Pub Date : 2025-02-01DOI: 10.1016/j.jpeds.2024.114395
Ayman Abou Mehrem MD, MSc, Marc Beltempo MD, MSc
{"title":"Noninvasive Respiratory Support for Stabilization After Birth is a Safe Approach in Infants Who are Micropreterm","authors":"Ayman Abou Mehrem MD, MSc, Marc Beltempo MD, MSc","doi":"10.1016/j.jpeds.2024.114395","DOIUrl":"10.1016/j.jpeds.2024.114395","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114395"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jpeds.2024.114380
Tandy Aye MD , David A. Turner MD , Angela S. Czaja MD, MSc, PhD , Cynthia M. Holland-Hall MD, MPH , Mary E. Moffatt MD , Patrick J. Myers MD , Jill J. Fussell MD , Council of Pediatric Subspecialties (CoPS)
{"title":"Subspecialty Perspectives on the Education Needs for Pediatrics Residency Training","authors":"Tandy Aye MD , David A. Turner MD , Angela S. Czaja MD, MSc, PhD , Cynthia M. Holland-Hall MD, MPH , Mary E. Moffatt MD , Patrick J. Myers MD , Jill J. Fussell MD , Council of Pediatric Subspecialties (CoPS)","doi":"10.1016/j.jpeds.2024.114380","DOIUrl":"10.1016/j.jpeds.2024.114380","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114380"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jpeds.2024.114414
Alan M. Groves MBChB , Monica M. Bennett PhD , John Loyd MD , Reese H. Clark MD , Veeral N. Tolia MD
Objective
To describe the trends in percentage oxygen requirement and mode of respiratory support delivered to extremely premature infants in the 12 weeks after birth.
Study design
This is a retrospective study of extremely premature infants (≤276/7 weeks) discharged from neonatal intensive care units managed by Pediatrix Medical Group between January 1, 2016, and December 31, 2021. Demographic and daily clinical data (mode of respiratory support and fraction of inspired oxygen [FiO2]) were extracted from the Pediatrix Clinical Data Warehouse.
Results
A total of 16 386 infants with a median gestational age of 25 weeks and birthweight of 765 g were included. There were 3808 (23.2%) infants who died. Of the cohort, 6019 (43.1%) infants who survived to 36 weeks’ gestation had bronchopulmonary dysplasia. Median FiO2 at all gestations followed a biphasic pattern with a peak on day of life 1, reduction to a nadir by day 4 to 5, and an increase to a second peak around day 14. Infants born at lower gestational ages had a higher median FiO2 at each time point. At lower gestations, there were higher proportions of infants receiving mechanical ventilation and a later introduction of noninvasive modes.
Conclusions
Extremely premature infants show a consistent biphasic pattern in percentage of supplemental oxygen required after birth.
{"title":"Trajectory of Postnatal Oxygen Requirement in Extremely Preterm Infants","authors":"Alan M. Groves MBChB , Monica M. Bennett PhD , John Loyd MD , Reese H. Clark MD , Veeral N. Tolia MD","doi":"10.1016/j.jpeds.2024.114414","DOIUrl":"10.1016/j.jpeds.2024.114414","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the trends in percentage oxygen requirement and mode of respiratory support delivered to extremely premature infants in the 12 weeks after birth.</div></div><div><h3>Study design</h3><div>This is a retrospective study of extremely premature infants (≤27<sup>6/7</sup> weeks) discharged from neonatal intensive care units managed by Pediatrix Medical Group between January 1, 2016, and December 31, 2021. Demographic and daily clinical data (mode of respiratory support and fraction of inspired oxygen [FiO<sub>2</sub>]) were extracted from the Pediatrix Clinical Data Warehouse.</div></div><div><h3>Results</h3><div>A total of 16 386 infants with a median gestational age of 25 weeks and birthweight of 765 g were included. There were 3808 (23.2%) infants who died. Of the cohort, 6019 (43.1%) infants who survived to 36 weeks’ gestation had bronchopulmonary dysplasia. Median FiO<sub>2</sub> at all gestations followed a biphasic pattern with a peak on day of life 1, reduction to a nadir by day 4 to 5, and an increase to a second peak around day 14. Infants born at lower gestational ages had a higher median FiO<sub>2</sub> at each time point. At lower gestations, there were higher proportions of infants receiving mechanical ventilation and a later introduction of noninvasive modes.</div></div><div><h3>Conclusions</h3><div>Extremely premature infants show a consistent biphasic pattern in percentage of supplemental oxygen required after birth.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114414"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jpeds.2024.114088
Massimo Pettoello-Mantovani MD, PhD , Donjeta Bali MD , Maria Pastore MD , Ida Giardino MD , Leyla Namazova-Baranova MD, PhD , Georgios Konstantinidis MD , Mehmet Vural MD
{"title":"The Pressing Issue of Food Safety for Infants and the Role of the Pediatrician","authors":"Massimo Pettoello-Mantovani MD, PhD , Donjeta Bali MD , Maria Pastore MD , Ida Giardino MD , Leyla Namazova-Baranova MD, PhD , Georgios Konstantinidis MD , Mehmet Vural MD","doi":"10.1016/j.jpeds.2024.114088","DOIUrl":"10.1016/j.jpeds.2024.114088","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114088"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jpeds.2024.114409
Courtney Temple MD, Emma Cassidy MD, Robert G. Hendrickson MD
Children exposed to illicit fentanyl often experience severe toxicity and receive repeated naloxone doses and prolonged airway support. This retrospective study presents the clinical course and management of 4 cases, emphasizing the urgent need for prompt recognition and intervention to address the severe, extended effects of illicit fentanyl exposure in very young children.
{"title":"Characteristics of Fentanyl Toxicity in Very Young Children","authors":"Courtney Temple MD, Emma Cassidy MD, Robert G. Hendrickson MD","doi":"10.1016/j.jpeds.2024.114409","DOIUrl":"10.1016/j.jpeds.2024.114409","url":null,"abstract":"<div><div>Children exposed to illicit fentanyl often experience severe toxicity and receive repeated naloxone doses and prolonged airway support. This retrospective study presents the clinical course and management of 4 cases, emphasizing the urgent need for prompt recognition and intervention to address the severe, extended effects of illicit fentanyl exposure in very young children.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114409"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jpeds.2025.114467
Paul G. Fisher MD
{"title":"Step Up After Concussion","authors":"Paul G. Fisher MD","doi":"10.1016/j.jpeds.2025.114467","DOIUrl":"10.1016/j.jpeds.2025.114467","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114467"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/S0022-3476(24)00554-7
{"title":"Information for Readers","authors":"","doi":"10.1016/S0022-3476(24)00554-7","DOIUrl":"10.1016/S0022-3476(24)00554-7","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114451"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jpeds.2025.114468
Thomas R. Welch MD
{"title":"One of the Most Common Diseases You May Never Have Heard About","authors":"Thomas R. Welch MD","doi":"10.1016/j.jpeds.2025.114468","DOIUrl":"10.1016/j.jpeds.2025.114468","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114468"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jpeds.2024.114411
Marie-Coralie Cornet MD, PhD , Adam L. Numis MD , Sarah E. Monsell MS , Natalie H. Chan MD, MPH , Fernando F. Gonzalez MD , Bryan A. Comstock MS , Sandra E. Juul MD, PhD , Courtney J. Wusthoff MD, MS , Yvonne W. Wu MD, MPH , Hannah C. Glass MDCM, MAS
Objective
To assess the relationship between the Sarnat exam, early electroencephalogram (EEG) background, and death or neurodevelopmental impairment (NDI) at age 2 years among neonates with moderate to severe hypoxic-ischemic encephalopathy treated with therapeutic hypothermia.
Study design
Neonates enrolled in the High-dose Erythropoietin for Asphyxia and Encephalopathy trial with EEG (n = 463) or amplitude-integrated electroencephalogram (n = 15) reports available on the first day after birth were included in this cohort study. A Sarnat exam was performed between 1 and 6 hours after birth, and neonates were classified into 3 groups of increasing severity based on the number of severe features (none, 1-2, or 3+). EEG background continuity was extracted from reports and categorized as normal, excessively discontinuous, or severely abnormal. The primary outcome was severe NDI or death at age 2.
Results
Among 478 neonates with hypoxic-ischemic encephalopathy, EEG background continuity was normal in 186 (39%), excessively discontinuous in 171 (36%), and severely abnormal in 121 (25%). For each additional severe feature on the Sarnat exam, the risk of abnormal EEG background increased by 16% (relative risk 1.16 [95% CI 1.09-1.23]). Both the Sarnat exam and EEG background severity were associated with an increased risk of severe NDI or death. After adjusting for Sarnat exam severity, severe EEG background remained associated with severe NDI and death (relative risk 5.7 [95% CI 3.7-8.9]).
Conclusions
The early EEG background provides additional information beyond the Sarnat exam and could be an additional early marker when assessing the severity of HIE.
研究目的评估接受治疗性低温的中重度缺氧缺血性脑病(HIE)新生儿的萨纳特检查、早期脑电图(EEG)背景与两岁时死亡或神经发育障碍(NDI)之间的关系:研究设计:参加 "高剂量促红细胞生成素治疗窒息和脑病(HEAL)"试验的新生儿在出生后第一天即可获得脑电图(463 例)或 aEEG(15 例)报告,这些新生儿被纳入本队列研究。新生儿在出生后 1 到 6 小时之间进行 Sarnat 检查,并根据严重特征的数量(无、1 到 2 或 3+)将其分为严重程度依次递增的三组。从报告中提取脑电图背景连续性,并将其分为正常、过度不连续或严重异常。主要结果是两岁时出现严重NDI或死亡:在 478 例 HIE 新生儿中,186 例(39%)脑电图背景连续性正常,171 例(36%)过度不连续,121 例(25%)严重异常。萨纳特检查每增加一个严重特征,脑电图背景异常的风险就增加 16% (RR 1.16 [95% CI 1.09-1.23])。萨纳特检查和脑电图背景严重程度都与严重 NDI 或死亡风险的增加有关。调整 Sarnat 检查严重程度后,严重脑电图背景仍与严重 NDI 和死亡相关(RR 5.7 [95% CI 3.7-8.9]):结论:早期脑电图背景提供了 Sarnat 检查以外的额外信息,可作为评估 HIE 严重程度的额外早期标志物。
{"title":"Assessing Early Severity of Hypoxic-Ischemic Encephalopathy: The Role of Electroencephalogram Background in Addition to Sarnat Exam","authors":"Marie-Coralie Cornet MD, PhD , Adam L. Numis MD , Sarah E. Monsell MS , Natalie H. Chan MD, MPH , Fernando F. Gonzalez MD , Bryan A. Comstock MS , Sandra E. Juul MD, PhD , Courtney J. Wusthoff MD, MS , Yvonne W. Wu MD, MPH , Hannah C. Glass MDCM, MAS","doi":"10.1016/j.jpeds.2024.114411","DOIUrl":"10.1016/j.jpeds.2024.114411","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the relationship between the Sarnat exam, early electroencephalogram (EEG) background, and death or neurodevelopmental impairment (NDI) at age 2 years among neonates with moderate to severe hypoxic-ischemic encephalopathy treated with therapeutic hypothermia.</div></div><div><h3>Study design</h3><div>Neonates enrolled in the High-dose Erythropoietin for Asphyxia and Encephalopathy trial with EEG (n = 463) or amplitude-integrated electroencephalogram (n = 15) reports available on the first day after birth were included in this cohort study. A Sarnat exam was performed between 1 and 6 hours after birth, and neonates were classified into 3 groups of increasing severity based on the number of severe features (none, 1-2, or 3+). EEG background continuity was extracted from reports and categorized as normal, excessively discontinuous, or severely abnormal. The primary outcome was severe NDI or death at age 2.</div></div><div><h3>Results</h3><div>Among 478 neonates with hypoxic-ischemic encephalopathy, EEG background continuity was normal in 186 (39%), excessively discontinuous in 171 (36%), and severely abnormal in 121 (25%). For each additional severe feature on the Sarnat exam, the risk of abnormal EEG background increased by 16% (relative risk 1.16 [95% CI 1.09-1.23]). Both the Sarnat exam and EEG background severity were associated with an increased risk of severe NDI or death. After adjusting for Sarnat exam severity, severe EEG background remained associated with severe NDI and death (relative risk 5.7 [95% CI 3.7-8.9]).</div></div><div><h3>Conclusions</h3><div>The early EEG background provides additional information beyond the Sarnat exam and could be an additional early marker when assessing the severity of HIE.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114411"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jpeds.2024.114407
Mathies Rondagh MD , Linda S. de Vries MD, PhD , Andrea van Steenis MD , Unoke Meder MD , Laszlo Szakacs MSc , Agnes Jermendy MD, PhD, MPI , Sylke J. Steggerda MD, PhD
Objectives
To validate the prognostic accuracy of a previously published tool (HOPE calculator) using longitudinal analysis of amplitude-integrated electroencephalography (aEEG) background activity and sleep-wake cycling to predict favorable or adverse 2-year neurodevelopmental outcome in infants with hypoxic-ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH), and to evaluate the predictive value for outcome at 5-8 years of age.
Study design
Single-center retrospective cohort study in 117 infants who underwent TH for HIE between 2008 and 2022. We scored 2-channel aEEG BGPs, sleep-wake cycling, and seizure activity at 6-hour intervals for 84 hours. Neurodevelopmental outcome at 2 years was evaluated using the Bayley Scales of Infant Development-III, defining adverse outcome as death, cerebral palsy, and/or cognitive/motor scores of <85. Adverse outcome at 5-8 years was defined as a total IQ score of <85, a Movement-ABC-2 score of less than p15, cerebral palsy, severe sensory impairment, or death.
Results
The prediction model showed an area under the curve of 0.90 (95% CI, 0.83-0.95) at 2 years and 0.83 (95% CI, 0.73-0.92) at 5-8 years. Mean predicted probability of favorable outcome was 74.5% (95% CI, 69.4-79.6) in the favorable outcome group compared with 32.8% (95% CI, 23.5-42.2) in the adverse outcome group (P < .001) at 2 years (n = 115) and 76.85% (95% CI, 70.0-83.4) compared with 40.7% (95% CI, 30.0-51.4) at 5-8 years (n = 68).
Conclusions
Our study provided external validation of the HOPE calculator, assessing longitudinal aEEG background activity during TH in infants with HIE. The results suggest that this method can predict favorable or adverse outcomes accurately not only at 2 but also at 5-8 years of age.
{"title":"Longitudinal Analysis of Amplitude-Integrated Electroencephalography for Outcome Prediction in Infants with Hypoxic-Ischemic Encephalopathy: A Validation Study","authors":"Mathies Rondagh MD , Linda S. de Vries MD, PhD , Andrea van Steenis MD , Unoke Meder MD , Laszlo Szakacs MSc , Agnes Jermendy MD, PhD, MPI , Sylke J. Steggerda MD, PhD","doi":"10.1016/j.jpeds.2024.114407","DOIUrl":"10.1016/j.jpeds.2024.114407","url":null,"abstract":"<div><h3>Objectives</h3><div>To validate the prognostic accuracy of a previously published tool (HOPE calculator) using longitudinal analysis of amplitude-integrated electroencephalography (aEEG) background activity and sleep-wake cycling to predict favorable or adverse 2-year neurodevelopmental outcome in infants with hypoxic-ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH), and to evaluate the predictive value for outcome at 5-8 years of age.</div></div><div><h3>Study design</h3><div>Single-center retrospective cohort study in 117 infants who underwent TH for HIE between 2008 and 2022. We scored 2-channel aEEG BGPs, sleep-wake cycling, and seizure activity at 6-hour intervals for 84 hours. Neurodevelopmental outcome at 2 years was evaluated using the Bayley Scales of Infant Development-III, defining adverse outcome as death, cerebral palsy, and/or cognitive/motor scores of <85. Adverse outcome at 5-8 years was defined as a total IQ score of <85, a Movement-ABC-2 score of less than p15, cerebral palsy, severe sensory impairment, or death.</div></div><div><h3>Results</h3><div>The prediction model showed an area under the curve of 0.90 (95% CI, 0.83-0.95) at 2 years and 0.83 (95% CI, 0.73-0.92) at 5-8 years. Mean predicted probability of favorable outcome was 74.5% (95% CI, 69.4-79.6) in the favorable outcome group compared with 32.8% (95% CI, 23.5-42.2) in the adverse outcome group (<em>P</em> < .001) at 2 years (n = 115) and 76.85% (95% CI, 70.0-83.4) compared with 40.7% (95% CI, 30.0-51.4) at 5-8 years (n = 68).</div></div><div><h3>Conclusions</h3><div>Our study provided external validation of the HOPE calculator, assessing longitudinal aEEG background activity during TH in infants with HIE. The results suggest that this method can predict favorable or adverse outcomes accurately not only at 2 but also at 5-8 years of age.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114407"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}