Background: Neonatal Cholestasis (NC) is a sign of hepatobiliary disorder due to various etiologies. In the neonatal intensive care unit (NICU) extensive evaluvation is done to rule out treatable causes. Neonates with fetal growth retardation (FGR) have an increased incidence of cholestasis. Aim: To determine the prevalence, management, additional healthcare cost and outcome of cholestasis in neonates born with FGR. Methods: Retrospective review of all neonates admitted to the NICU at Valley Children’s Hospital, from January 1, 2021 to December 31, 2022 was done. Data of the infants with FGR was collected. Results: Of 2850 infants admitted in the 2-year period, 42 had a birth weight of less than 10th percentile, of which 19 developed cholestasis (45%). 12 of the 19 infants were preterm infants and 7 were term infants. Average gestational age at birth was 31.6 and average direct bilirubin of 5.2 mg/dL. The average length of stay was 54 days Of the 19 infants who developed NC, 8 were discharged on ursodiol and followed up in gastroenterology clinic. 17 showed resolution of NC within 6 months of discharge. Some infants underwent extensive work-up. Costs for the work-up added up to an average of $8,920. Conclusion: Prognosis for NC in the FGR neonates appears to be good with resolution in our study population within the first year of life. Hence, it may be safe to monitor these neonates with outpatient followup with early limited evaluation until complete resolution of cholestasis.
{"title":"Cholestasis in neonates with fetal growth restriction","authors":"Bhavishya Devireddy, Archana Lingannan, Indira Chandrasekar","doi":"10.46439/pediatrics.3.022","DOIUrl":"https://doi.org/10.46439/pediatrics.3.022","url":null,"abstract":"Background: Neonatal Cholestasis (NC) is a sign of hepatobiliary disorder due to various etiologies. In the neonatal intensive care unit (NICU) extensive evaluvation is done to rule out treatable causes. Neonates with fetal growth retardation (FGR) have an increased incidence of cholestasis.\u0000\u0000Aim: To determine the prevalence, management, additional healthcare cost and outcome of cholestasis in neonates born with FGR.\u0000\u0000Methods: Retrospective review of all neonates admitted to the NICU at Valley Children’s Hospital, from January 1, 2021 to December 31, 2022 was done. Data of the infants with FGR was collected.\u0000\u0000Results: Of 2850 infants admitted in the 2-year period, 42 had a birth weight of less than 10th percentile, of which 19 developed cholestasis (45%). 12 of the 19 infants were preterm infants and 7 were term infants. Average gestational age at birth was 31.6 and average direct bilirubin of 5.2 mg/dL. The average length of stay was 54 days Of the 19 infants who developed NC, 8 were discharged on ursodiol and followed up in gastroenterology clinic. 17 showed resolution of NC within 6 months of discharge. Some infants underwent extensive work-up. Costs for the work-up added up to an average of $8,920.\u0000\u0000Conclusion: Prognosis for NC in the FGR neonates appears to be good with resolution in our study population within the first year of life. Hence, it may be safe to monitor these neonates with outpatient followup with early limited evaluation until complete resolution of cholestasis.","PeriodicalId":93307,"journal":{"name":"Journal of clinical pediatrics and neonatology","volume":"38 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138952497","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}
Pub Date : 2023-12-21DOI: 10.46439/pediatrics.3.021
Md. Abdul Mannan
Background: Retinopathy of prematurity (ROP), a leading cause of childhood blindness, occurs in premature babies. Several factors like perinatal infection, inflammation, hypoxia, hypercapnia, higher oxygen support etc. have been attributed to the cause. Identifying the potentially modifiable risk factors will contribute to making preventive strategy. Objective: To identify the frequency and risk factors of ROP in premature babies. Methodology: This prospective observational study was conducted in the Department of Neonatology of BSMMU after approval from the institutional review board over a period of twelve months. Infants born <35 completed weeks, weighing <2000 g admitted in NICU are included in this study. After enrollment, screening for ROP was done at 20 days for the baby -gestational age of ≤ 30 weeks or birth weight ≤ 1200 g and at 30 days for the baby- gestational age ≤ 35 weeks or birth weight ≤ 2000g. ROP screening test was done by a pediatric ophthalmologist with indirect Ophthalmoscope. The outcome measures were the frequency and risk factors of ROP. Results: Between 2021 and 2022, 154 infants born ≤ 35 weeks gestation, weighing ≤ 2000 g were screened for ROP. Among the studied cases 30 (19.5%) patients had ROP. Among the 30 patients, 16 (53.33%) had AP-ROP, 3 (10%) had plus disease and 3 (10%) had stage IV (6.67%) ROP. Among the newborns diagnosed with ROP, 23 (76.67%) required treatments. Among them, Inj. Avastin was given to 18 (78.26%) patients, 5 (21.7%) needed Laser therapy but none of them required surgery. Univariate analysis showed risk of ROP was significantly higher in lower gestational age and lower birth weight group. Frequency of sepsis, duration of oxygen support, need for CPAP, hospital stay, and Intraventricular hemorrhage (IVH) were significantly higher among ROP group. Antenatal corticosteroid significantly lowered the risk of ROP. Multivariate analysis also showed that antenatal corticosteroid had protective effect against ROP and prematurity, lower birth weight, sepsis, longer duration of oxygen therapy, and longer duration of hospital stay increased the risk of ROP. Conclusions: This prospective observational study showed frequency of ROP was 19.5%. Prematurity, lower birth weight, lack of antenatal-corticosteroid, sepsis, longer duration of oxygen support, and longer hospital stay are some potential risk factors of developing ROP
{"title":"Frequency and risk factors of retinopathy of prematurity among preterm neonates in a tertiary care hospital of Bangladesh","authors":"Md. Abdul Mannan","doi":"10.46439/pediatrics.3.021","DOIUrl":"https://doi.org/10.46439/pediatrics.3.021","url":null,"abstract":"Background: Retinopathy of prematurity (ROP), a leading cause of childhood blindness, occurs in premature babies. Several factors like perinatal infection, inflammation, hypoxia, hypercapnia, higher oxygen support etc. have been attributed to the cause. Identifying the potentially modifiable risk factors will contribute to making preventive strategy.\u0000\u0000Objective: To identify the frequency and risk factors of ROP in premature babies.\u0000\u0000Methodology: This prospective observational study was conducted in the Department of Neonatology of BSMMU after approval from the institutional review board over a period of twelve months. Infants born <35 completed weeks, weighing <2000 g admitted in NICU are included in this study. After enrollment, screening for ROP was done at 20 days for the baby -gestational age of ≤ 30 weeks or birth weight ≤ 1200 g and at 30 days for the baby- gestational age ≤ 35 weeks or birth weight ≤ 2000g. ROP screening test was done by a pediatric ophthalmologist with indirect Ophthalmoscope. The outcome measures were the frequency and risk factors of ROP.\u0000\u0000Results: Between 2021 and 2022, 154 infants born ≤ 35 weeks gestation, weighing ≤ 2000 g were screened for ROP. Among the studied cases 30 (19.5%) patients had ROP. Among the 30 patients, 16 (53.33%) had AP-ROP, 3 (10%) had plus disease and 3 (10%) had stage IV (6.67%) ROP. Among the newborns diagnosed with ROP, 23 (76.67%) required treatments. Among them, Inj. Avastin was given to 18 (78.26%) patients, 5 (21.7%) needed Laser therapy but none of them required surgery. Univariate analysis showed risk of ROP was significantly higher in lower gestational age and lower birth weight group. Frequency of sepsis, duration of oxygen support, need for CPAP, hospital stay, and Intraventricular hemorrhage (IVH) were significantly higher among ROP group. Antenatal corticosteroid significantly lowered the risk of ROP. Multivariate analysis also showed that antenatal corticosteroid had protective effect against ROP and prematurity, lower birth weight, sepsis, longer duration of oxygen therapy, and longer duration of hospital stay increased the risk of ROP.\u0000\u0000Conclusions: This prospective observational study showed frequency of ROP was 19.5%. Prematurity, lower birth weight, lack of antenatal-corticosteroid, sepsis, longer duration of oxygen support, and longer hospital stay are some potential risk factors of developing ROP","PeriodicalId":93307,"journal":{"name":"Journal of clinical pediatrics and neonatology","volume":"106 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138994131","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}
Pub Date : 2023-05-08DOI: 10.46439/pediatrics.3.020
S. Bittmann
{"title":"Pediatric telemedicine and abdominal pain in children","authors":"S. Bittmann","doi":"10.46439/pediatrics.3.020","DOIUrl":"https://doi.org/10.46439/pediatrics.3.020","url":null,"abstract":"","PeriodicalId":93307,"journal":{"name":"Journal of clinical pediatrics and neonatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48527136","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}
Pub Date : 2023-02-07DOI: 10.24966/ncp-878x/100103
S. Miranda
Infantile Myofibroma (IM) is a rare, benign tumor that affects infants and young children, presenting as a solitary or multicentric nodular mass involving the skin, muscles, bones, and/or visceral organs
{"title":"A Solitary Infantile Myofibroma – Case Report","authors":"S. Miranda","doi":"10.24966/ncp-878x/100103","DOIUrl":"https://doi.org/10.24966/ncp-878x/100103","url":null,"abstract":"Infantile Myofibroma (IM) is a rare, benign tumor that affects infants and young children, presenting as a solitary or multicentric nodular mass involving the skin, muscles, bones, and/or visceral organs","PeriodicalId":93307,"journal":{"name":"Journal of clinical pediatrics and neonatology","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90727620","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}
Pub Date : 2023-02-07DOI: 10.24966/ncp-878x/100104
Joana Vilaça
Obstructive shock is the least common type of pediatric shock. It results from obstruction of cardiac output, with intra-abdominal masses being a rare cause
梗阻性休克是小儿休克中最不常见的一种。它是由心排血量梗阻引起的，腹内肿块是一种罕见的原因
{"title":"Obstructive shock as presentation of an abdominal mass - Case Report","authors":"Joana Vilaça","doi":"10.24966/ncp-878x/100104","DOIUrl":"https://doi.org/10.24966/ncp-878x/100104","url":null,"abstract":"Obstructive shock is the least common type of pediatric shock. It results from obstruction of cardiac output, with intra-abdominal masses being a rare cause","PeriodicalId":93307,"journal":{"name":"Journal of clinical pediatrics and neonatology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80194931","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}
Pub Date : 2022-12-31DOI: 10.46439/pediatrics.2.018
M. Gondwe, N. Desmond, M. Aminu, S. Allen
WHO developed a guideline for implementing stillbirth and neonatal death audits at healthcare facilities in 2016. Like many other poor resource countries, stillbirths and neonatal deaths rates remain high in Malawi despite implementation of audit. This paper assesses the quality of facility-based stillbirth and neonatal death audit implementation in Malawian hospitals and provides recommendations for improvement. In accordance with the WHO audit guidelines, we applied mixed methods to determine the quality of audit implementation in seven hospitals in Malawi. We reviewed hospital surveillance data; audit document forms and action plans. We sought staff perceptions and opinions through a questionnaire and interviews and observed audit meetings. Quantitative data was analysed using IBM SPSS 26.0 and presented using frequencies and proportions. Qualitative data were analysed using predefined themes in a survey guide. The frequency of audits and number of stillbirth and neonatal deaths audited varied significantly between hospitals. No hospital had national audit guidelines. Deficiencies included limited information on neonatal death audit data collection and reporting tools, incomplete documentation, lack of senior staff commitment and a blame or shame atmosphere. Audit meetings often did not start with review of ward statistics, previous minutes and follow-up as to whether previous recommendations had been implemented. Challenges in analysing audit information and recommending solutions resulted in lowquality action plans. No objective evidence was found that audit recommendations were implemented. Assessed according to WHO guidelines, audits were of low quality resulting in challenges in identifying and addressing factors contributing to mortality. We recommend regular audit implementation, with completion of audit cycles for audit to contribute to mortality reduction.
{"title":"Quality of stillbirth and neonatal death audit in Malawi: A descriptive observational study","authors":"M. Gondwe, N. Desmond, M. Aminu, S. Allen","doi":"10.46439/pediatrics.2.018","DOIUrl":"https://doi.org/10.46439/pediatrics.2.018","url":null,"abstract":"WHO developed a guideline for implementing stillbirth and neonatal death audits at healthcare facilities in 2016. Like many other poor resource countries, stillbirths and neonatal deaths rates remain high in Malawi despite implementation of audit. This paper assesses the quality of facility-based stillbirth and neonatal death audit implementation in Malawian hospitals and provides recommendations for improvement. In accordance with the WHO audit guidelines, we applied mixed methods to determine the quality of audit implementation in seven hospitals in Malawi. We reviewed hospital surveillance data; audit document forms and action plans. We sought staff perceptions and opinions through a questionnaire and interviews and observed audit meetings. Quantitative data was analysed using IBM SPSS 26.0 and presented using frequencies and proportions. Qualitative data were analysed using predefined themes in a survey guide. The frequency of audits and number of stillbirth and neonatal deaths audited varied significantly between hospitals. No hospital had national audit guidelines. Deficiencies included limited information on neonatal death audit data collection and reporting tools, incomplete documentation, lack of senior staff commitment and a blame or shame atmosphere. Audit meetings often did not start with review of ward statistics, previous minutes and follow-up as to whether previous recommendations had been implemented. Challenges in analysing audit information and recommending solutions resulted in lowquality action plans. No objective evidence was found that audit recommendations were implemented. Assessed according to WHO guidelines, audits were of low quality resulting in challenges in identifying and addressing factors contributing to mortality. We recommend regular audit implementation, with completion of audit cycles for audit to contribute to mortality reduction.","PeriodicalId":93307,"journal":{"name":"Journal of clinical pediatrics and neonatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44314251","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}
Pub Date : 2022-12-31DOI: 10.46439/pediatrics.2.017
Toshihiko Nakamura, Michiko Kusakari, Kana Ito, Shota Inoue, Eisuke Fukama, T. Nomura, D. Hatanaka, Hidehiro Takahashi
We experienced a female infant weighing 866 g at birth after 28 weeks 1 day gestation with apparent intrauterine infection. Bi-level-nasal CPAP was selected for respiratory management as a strategy to minimize the severity of chronic lung disease (CLD). As a result, she survived the acute phase without tracheal intubation and improved without requiring home oxygen therapy. Her urinary β2 microglobulin (u-BMG) in the early neonatal period was less than the cutoff value of 100,000 μg/gCr for the onset of CLD. However, her u-BMG then rose to a markedly high value that peaked at 3 weeks after birth. Her serum KL-6 was markedly high early after birth and increased sharply to a peak of 3016 U/mL on day 9. The increase in KL-6 in the early postnatal period indicated that lung tissue had already been injured by intrauterine inflammation, and although postnatal tracheal intubation was avoided, spontaneous breathing inevitably additionally injured the immature lung. It appears that substantial repair had occurred with fibrosis. It should be noted that the peak of u-BMG was delayed by more than 10 days from the peak of KL-6. This may suggest that the inflammatory cytokine interferon-γ, which increases the production of BMG, had not only an inflammatory effect that exacerbates lung damage, but also a biological self-defense effect that mainly suppresses lung fibrosis.
{"title":"Investigation of urinary β2 microglobulin; substitute for interferon-γ as a suppressor of pulmonary fibrosis in a preterm with chronic lung disease following intrauterine infection","authors":"Toshihiko Nakamura, Michiko Kusakari, Kana Ito, Shota Inoue, Eisuke Fukama, T. Nomura, D. Hatanaka, Hidehiro Takahashi","doi":"10.46439/pediatrics.2.017","DOIUrl":"https://doi.org/10.46439/pediatrics.2.017","url":null,"abstract":"We experienced a female infant weighing 866 g at birth after 28 weeks 1 day gestation with apparent intrauterine infection. Bi-level-nasal CPAP was selected for respiratory management as a strategy to minimize the severity of chronic lung disease (CLD). As a result, she survived the acute phase without tracheal intubation and improved without requiring home oxygen therapy. Her urinary β2 microglobulin (u-BMG) in the early neonatal period was less than the cutoff value of 100,000 μg/gCr for the onset of CLD. However, her u-BMG then rose to a markedly high value that peaked at 3 weeks after birth. Her serum KL-6 was markedly high early after birth and increased sharply to a peak of 3016 U/mL on day 9. The increase in KL-6 in the early postnatal period indicated that lung tissue had already been injured by intrauterine inflammation, and although postnatal tracheal intubation was avoided, spontaneous breathing inevitably additionally injured the immature lung. It appears that substantial repair had occurred with fibrosis. It should be noted that the peak of u-BMG was delayed by more than 10 days from the peak of KL-6. This may suggest that the inflammatory cytokine interferon-γ, which increases the production of BMG, had not only an inflammatory effect that exacerbates lung damage, but also a biological self-defense effect that mainly suppresses lung fibrosis.","PeriodicalId":93307,"journal":{"name":"Journal of clinical pediatrics and neonatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42950816","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}
Pub Date : 2022-12-31DOI: 10.46439/pediatrics.2.019
S. Nafday
Targeted hearing screening for congenital cytomegalovirus (cCMV) with CMV polymerase chain reaction testing completed before 3 weeks of age for infants who fail newborn hearing screening is a reasonable option to improve cCMV related non-genetic sensory-neural hearing loss (SNHL). Universal cCMV screening using dried blood spots that is used on almost newborn infants has the potential to benefit those children at risk for SNHL and will be a great public health option.
{"title":"Congenital Cytomegalovirus screening in newborns: Current status in the United States","authors":"S. Nafday","doi":"10.46439/pediatrics.2.019","DOIUrl":"https://doi.org/10.46439/pediatrics.2.019","url":null,"abstract":"Targeted hearing screening for congenital cytomegalovirus (cCMV) with CMV polymerase chain reaction testing completed before 3 weeks of age for infants who fail newborn hearing screening is a reasonable option to improve cCMV related non-genetic sensory-neural hearing loss (SNHL). Universal cCMV screening using dried blood spots that is used on almost newborn infants has the potential to benefit those children at risk for SNHL and will be a great public health option.","PeriodicalId":93307,"journal":{"name":"Journal of clinical pediatrics and neonatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47340655","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}
Pub Date : 2021-12-31DOI: 10.46439/pediatrics.1.015
{"title":"Epigenetics of pediatric liver cancer and potential therapy","authors":"","doi":"10.46439/pediatrics.1.015","DOIUrl":"https://doi.org/10.46439/pediatrics.1.015","url":null,"abstract":"","PeriodicalId":93307,"journal":{"name":"Journal of clinical pediatrics and neonatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49590329","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}
Pub Date : 2021-12-31DOI: 10.46439/pediatrics.1.014
{"title":"Hypothermic neuroprotection following neonatal hypoxic-ischemic encephalopathy: medico-legal implications","authors":"","doi":"10.46439/pediatrics.1.014","DOIUrl":"https://doi.org/10.46439/pediatrics.1.014","url":null,"abstract":"","PeriodicalId":93307,"journal":{"name":"Journal of clinical pediatrics and neonatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45180308","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}
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