501775","url":null,"abstract":"<p><p>Epidural procedures are widely used as an analgesic adjunct in various surgeries, allowing for a reduction in the use of opioids and the avoidance of their side effects. According to the third National Audit Project in the United Kingdom, the incidence of serious complications related to epidural puncture is very low. A case is presented of a 66-year-old woman who underwent surgery for ovarian oncological pathology and developed, as a complication of neuroaxial anaesthesia in the postoperative period, a sensory-motor disorder limited to the lower limbs, compatible with the paraparesis variant of Guillain-Barré syndrome.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501775"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145224","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":"Anaesthesia management of anterior cervical discectomy and fusion.","authors":"C Beltrán Piles, B Monleón, R Badenes, D Tabares, P Capilla","doi":"10.1016/j.redare.2025.501801","DOIUrl":"10.1016/j.redare.2025.501801","url":null,"abstract":"<p><p>Anterior Cervical Discectomy and Fusion (ACDF) is a common surgical procedure with positive outcomes, but it is not without potentially serious complications for the patient. We present the case of a patient who underwent ACDF and was found to have a cervical swelling prior to extubation. After a joint evaluation with the otolaryngology team, a suspicion of laryngeal structure dislocation was raised. A manual repositioning was performed prior to neuromuscular relaxation, and the patient was transferred intubated to the Recovery Unit due to a high risk of upper airway obstruction secondary to edema. After 24 h of monitoring under scheduled corticosteroid treatment, a planned and safe extubation was carried out, witnessed by the otolaryngology team.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501801"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145214","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":"Feasibility and acceptability of an app for monitoring acute postoperative pain in major outpatient surgery.","authors":"S Vitale, M I Fábregas Blanco, P Ricós Bugeda, R Torruella Turró, H Fernández Fernández, E Reñé de Antonio","doi":"10.1016/j.redare.2025.501854","DOIUrl":"10.1016/j.redare.2025.501854","url":null,"abstract":"<p><strong>Introduction: </strong>By allowing intensive monitoring of acute postoperative pain (APP), mHealth could be clinically useful in contexts with a high prevalence of moderate to severe APP.</p><p><strong>Objective: </strong>The primary objective was to evaluate the feasibility and acceptability of an app for monitoring DAP. The secondary objectives were to describe DAP during the first week of the postoperative period, to analyse factors associated with it and to assess adherence and satisfaction with analgesic treatment.</p><p><strong>Materials and methods: </strong>Observational and prospective study in patients undergoing surgery under major ambulatory surgery (MAS) regimen who reported the intensity of DAP for 7 days with an app. We determined the proportions that agreed to use it and who made trajectories of DAP ≥5 days, the pattern of use of the app and the results. Risk factors associated with DAP were analyzed. Satisfaction with DAP control and adherence to the analgesic regimen were assessed through surveys.</p><p><strong>Results: </strong>53.4% ​​of patients measured their DAP with the app. The main reason for exclusion was technological limitations (75.1%). An uninterrupted DAP trajectory of ≥5 days was traced in 74.4% of patients and a high prevalence of moderate to severe DAP was observed, as well as a high proportion of patients who adhered little or not at all and were little or not at all satisfied with the analgesic results obtained.</p><p><strong>Conclusions: </strong>Monitoring DAP with the app used was feasible and accepted by patients. It provided clinically useful information by allowing DAP trajectories to be traced and detecting high proportions of patients with moderate to severe DAP, dissatisfied with the analgesic results obtained and non-compliant with analgesic guidelines.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501854"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145220","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 serratus plane and erector spinae plane blocks for postoperative analgesia in unilateral breast surgery.","authors":"K Şahin, C Sayman, S Kına, A Surhan Çınar","doi":"10.1016/j.redare.2025.501830","DOIUrl":"10.1016/j.redare.2025.501830","url":null,"abstract":"<p><strong>Objective: </strong>The use of interfascial plane blocks for postoperative analgesia is becoming more widespread because they are easier to perform and have fewer complications. This prospective, single-blind, randomized controlled study compares the efficacy of serratus plane block (SPB) and erector spinae plane block (ESPB) for postoperative analgesia in patients undergoing unilateral breast surgery.</p><p><strong>Methods: </strong>Seventy-four ASA I-II patients aged 18-65 years who underwent elective unilateral breast surgery were included in the study. After exclusion, 70 patients were randomized to receive SPB (n=35) or ESPB (n=35). In both groups, nerve blocks were administered under ultrasound guidance with 25ml of 0.25% bupivacaine. Postoperative pain (assessed using the visual analogue scale [EVA]), duration of analgesia, tramadol consumption, and incidence of complications were recorded.</p><p><strong>Results: </strong>There were no significant differences in EVA scores between groups. However, duration of analgesia was significantly higher in the ESPB group (395.6±141.9min) vs the SPB group (290.3±148.3min) (p=0.003). Total tramadol consumption over 24h was similar between groups: 70.9±48.6mg in the SPB group and 70.3±50.5mg in the ESPB group. Minimal postoperative complications, including nausea and vomiting, were noted with no significant difference between groups.</p><p><strong>Conclusion: </strong>Both SPB and ESPB were safe and provided similar postoperative analgesia in patients undergoing unilateral breast surgery. ESPB provides longer lasting analgesia, and therefore improves patient comfort in the early postoperative period.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501830"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145217","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":"Postoperative acute kidney injury in major abdominal surgery. Utility of the urinary biomarker [TIMP-2] × [IGFBP7] (NephroCheck™).","authors":"A Lara-Jiménez, P Monedero, G Echarri","doi":"10.1016/j.redare.2025.501853","DOIUrl":"10.1016/j.redare.2025.501853","url":null,"abstract":"<p><strong>Background: </strong>The urinary biomarker [TIMP-2] × [IGFBP7] enables the prediction of postoperative acute kidney injury (PO-AKI). Our study aimed to assess the incidence of PO-AKI in high-risk patients undergoing major abdominal surgery and to evaluate the impact of implementing KDIGO renal optimization measures in those with renal stress identified by [TIMP-2]×[IGFBP7].</p><p><strong>Materials and methods: </strong>This was a prospective study including 182 patients who underwent major abdominal surgery. Perioperative data, [TIMP-2] × [IGFBP7] levels, and the implementation of KDIGO renal protection strategies in the ICU were collected. Predictors of PO-AKI were identified through multivariate analysis.</p><p><strong>Results: </strong>The overall incidence of PO-AKI was 25.3%, reaching 42.7% in ICU patients. [TIMP-2] × [IGFBP7] showed moderate predictive ability (AUROC = 0.74), with a PO-AKI incidence of 47.5% in patients with elevated levels. Despite the implementation of KDIGO measures in the ICU, the incidence of PO-AKI in patients with elevated [TIMP-2] × [IGFBP7] was 65.6%. In multivariate analysis, the main predictors of PO-AKI were elevated [TIMP-2] × [IGFBP7] (OR = 6.3; 95% CI: 2.6-15.6; p < 0.001), male sex (OR = 6.1; 95% CI: 1.9-19.6; p = 0.002), and ICU admission (OR = 4.5; 95% CI: 1.5-13.6; p = 0.009).</p><p><strong>Conclusions: </strong>PO-AKI is common after major abdominal surgery, particularly in ICU patients. The [TIMP-2] × [IGFBP7] biomarker allows for early identification of at-risk patients, although the implementation of KDIGO measures in the ICU did not significantly reduce its incidence.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501853"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133357","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":"Preliminary study: Changes in systolic volume index during Nuss surgery.","authors":"B Cabeza Martín, M García-Navlet, A Melone, M Arellano Pulido, E Sanjuan, M Hervías","doi":"10.1016/j.redare.2025.501726","DOIUrl":"10.1016/j.redare.2025.501726","url":null,"abstract":"<p><strong>Introduction: </strong>The surgical correction of the pectus excavatum (PE) is justified by the progressive cardiopulmonary involvement. There are few studies that analyze the hemodynamic changes during the intraoperative period.</p><p><strong>Objectives: </strong>To describe the stroke volume index (SVI) changes during the intraoperative with the Nuss technique, through the monitoring of the invasive blood pressure curve (IAP).</p><p><strong>Material and methods: </strong>A prospective observational study of pediatric patients undergoing Nuss surgery by right video-assisted thoracoscopy (VATS). By analyzing the IAP curve using the FloTrac monitor (Edwars®), the following dynamic parameters were evaluated: stroke volume index (SVI), cardiac index (CI), stroke volume variation (SVV). The dates were collected on 3 occasions: baseline, before bar placement (after preload optimization in search of the target IVS) and after bar placement.</p><p><strong>Results: </strong>Were included 6 patients aged 14-16 years, 5/6 males. Five of six had cardiac MRI with decreased FEVD (33%-44%), 1/6 with FEVD 53%. At baseline, IVS and CI were decreased, 19-29 ml/lat/m² and 1.1-1.9 L/min/m². Two-Three overloads of volume were performed to reach target IVS (25-35 ml/lat/m²), with an increase of 0%-75%. After the placement of the bar, the IVS was increased by 8%-42% (35-40 ml/lat/m²) with respect to the target IVS, with normalization of the CI (2.5-3.5 L/min/m²).</p><p><strong>Conclusions: </strong>PE produces compression of the VD, with descent of the IVS. After the placement of the Nuss bar, through the analysis of the IAP, we can objectifield an increase in the IVS and normalization of the CI.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501726"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133396","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":"Factors associated with postoperative anastomotic leak and comparison of 4 prediction scales in colorectal surgery.","authors":"J M Nieves-Alonso, L A Gómez Arredondo, P Maestre Serantes, C Martín Martín, F Guitart de la Lastra, F Ramasco Rueda","doi":"10.1016/j.redare.2025.501852","DOIUrl":"10.1016/j.redare.2025.501852","url":null,"abstract":"<p><strong>Introduction: </strong>Anastomotic leakage is a serious post-colorectal surgery complication, and has an incidence ranging from 2.8% to 30%. Identifying risk factors and evaluating prediction scores could optimize perioperative management. This study analyses factors associated with dehiscence and compares the predictive capacity of four scales: ASA, CCI, RCRI and AUB-HAS2.</p><p><strong>Methods: </strong>Retrospective observational study in 182 patients undergoing colorectal surgery with anastomosis in a Spanish tertiary hospital (2018-2020). Clinical and perioperative data were collected, and the ASA, CCI, RCRI and AUB-HAS2 scores were calculated. Risk factors were analysed using multivariate logistic regression, and predictive capacity was assessed with ROC curves.</p><p><strong>Results: </strong>Leakage occurred in 13.2% of cases. In the multivariate analysis, heart failure (OR: 4.14; 95% CI: 1.14-13.77) and laparotomy (OR: 2.67; 95% CI: 1.07-6.60) were significantly associated with dehiscence. None of the scales predicted this complication. The AUB-HAS2 and CCI scales were associated with 30-day mortality (AUC: 0.81 and 0.74, respectively), and the CCI predicted the need for organ support (AUC: 0.71).</p><p><strong>Conclusion: </strong>Heart failure and laparotomy are independent risk factors for anastomotic leakage. Although none of the scales predicted this complication, the AUB-HAS2 and CCI were useful in stratifying postoperative mortality. This highlights the importance of personalized assessment.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501852"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096612","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":"Clinical guidelines and strategic plan for the prevention, diagnosis and treatment of delirium: The zero delirium project.","authors":"O de la Varga-Martínez, R Badenes, C Gordaliza, S de Miguel Manso, G E Landázuri Castillo, C Armenteros Aragon, M Fernández Castro, A B Martin Santos, R Lopez Herrero, R Navarro Pérez, A Abad Gurumeta, M Varela Duran, M Heredia Rodriguez, E Tamayo Gómez","doi":"10.1016/j.redare.2025.501805","DOIUrl":"10.1016/j.redare.2025.501805","url":null,"abstract":"<p><p>The aim of this clinical practice guideline is to provide a rationale for the implementation of the Zero Delirium Project (ZDP) - a series of recommendations for patients in special critical care units (SCCU). The recommendations were developed by a group of anaesthesiologists from around Spain, and were reviewed by the Scientific Committee of the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy. Delirium is an acute, fluctuating, multifactorial syndrome characterised by inattention, disorganised thinking, and an altered level of consciousness. It may affect up to 56% in patients during their stay in critical care, and is important because many SCCUs have not yet introduced routine delirium screening, treatment and prevention strategies. Staff that are able to recognise and diagnose delirium can prevent it, treat it and reduce its incidence, which in turn reduces morbidity, mortality and costs. The ZDP was created with this aim in mind.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501805"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096606","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}