Voprosy Prakticheskoi Pediatrii最新文献

{"title":"Palliative medical care for children at the federal and regional levels: analysis of expert opinions and new challenges to the healthcare system","authors":"V. Stupak, E. S. Feduleeva, A. Ishutin, L. S. Zolotareva","doi":"10.20953/1817-7646-2022-5-36-42","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-5-36-42","url":null,"abstract":"The Resolution on Palliative Care (PC) adopted by the World Health Assembly in 2014 implies PC integration into healthcare at all levels. In the Russian Federation, PC management and improvement are regulated by territorial health development programs. Objective. To analyze expert opinions on the quality of PC in various regions of the Russian Federation to optimize pediatric PC. Materials and methods. This prospective cohort study was conducted in 80 regions of the Russian Federation in October–December 2020. We interviewed 276 chief consultants, top healthcare executives, heads of healthcare institutions, pediatric departments, neonatology departments, and gynecological departments. Results. Respondents reported high quality of PC and equipment in healthcare institutions. However, they also marked limited territorial accessibility and volume of PC. They believe that PC in Russia requires better funding and expansion of home care, medical care in day hospitals and regular hospitals, and improvement of legal protection of patients. Conclusion. PC in the Russian Federation is one of the top priorities in healthcare. Several regulatory documents (including orders No 345n/372n and No 348n, resolution No 813, orders for the Moscow Region No 4-r and No 87-r) have been implemented. However, organizational problems still exist in some regions, which requires the improvement of the regulatory framework. Key words: pediatric palliative care, children, hospice and palliative care, medical and organizational measures, quality of life, suffering alleviation","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67747624","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":"Formation of pyeloenteroureteroanastamosis in a child with recurrent hydronephrosis caused by long-term ureteral stenosis","authors":"S. Sharkov, O. Shmyrov, A.Yu. Lobach, A. Kulaev, R. V. Surov, M. N. Lazishvili, A. Kovachich","doi":"10.20953/1817-7646-2022-6-121-124","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-6-121-124","url":null,"abstract":"Hydronephrosis is a disease characterized by expansion of the renal pelvis and calyces resulted from improper urine outflow in the pelvic ureter that causes damage to the kidney parenchyma and a progressive decrease in its function. Anderson–Hynes pyeloplasty is a highly effective surgical method for this disease. The recurrence rate after this procedure does not exceed 3–5%. One of the possible causes of relapse is long-term ureteral stenosis, which requires a repeated reconstructive surgery. We report a case of recurrent hydronephrosis associated with long-term ureteral stenosis. The patient has undergone laparoscopic surgery with the formation of pyeloenteroureteroanastamosis. Key words: hydronephrosis, relapse, laparoscopy, pyeloenteroureteroanastamosis, pyeloplasty","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67748051","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":"Secondary hemophagocytic lymphohistiocytosis: prognostic model and early markers in patients with systemic juvenile idiopathic arthritis. Results of a cohort retrospective study","authors":"I. Kriulin, E. Alexeeva, Ilia Y. Shilkrot, T. Dvoryakovskaya","doi":"10.20953/1817-7646-2022-6-17-24","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-6-17-24","url":null,"abstract":"Background. Secondary hemophagocytic lymphohistiocytosis (sHLH) is a potentially fatal complication of systemic juvenile idiopathic arthritis (sJIA) characterized by hyperinflammation and a variety of clinical and laboratory manifestations. This condition is also referred to as macrophage activation syndrome (MAS) in patients with rheumatic diseases, including those with sJIA. In this article, we use the term sHLH. Approximately 40% of sHLH cases are asymptomatic, especially in patients who receive biologicals. Thus, the development of a prognostic model and identification of early sHLH markers in sJIA patients will enable timely initiation of anti-inflammatory and immunosuppressive therapy. Objective. To develop a prognostic model and identify early sHLH markers in sJIA patients. Methods. This study included 100 sJIA patients who were examined and treated in the Department of Rheumatology, National Medical Research Center for Children's Health between August 2010 and May 2021. A total of 114 sHLH episodes were registered among study participants. We analyzed medication history, as well as clinical and laboratory parameters reflecting the activity of sHLH and sJIA as potential early markers of sHLH. Multivariate logistic regression analysis was used to assess the predictive value of these markers for sHLH development. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for each factor to evaluate its significance. Receiver operating characteristic (ROC) curves were constructed to assess the sensitivity and specificity of the model. Results. We analyzed a number of factors as potential early sHLH markers, including medication history (treatment with oral or injectable glucocorticoids (GCs) before sHLH, immunosuppressants (methotrexate, cyclosporine, or leflunomide), and biologicals (tocilizumab, canakinumab, adalimumab, etanercept)), clinical signs (fever, rash, hepatomegaly, splenomegaly, lymphadenopathy, myalgia, hemorrhagic syndrome, central nervous system (CNS) lesions, kidney lesions, lung lesions, heart lesions), and laboratory parameters (hemoglobin, absolute count of red blood cells (RBCs), white blood cells (WBCs), neutrophils, lymphocytes, and platelets, erythrocyte sedimentation rate (ESR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), lactate dehydrogenase (LDH), creatinine, blood urea, c-reactive protein (CRP), ferritin, triglycerides, procalcitonin (PCT), total protein, albumin, blood electrolytes (sodium, potassium, chlorides, iron), coagulation parameters (Quick prothrombin, thrombin time, prothrombin time, international normalized ratio (INR), partial thromboplastin time (APTT), D-dimer, fibrinogen, fibrin monomer, von Willebrand factor, protein S, and protein C). Our prognostic model demonstrated that the following variables were significant predictors of sHLH in sJIA patients: lymphadenopathy, red blood cell count <4.34 × 106 cells/mL, platelets <208 × 103 c","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67748381","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":"Necrotizing enterocolitis in newborns with congenital heart defects: incidence and risk factors","authors":"A. Kaplina, N. Petrova, V. Nikiforov, T. Pervunina, A. I. Khavkin, Y. Markova, A. Sukhotskaya, T.V. Podgurskaya, S. Sitkin","doi":"10.20953/1817-7646-2022-6-62-73","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-6-62-73","url":null,"abstract":"Necrotizing enterocolitis (NEC) is a serious complication in newborns with critical congenital heart disease (CHD), prolonging hospital stay, worsening neurological prognosis, and increasing mortality. The leading role in the pathogenesis of NEC in these infants is the violation of mesenteric perfusion. A decrease in arterial blood oxygenation may be an additional risk factor for intestinal hypoxia. Objective. To assess the incidence and risk factors for NEC in full-term newborns with CHD born in 2019–2021 at the Perinatal Center of Almazov National Research Medical Center. Patients and methods. The article presents an analysis of the frequency and risk factors of NEC in children with CHD born at the Almazov National Medical Research Centre in 2019–2021. In the group of critical and duct-dependent CHD (n = 264), the overall incidence of NEC was 15.9% (42 cases). The frequency of surgical stages of NEC (IIIA) was 1.1% (3 cases). In the preoperative period, there was a trend towards a higher frequency of inotropic therapy in a subgroup of children who subsequently developed NEC. NEC in newborns with duct-dependent CHD developed mainly in the early postoperative period after cardiac surgery. In children with duct-dependent pulmonary blood flow, a higher incidence of NEC after surgery was noted compared to children with duct-dependent systemic blood flow. Conclusion. Risk factors for NEC in the postoperative period were arterial hypotension and hemodynamically significant cardiac arrhythmias. Dysbiosis of the gut microbiota and changes in microbial metabolism may be additional risk factors for NEC in children with CHD. Key words: necrotizing enterocolitis, risk factors, congenital heart disease, cardiopulmonary bypass, intestinal microbiome, metabolomics","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67748747","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":"Role of antiviral therapy in respiratory infections in children: analysis of clinical and laboratory observations","authors":"M. Savenkova, E. Isaeva, E. Vetrova, G. Kraseva, N. A. Abramova, M. Shabat, R. Dushkin, S. Fadeeva, S. Kontio, M. P. Savenkov","doi":"10.20953/1817-7646-2022-6-45-54","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-6-45-54","url":null,"abstract":"Objective. To evaluate the efficacy of therapy for acute respiratory viral infections (ARVIs) in children with antiviral medications: inosine pranobex (Groprinosin®, Gedeon Richter) and Kagocel (Kagocel®, Niarmedic Pharma LLC) in comparison with symptomatic treatment without etiotropic agents based on clinical and laboratory parameters. Patients and methods. The clinical and laboratory observation was conducted in an outpatient setting in the pre-COVID-19 period between 2018 and 2020. Acute respiratory infections were diagnosed using licensed testing systems by multiplex polymerase chain reaction (PCR) with detection of nucleic acid viral genomes: influenza, rhinovirus, respiratory syncytial virus, metapneumovirus, parainfluenza, seasonal coronaviruses, adenoviruses, and bocavirus). A total of 151 children aged 3 to 15 years were examined and monitored in dynamics, with 78.7% of positive and 21.3% of negative results detected by PCR in the nasopharyngeal and oropharyngeal swabs. The patients were randomized into three groups depending on the antiviral medication prescribed: group 1 (53 children) received Groprinosin®; group 2 (52 children) received Kagocel®; group 3 (control, 46 children) received only symptomatic therapy without antiviral agents. Results. The study demonstrated a significant positive effect in patients in group 1 treated with Groprinosin® (n = 53). At the end of therapy for both mono- and mixed infections, there were 95.8% of negative results (according to PCR diagnosis, that is, the absence of viral genome). In children in group 2 (n = 52) treated with Kagocel®, the absence of viral nucleic acids (NAs) was observed less frequently (in 77.3% of cases). In children in group 3 (n = 46) who did not receive etiotropic antiviral therapy, there were only 40.3% of negative results after the end of treatment, and viral NAs were detected in 59.7% of patients. In this case, a 5-day course of Groprinosin® was prescribed, after which the PCR results became negative in all patients. Therefore, children with recurrent respiratory infections, mixed infections, and herpesvirus infections require longer therapy. Additionally, a high frequency of ARVI complications was noted in group 3 (5 (10.9%) patients, where otitis was observed in 1 case, sinusitis – in 2 cases, bronchitis – in 2 cases), whereas 1 (1.8%) patient taking Groprinosin® had otitis, and 1 (1.9%) patient taking Kagocel® had pneumonia. Conclusion. This study was the first to investigate antibody titers to respiratory viruses in dynamics at 3, 6 and 12 months after the onset of ARVI. It showed that the development of antibodies to respiratory viruses is very unstable and does not occur in all patients. Antibodies almost disappeared by the third month after ARVI and were no longer detectable by the sixth month. After 12 months, patients suffered a new ARVI and developed the corresponding antibodies. This information will be especially relevant in conditions of the rise in the incidence","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67749075","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":"Phenotypic manifestations of the CFTR c.3140-16T>A (3272-16T>A) variant in homozygous state in a child with cystic fibrosis","authors":"V. Shadrina, Y. Melyanovskaya, E. Furman","doi":"10.20953/1817-7646-2022-3-109-112","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-3-109-112","url":null,"abstract":"We report a case of cystic fibrosis (CF) in a 9-year-old child with the rare c.3140-16T>A (3272-16T>A) variant of the CFTR gene in homozygous state. CF was suspected at neonatal screening. The results of the sweat test (Nanoduct) were 88 and 84 mmol/L. Since the age of 1.5 months, the patient received inhalation of dornase alfa, kinesitherapy, pancreatic enzymes (only in case of abundant intake of fatty foods), and vitamin therapy. The boy early developed cough with sputum; at the age of 5 years, he also developed chronic sinusitis. At the age of 3 years, his level of fecal pancreatic elastase 1 was 597 μg/g, which indicated preserved exocrine function of the pancreas. At the age of 9 years, the boy demonstrated normal physical development and lung function (examined using spirometry). Computed tomography showed no bronchiectasis. X-ray revealed radiological signs of chronic sinusitis. The assessment of intestinal current measurement (ICM) demonstrated a reduced CFTR function typical of mild genetic variants. Thus, the patient with the c.3140-16T>A (3272-16T>A) variant in homozygous state has developed only chronic rhinosinusitis by the age of 9 years. Measurement of ICM confirmed the diagnosis of mild CF genotype. Key words: c.3140-16T>A (3272-16T>A) genetic variant, cystic fibrosis, mild phenotype","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67743778","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":"Functional gastrointestinal disorders in infants: is it possible to treat them with infant formulas?","authors":"I.N.Kholodova I.N.Kholodova, E.S.Kiseleva E.S.Kiseleva","doi":"10.20953/1817-7646-2022-1-157-166","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-1-157-166","url":null,"abstract":"The etiology, pathogenesis, and characteristics of neonatal colic are being actively explored by clinicians and researchers. The impact of nutrition on colic in newborns is still not fully understood and requires further investigations. This article discusses the role of functional nutrients of infant formulas (including prebiotics and probiotics) in the prevention and correction of colic in newborns and their impact on the formation of the intestinal microbiota. It also focuses on the effect of prebiotics in the diet on the intestinal microbiome composition, severity of colic in newborns, and association between the presence of probiotic cultures in the diet and development of colic. We emphasize the importance of studying microbiome composition and metabolites produced by intestinal commensals, including short-chain fatty acids. We also describe possible prebiotic and probiotic effects of infant formula containing goat milk. Key words: infantile colic, infant formula, prebiotics, prebiotics, oligosaccharides 2'-FL, GOS, Bifidobacterium lactis, gut microbiota, goat milk","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67741289","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":"Changes in the body mass index of children, adolescents, and youth: trends observed in the end of the 20th century and beginning of the 21st century","authors":"V. Lyakh, S. Levushkin, N. Skoblina","doi":"10.20953/1817-7646-2022-1-185-189","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-1-185-189","url":null,"abstract":"The investigation of changes in the parameters reflecting physical development of children, adolescents, and youth under the influence of genetic, environmental, social, and other factors has both scientific and practical value. Objective. To analyze changes in the body mass index (BMI) of children, adolescents, and youth in the late 20th century and early 21st century in different countries. We used the information form the Scopus database and Russian citation databases. We observed global secular trends demonstrating increasing BMI index and the number of overweight and obese children, adolescents, and youth. The last 40 years were characterized by particularly worrying trends with the proportion of overweight and obese children and adolescents reaching 25.0%. From pathophysiological point of view, this leads to a number of metabolic diseases. In countries with a well-developed industrial sector, the secular trends in height of children, adolescents, and youth weakened in the last decade of the 20th century and in the beginning of the 21st century. By contrast, their body weight continued to increase during this period. Conclusion. Overweight and obesity have become so widespread globally that many researchers are currently talking about an obesity epidemic. Key words: children, body mass index, physical development","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67741610","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":"Screening of palatopharyngeal incoordination in mechanically ventilated critically ill infants","authors":"H. Youssef, A. R. Rezk, A. Mohamed, A. Salem, Asim A Mohamed","doi":"10.20953/1817-7646-2022-5-20-27","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-5-20-27","url":null,"abstract":"Objective. Screening of palatopharyngeal incoordination in infants who required mechanical ventilation. Patients and methods. This study included 51 patients admitted to the pediatric intensive care unit (PICU), Faculty of Medicine, Ain Shams University. The study was conducted during the period from February 2021 to February 2022. All patients were divided into five groups according to the results of the Fiberoptic Flexible Endoscopic Evaluation of Swallowing (FEES) postintubation, FEES post-extubation, Videofluoroscopic Swallow Study (VFSS) post-extubation, and dye study: group 1 – not affected infants, group 2 – infants with palatopharyngeal incoordination, group 3 – infants with palatopharyngeal incoordination and gastroesophageal reflux, group 4 – infants with reflux, group 5 – infants with congenital upper air way anomalies. Results. Palatopharyngeal incoordination was detected in 16 (31.3%) patients, congenital upper airway anomalies – in 12 (23.5%) patients, and gastroesophageal reflux – in 10 (19.6%) patients. After three months, palatopharyngeal incoordination was resolved in 92.3% of patients, and 7.7 % had silent aspiration. Conclusion. Palatopharyngeal incoordination is a multifactorial process with the important implications for early diagnosis and interventions to treat this condition in pediatric patients. Key words: silent aspiration, mechanical ventilation, infants, palatopharyngeal incoordination","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67747597","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":"Probiotics and probiotic products for children with intestinal disorders","authors":"A. Khavkin, M. Gurova, V. Novikova, A. Vashura","doi":"10.20953/1817-7646-2022-6-97-105","DOIUrl":"https://doi.org/10.20953/1817-7646-2022-6-97-105","url":null,"abstract":"This article outlines current concepts of probiotic drugs and probiotic foods for children, provides the list of gastrointestinal disorders in children that can be considered as indications for probiotics, as well as their mechanism of action. Particular attention is paid to probiotic use according to the criteria of evidence-based medicine. The review also focuses on the positive role of the probiotic strain Bifidobacterium animalis subsp. lactis in the treatment and prevention of gastroenterological disorders in children, both as part of pharmacotherapy and enriched food products. Key words: intestinal microbiota, dysbiosis, Bifidobacterium animalis subsp. lactis, probiotics, probiotic foods for children","PeriodicalId":38157,"journal":{"name":"Voprosy Prakticheskoi Pediatrii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67749320","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}