Perioperative Care and Operating Room Management最新文献

{"title":"Green anesthesia: A call for equitable and context-specific sustainable perioperative care","authors":"Mobin Mottahedi","doi":"10.1016/j.pcorm.2025.100589","DOIUrl":"10.1016/j.pcorm.2025.100589","url":null,"abstract":"<div><div>Healthcare systems contribute significantly to climate change, with perioperative care among the most resource-intensive domains. Anesthetic practice plays a major role due to the environmental burden of volatile agents and the growing challenges of plastic waste and water pollution. This commentary examines the environmental trade-offs inherent in current anesthetic techniques and outlines equitable, context-specific strategies for greener perioperative care.</div><div>Practical approaches include minimizing fresh gas flow, avoiding desflurane and nitrous oxide, and adopting intravenous or regional techniques when clinically appropriate. While volatile-capture devices have been proposed as a technical solution, recent real-world studies demonstrate low efficiency and prohibitive costs, highlighting the need for alternative strategies. Equally important are innovations from resource-limited settings, such as low-cost reusable equipment and streamlined supply practices, which offer scalable lessons for high-resource health systems.</div><div>This commentary further underscores the importance of governance and local leadership. Strengthening institutional review boards in resource-limited settings ensures sustainability initiatives align with local priorities rather than being externally imposed. By integrating clinical, environmental, and ethical considerations, anesthesiologists can act as change agents who drive sustainable practices in both high- and low-resource contexts.</div><div>In conclusion, achieving green anesthesia requires acknowledging unavoidable trade-offs, tailoring solutions to local realities, and promoting mutual learning across diverse health systems. Equity and context-specific strategies are central to ensuring that perioperative sustainability advances environmental goals while supporting patient safety, resource stewardship, and social justice.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100589"},"PeriodicalIF":1.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571748","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":"Examination of cardiac symptoms, anxiety levels, and attitudes toward death in patients after coronary artery bypass grafting using telehealth","authors":"Sevda SUÇEKEN ,&nbsp;Semra BÜLBÜLOĞLU ,&nbsp;Fatma ETİ ASLAN","doi":"10.1016/j.pcorm.2025.100587","DOIUrl":"10.1016/j.pcorm.2025.100587","url":null,"abstract":"<div><h3>Background/aim</h3><div>Coronary artery bypass grafting is a widely performed surgical procedure in patients with advanced coronary artery disease. Despite physical recovery, patients in the postoperative period frequently experience cardiac symptoms, increased anxiety, and concerns about death, which may negatively affect their overall recovery and quality of life. This study aimed to comprehensively evaluate cardiac symptoms, anxiety levels, and attitudes toward death in patients after coronary artery bypass grafting via telehealth and to demonstrate the potential of this approach as a significant support in enhancing the effectiveness of postoperative care.</div></div><div><h3>Methods</h3><div>This prospective, descriptive, cross-sectional study was conducted at the authors’ institution. The study included 180 patients who underwent coronary artery bypass graft surgery and completed at least four to six weeks of the postoperative period. During the data collection process, patients were reached by telehealth method and sociodemographic and health-related data recording form, Cardiac Symptom Scale, Dyspnoea-12 Scale, Beck Anxiety Scale, Death Anxiety Scale, and Attitude Towards Death Scale were used. The reporting of this study was conducted in accordance with the STROBE guidelines.</div></div><div><h3>Results</h3><div>The most common cardiac symptoms were sadness (18.3%), sleep problems (18.3%), shortness of breath (16.1%), chest pain (15.6%), and fatigue (13.9%). Fatigue and shortness of breath were reported as the most severe and debilitating symptoms. Significant positive correlations were found between dyspnea, anxiety, fear of death, and cardiac symptoms (p&lt;0.05). Of the participants in the study, 14.4% were readmitted to the hospital after discharge, with the most common reasons for readmission being shortness of breath (46.2%), tachycardia (15.4%), and fatigue (11.5%). A significant and positive relationship was found between psychiatric outpatient clinic visits and the total Beck Anxiety Scale score (p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>It has been determined that an increase in the severity of cardiac symptoms following coronary artery bypass grafting leads to a significant rise in patients' levels of anxiety and fear of death, highlighting the importance of monitoring patients' physical and psychological conditions during the postoperative period. In this context, telehealth applications can be used as an easily accessible and economical method in the follow-up and evaluation processes of patients, and can be an important tool in effectively supporting the recovery process.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100587"},"PeriodicalIF":1.0,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of fibroblastic sleeve and catheter related thrombosis with novel mid-clavicular midline catheters - a prospective longitudinal observational study","authors":"Ajiba Sabana Rafeekullah Khan ,&nbsp;Charulatha Ravindran,&nbsp;Swetha Nallasamy Sivachalam ,&nbsp;Sivashanmugam Thiyagarajan","doi":"10.1016/j.pcorm.2025.100586","DOIUrl":"10.1016/j.pcorm.2025.100586","url":null,"abstract":"<div><h3>Background</h3><div>Fibroblastic sleeve (FS) and catheter-related thrombosis (CRT) are two distinct non–infective complications of venous access devices and differentiating between them is essential for decision-making on therapeutic interventions. This study explored the incidence of FS and CRT with the novel midclavicular midline catheters.</div></div><div><h3>Methods</h3><div>Fifty consecutive mid-clavicular midline catheters during the study period were scanned at the bedside every alternate day using established diagnostic criteria to identify the development and progression of FS and CRT. The presence of forward and backwards flow, types of infusates and signs of local and systemic infections were recorded by the departmental vascular access team.</div></div><div><h3>Results</h3><div>50 catheters served for 513 catheter days. The FS was identified in 12 catheters on a median catheter day of 7. The detection of FS coincides with the loss of backwards flow, and none of the FS progressed to CRT, and 83 % of FS catheters completed the intended duration of therapy. The CRT was noted in 6 catheters on a median catheter day of 5.5. Among the 6 CRT, 3 were symptomatic necessitating removal on detection, while three asymptomatic CRT were removed on loss of forward flow on median catheter day of 5. All CRTs were resolved on patient discharge without anticoagulant intervention.</div></div><div><h3>Conclusion</h3><div>The incidence of FS and CRT was 23 and 11.7 per 1000 catheter days, respectively. The incidence of symptomatic CRT was 5.85 per 1000 catheter days. Catheter removal led to thrombus dissolution in all patients without the need for therapeutic anticoagulation.</div><div>Trial Registry number</div><div>Clinical Trial Registry – India</div><div>URL – <span><span>https://ctri.nic.in</span><svg><path></path></svg></span></div><div>Registration number – CTRI/ 2021/ 09/036967</div><div>Date of registration – 29.09.2021</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100586"},"PeriodicalIF":1.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571747","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":"Padding strategies for high-risk pressure points in common surgical positions: A prospective simulation-based study","authors":"Ravi Yadav ,&nbsp;Debasrita Banerjee ,&nbsp;Rohin Kumar","doi":"10.1016/j.pcorm.2025.100583","DOIUrl":"10.1016/j.pcorm.2025.100583","url":null,"abstract":"<div><h3>Background</h3><div>Perioperative pressure injuries (PIs) are a preventable source of morbidity in surgical patients, commonly arising from sustained tissue loading over bony prominences. Evidence on the relative efficacy of padding materials across surgical positions remains limited, particularly from controlled simulation-based studies.</div></div><div><h3>Aim</h3><div>To compare the effectiveness of five padding materials in redistributing interface pressure and preventing early skin changes across common surgical positions.</div></div><div><h3>Methods</h3><div>A prospective, simulation-based study was conducted on 20 healthy volunteers. Participants were sequentially placed in supine, prone, lateral decubitus, lithotomy, and Trendelenburg positions. Five padding materials—viscoelastic memory foam, silicone gel sheets, polyurethane foam, air-inflated pads, and cotton sheets—were applied in randomized order at high-risk anatomical points. Interface pressures were measured using a pressure mapping system at 5 and 15 min, while skin was assessed using a modified Skin Pressure Assessment Score (SPAS). Data were analyzed using repeated-measures ANOVA.</div></div><div><h3>Results</h3><div>Mean peak pressures across conditions were consistent (∼29–31 mmHg). Neither padding material nor position independently influenced interface pressure (<em>p</em> &gt; 0.75). A significant interaction was observed (<em>p</em> = 0.035), driven by slightly higher pressures with silicone gel compared to cotton in the lithotomy position (<em>p</em> = 0.028). Mean SPAS scores ranged from 1.3 to 1.6 (mild transient erythema), with no significant differences between padding materials or positions (<em>p</em> &gt; 0.5).</div></div><div><h3>Conclusion</h3><div>All tested padding materials performed similarly in pressure redistribution and early skin protection under short simulated exposures. While advanced materials did not show superiority over cotton in this setting, further clinical trials with longer operative durations and at-risk patients are warranted to confirm their role in PI prevention.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100583"},"PeriodicalIF":1.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of music therapy on postoperative pain and physiological parameters in pulmonary lobectomy patients","authors":"Yekta Altemur Karamustafaoğlu ,&nbsp;Ayşe Gökce Işıklı ,&nbsp;Figen Dığın ,&nbsp;Levent Öztürk","doi":"10.1016/j.pcorm.2025.100582","DOIUrl":"10.1016/j.pcorm.2025.100582","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to determine the effect of music therapy on postoperative pain and physiological parameters in patients undergoing lobectomy.</div></div><div><h3>Method</h3><div>This prospective and randomized controlled study was conducted between January 2023 and September 2024 in the Thoracic Surgery Clinic of Trakya University. The study was determined to be performed with at least 20 patients in each group and 60 patients in total. Patients were divided into Group 1 (nature-based sound therapy), Group 2 (music of the patient's own choice), and Group 3 (control group).</div></div><div><h3>Results</h3><div>According to the 1st, 2nd, and 3rd measurement values of the pain variable of the patients participating in the study, it was determined that the pain score of the nature-based sound therapy group was statistically significantly lower than the music and control group (<em>p</em> = 0.000; <em>p</em> = 0.002; <em>p</em> = 0.002; <em>p</em> = 0.000; <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>It was determined that the pain score of the nature-based sound therapy group of the patients participating in the study was lower than the music and control group in the first minutes after surgery. In addition, it was determined that the pain level of the nature-based sound therapy group was lower in the 8th hour after the intervention compared to before.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100582"},"PeriodicalIF":1.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466540","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":"Optimising theatre time management for orthopaedic surgery","authors":"Andrew Girjes,&nbsp;Holly Wardlaw,&nbsp;Richard Page,&nbsp;Stephen Gill,&nbsp;Margaret Rogers,&nbsp;Kevin Eng","doi":"10.1016/j.pcorm.2025.100584","DOIUrl":"10.1016/j.pcorm.2025.100584","url":null,"abstract":"<div><h3>Background</h3><div>Theatre inefficiencies can lead to delayed care, increased costs, and reduced patient satisfaction. A tertiary hospital in regional Australia identified delays in orthopaedic surgery start times and prolonged turnaround times.</div></div><div><h3>Methods</h3><div>A strategic initiative to improve theatre efficiency was introduced at a regional tertiary hospital in south-west Victoria, Australia in July 2023. Operating room data were compared 12 months pre and post intervention.</div></div><div><h3>Intervention</h3><div>Earlier starting times for perioperative staff, improved timepoint recording and focus on causes for delay.</div></div><div><h3>Results</h3><div>Procedure volume increased by 6 %. On-time starts rose from 38 % to 47 % (<em>p</em> &lt; 0.01), and turnaround time decreased by 2 min (<em>p</em> = 0.02). Recorded reasons for delay increased and \"Not specified\" decreased.</div></div><div><h3>Conclusion</h3><div>Small but meaningful changes improved data capture and theatre flow.</div></div><div><h3>Recommendations</h3><div>Redesigning theatre processes using value stream mapping can lead to measurable improvements in theatre efficiency and data quality. With enhanced data capture, further targeted process such as optimising staffing patterns, improving handover protocols, and reducing variability in surgical lists can be made.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100584"},"PeriodicalIF":1.0,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519809","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":"Machine learning surgery duration predictions compared to traditional methods: A systematic review","authors":"Richard T. Park ,&nbsp;Christopher H. Stucky ,&nbsp;Chandler H. Moser","doi":"10.1016/j.pcorm.2025.100581","DOIUrl":"10.1016/j.pcorm.2025.100581","url":null,"abstract":"<div><div>Introduction: Accurate estimation of surgical case duration is essential for operating room (OR) efficiency. We aimed to evaluate the performance of machine learning (ML) models to predict surgery duration compared to conventional estimation, and to explore the factors affecting ML performance and its practical implementation.</div><div>Methods: Following PRISMA guidelines, we searched literature using MEDLINE, Embase, and CINAHL for articles published between January 2019 and October 2024. Studies were eligible if they evaluated an ML-based model, reported performance data, and compared the models to traditional estimation methods. The risk of bias was assessed using the Prediction model Risk Of Bias Assessment Tool.</div><div>Results: Eleven studies met the inclusion criteria. Models trained on specific surgical populations generally outperformed broader models. Several studies had methodological issues, such as incomplete handling of missing data and limited validation. ML models typically improved accuracy over traditional estimates. The average improvement was 25.7 %, with the best models reducing error rates by 51 %. We found no correlation (<em>r</em> = −0.01) between the number of predictor variables and the percentage improvement in prediction accuracy.</div><div>Discussion: ML-based surgical duration prediction shows promise for improving OR scheduling efficiency. However, challenges remain, including the need for standardized reporting, robust external validation, and practical integration into existing workflows. The risk of bias and inconsistent reporting of validation methods reduces confidence in the generalizability of ML performance. Heterogeneity in study and model designs complicates direct comparisons. Adopting standardized ML model development and testing protocols for surgical duration prediction can better demonstrate its benefits.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100581"},"PeriodicalIF":1.0,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future of percutaneous tracheostomy: Is it time to embrace intensivist-led bedside practice?","authors":"Amr Salah Omar ,&nbsp;Mohamed Khalil","doi":"10.1016/j.pcorm.2025.100580","DOIUrl":"10.1016/j.pcorm.2025.100580","url":null,"abstract":"<div><div>The evolution of percutaneous dilatational tracheostomy (PDT) reflects the growing procedural autonomy of intensivists and the shift toward resource-conscious, patient-centered critical care. Bedside PDT performed or led by trained intensivists or dedicated tracheostomy teams has been shown to be safe, cost-effective, and carries an important ethical advantage by avoiding transport-related risks and reducing preventable harm compared with surgical tracheostomy in the operating room. It avoids transport-related risks, enhances care continuity, and optimizes ICU workflow—benefits that proved vital during the COVID-19 pandemic. Broader adoption of intensivist-led bedside PDT should be viewed not merely as a clinical option, but as a professional and institutional imperative.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100580"},"PeriodicalIF":1.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466541","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":"Examining the impact of the peer-mentor program on the clinical competence of surgical technology students at shiraz university of medical sciences","authors":"Shaghayegh Garmanjani ,&nbsp;Somayeh Gheysari ,&nbsp;Mehdi Hasanshahi ,&nbsp;Reza Tavakkol ,&nbsp;Jamshid Eslami","doi":"10.1016/j.pcorm.2025.100579","DOIUrl":"10.1016/j.pcorm.2025.100579","url":null,"abstract":"<div><h3>Background</h3><div>Peer-mentoring-based education is one of the most important educational aspects that constitutes a significant part of developing competent individuals. This study is a quasi-experimental study that investigates the impact of the peer-mentor program on the clinical competence of surgical technology students.</div></div><div><h3>Methods</h3><div>The present study is a quasi-experimental investigation conducted with 29 undergraduate students in the fourth semester of surgical technology, divided into control and intervention groups, with a pretest and posttest. The data collection tool was the Operating Room Nurses’ Clinical Competence self-assessment questionnaire, which was completed before and after the training. Descriptive statistics and independent-samples <em>t</em>-tests were used for data analysis.</div></div><div><h3>Results</h3><div>The results of this study indicated a statistically significant difference between the clinical competence scores before and after the intervention, demonstrating an increase in the clinical competence scores of students in both groups after the intervention (<em>p</em> &lt; 0.05). The independent <em>t</em>-test showed that there was no statistically significant difference in the mean clinical competence scores between the two groups after the intervention (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>The results of this research indicated that the clinical competence scores of students who utilized the peer-mentoring educational method were similar to those of the instructor-led group, suggesting that this educational approach can be as effective as instruction by teachers. Therefore, it is essential to develop clinical educational programs that provide a pathway for academic growth and an appropriate environment for acquiring clinical skills in learners.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100579"},"PeriodicalIF":1.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466542","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":"Tutorial on internal consistency assessment by Cronbach's alpha and McDonald’s omega","authors":"Farzan Madadizadeh ,&nbsp;Sajjad Bahariniya","doi":"10.1016/j.pcorm.2025.100568","DOIUrl":"10.1016/j.pcorm.2025.100568","url":null,"abstract":"<div><div>This tutorial study provides a comprehensive overview of internal consistency measures used in reliability analysis, focusing on six primary models: Cronbach's alpha, Kuder-Richardson methods (KR-20 and KR-21), Guttman's lambda-2, parallel and strict parallel methods, and McDonald's omega coefficient. The methods discussed are applicable primarily to psychometric instruments and questionnaire-based data commonly used in social, behavioral, and educational sciences. Internal consistency is crucial for assessing the reliability of measurement scales in these fields. The study reviews each method, detailing their theoretical underpinnings, assumptions, and practical applications, alongside software guidelines for implementation in SPSS, R, and STATA. It highlights the distinctions between these methods, particularly emphasizing the advantages of McDonald's omega over Cronbach's alpha for more accurate reliability estimates. This work aims to fill the gap in existing literature by providing a thorough comparative analysis and practical guidance for researchers seeking to measure internal consistency effectively.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100568"},"PeriodicalIF":1.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417695","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}