Pediatric Hematology Oncology Journal最新文献

{"title":"Palliative care in pediatric Leukemia: The value added to care","authors":"Manjusha Nair","doi":"10.1016/j.phoj.2025.100479","DOIUrl":"10.1016/j.phoj.2025.100479","url":null,"abstract":"<div><div>Childhood leukemias are one of the most curable cancers, because of revolutionary developments in the field of pediatric oncology. The diagnosis of leukemia in a child impacts the whole family, with disruption in their routines, behavior, attitudes and relationships, with long-term adverse psychosocial consequences. Comprehensive treatment of cancer involves not only the management of physical symptoms due to cancer but also attention to psychological, socio-cultural and spiritual domains of the child and family as a unit. Pediatric palliative care offers a holistic approach towards supporting the children and families during the entire course of treatment regardless of prognosis, and includes the full spectrum of physical, psychological, social, and spiritual care. Palliative care should go along with active cancer treatment and should be smoothly introduced to patients and their families, so that they do not feel abandoned by their treating teams if curative treatment is unsuccessful and palliative care teams are abruptly involved. Recent evidence proves that integration of palliative care is associated with significant improvements in the quality of life of children affected with cancer and their families, and should begin at diagnosis itself. This review explores the various ways in which palliative care can be incorporated in the treatment of children with haematological malignancies.</div></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"10 3","pages":"Article 100479"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144634454","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":"Infant acute lymphoblastic leukemia: a view from India","authors":"Debasish Sahoo,&nbsp;Sonali Mohapatra","doi":"10.1016/j.phoj.2025.100467","DOIUrl":"10.1016/j.phoj.2025.100467","url":null,"abstract":"<div><div>Improvement in outcomes of pediatric acute lymphoblastic leukemia (ALL) has been a success story with survival approaching 90% in various studies. However, ALL in infants, though rare, is an exception, with its distinct aggressive disease biology, molecular genetics and poor response to therapy with an excess of relapses. It characteristically presents with hyperleukocytosis, bulky disease and a higher incidence of central nervous system (CNS) and cutaneous involvement. Immunophenotyping is notable for CD10 negativity, and higher co-expression of various myeloid markers indicating a primitive hematopoietic cell of origin. Rearrangement in <em>KMT2A</em> gene i.e. <em>KMTA</em>-r (previously <em>MLL</em>), located on 11q23, is central to disease pathophysiology, playing a key role in epigenetic modification that drives leukemogenesis, and is the strongest negative prognostic marker in this subgroup. Hyperleukocytosis with total leukocyte count exceeding 3,00,000/mm³, younger age group (&lt;6 months age), poor prednisolone response and poor MRD response are other important negative prognostic markers in infant ALL. Despite highly intensive therapy and hematopoietic stem cell transplantation (HSCT), the incidence of relapse remains exceedingly high. Significant treatment related mortality and morbidity remain other barriers to successful outcomes. Recently, the use of blinatumomab has shown promising results in infant ALL and is being integrated into chemotherapy backbones in various trials e.g. Interfant 06. Early integration of immunotherapy including blinatumomab and chimeric antigen receptor (CAR) T cells, and other novel drugs in larger collaborative trials will be key in improving the prognosis in this population.</div></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"10 3","pages":"Article 100467"},"PeriodicalIF":0.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522744","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":"Lineage switch in B-lineage Acute Lymphoblastic Leukemia at relapse: a report","authors":"Hershavardhini K ,&nbsp;Likhitha Bhukya ,&nbsp;Abhilasha S","doi":"10.1016/j.phoj.2025.100461","DOIUrl":"10.1016/j.phoj.2025.100461","url":null,"abstract":"<div><h3>Background</h3><div>Lineage switch is an uncommon phenomenon at time of relapse and the mechanisms by which this occurs are unclear, but may represent an expanded pre-therapy sub-clone, clonal evolution of the original leukemia, or development of a new clone that may be therapy-related. Here we present two cases which explains the etiology of lineage switch being therapy-related clonal selection.</div></div><div><h3>Case report</h3><div>Case 1: A 9-year-old male child treated for pre-B ALL at our centre on chemotherapy relapsed with AML in the 8th cycle of the maintenance phase. Case 2: A 6-year-old female diagnosed with pre-B ALL relapsed with AML in the 5th cycle of maintenance therapy. Both of these cases at time of relapse also showed a <em>TP53</em> gene mutation, confirmed by next generation sequencing.</div></div><div><h3>Conclusion</h3><div>In this report, we have reported a lineage switch in two patients at time of relapse of pre-B ALL, in association with <em>T</em><em>P53</em> mutation with a poor outcome.</div></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"10 3","pages":"Article 100461"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical profile of children with sickle cell disease in the eastern region of Saudi Arabia","authors":"Abdalla Mohamed Zayed ,&nbsp;Sulaiman AL-Muhaimeed ,&nbsp;Turki AL-Otaibi ,&nbsp;Hossam Aldosari ,&nbsp;Tahani Alotaibi ,&nbsp;Yasser Awadallah ,&nbsp;Basheer Ahmed ,&nbsp;Shangrila-Joy Ancheta ,&nbsp;Ahmed Hassan ,&nbsp;Omer AL-Rasheedi","doi":"10.1016/j.phoj.2025.100463","DOIUrl":"10.1016/j.phoj.2025.100463","url":null,"abstract":"<div><h3>Background</h3><div>Sickle cell disease (SCD) is a monogenic disorder in which a single gene mutation interacts with variable environmental stimuli to modulate the disease's phenotypic expression. Patients living in the eastern region of Saudi Arabia (SA) have a milder phenotype than those living in the southwestern (SW). This phenotypic variability is thought to be related to the difference in genetic haplotypes between the regions. Little is known about the impact of the environment on the natural history of the disease in this country. The aim of this study is to demonstrate the clinical profiles of eastern and SW children with SCD living in the same environment, the eastern region of SA.</div></div><div><h3>Methods</h3><div>This is a retrospective cross-sectional study of children with SCD over the period from January 2010 to December 2020, who attended the outpatient clinics and the inpatient Pediatric Department, King Fahad Military Medical Complex, Dhahran, SA. The demographic data and different symptoms and complications of the disease were collected from their files and analyzed statistically.</div></div><div><h3>Results</h3><div>The study included 340 children with SCD: 191 (56.2 %) males and 149 females (43.8 %). There were two groups of patients: SW (246) and eastern (94). Compared with the eastern group, SW children had lower baseline hemoglobin (HB) and hemoglobin F (HBF) levels (8.6 vs. 9.2 gm/dL and 14.4 % vs. 18.4 %, p &lt; .05), respectively, and a higher hemoglobin S (HBS) and mean corpuscular volume (MCV) (69.7 % vs. 65.6 % and 79.3 vs. 75.0, p&lt;.05), respectively. Stroke occurred exclusively in SW children, who also experienced more acute chest syndrome (ACS) (32.1 % vs. 19.1 %, p&lt;.05) and received more blood transfusions (61.8 % vs. 46.8 %, p &lt; 0.05). The prevalence of gallstones (GS), vaso-occlusive crisis (VOC), splenic sequestration crisis (SSC), and hemolytic crises were higher in SW children, but the difference was not statistically significant (p &gt; 0.05). Avascular necrosis of the femoral head (AVN) occurred more in the eastern group, but this also lacked statistical significance (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Southwestern children with SCD residing in eastern SA exhibit a more severe disease profile than their eastern counterparts. While they share many environmental factors, apparent genetic differences exist. As not all genetic or environmental factors were examined, we propose that this difference in severity is likely, at least partially, attributable to genetic rather than environmental factors.</div></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"10 3","pages":"Article 100463"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical profile and outcome of children with Neuroblastoma: A single center retrospective study from North India","authors":"Zaibaish Khan,&nbsp;Nishant Verma","doi":"10.1016/j.phoj.2025.100466","DOIUrl":"10.1016/j.phoj.2025.100466","url":null,"abstract":"<div><h3>Background</h3><div>With advances in pediatric oncology care, the outcome of children with neuroblastoma has improved. However, in low and middle-income countries (LMICs), the survival rate remains low. This study was conducted because of the paucity of data regarding the clinico-epidemiological profile and outcome of children with neuroblastoma in India.</div></div><div><h3>Methods</h3><div>Children (&lt;13 y) with neuroblastoma treated at our centre between 2016 and 2022 were retrospectively analyzed.</div></div><div><h3>Results</h3><div>Over the 7-year study period, 53 children with neuroblastoma were treated at our centre. The age ranged from 1 month to 13 years (male: female ratio: 2.3:1). Adrenal was the most common primary site (58%). The majority of children had stage 4 disease (58.5%). The projected 2-year overall survival is 30%, whereas the event-free survival is 24.5%.</div></div><div><h3>Conclusions</h3><div>Children with neuroblastoma in our setting presented late with advanced disease. Even with a multidisciplinary approach, the survival rate for patients with advanced disease were still poor.</div></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"10 3","pages":"Article 100466"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470687","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":"Iron overload in non-transfusion-dependent thalassemia- experience at a tertiary care center in India","authors":"Sujata Sharma,&nbsp;Lekha Parikh,&nbsp;Prachi Pandhare","doi":"10.1016/j.phoj.2025.100458","DOIUrl":"10.1016/j.phoj.2025.100458","url":null,"abstract":"<div><h3>Background</h3><div>Non-transfusion-dependent thalassemia (NTDT) patients can be at risk of iron overload, despite not being transfused frequently. Iron overload is a major risk factor that increases morbidity and mortality in non-transfusion dependent thalassemia patients.</div></div><div><h3>Aim</h3><div>This study looked at the prevalence of iron overload in NTDT patients and evaluated the relationship between serum ferritin and calculated liver iron concentration (LIC) based on T2∗MRI.</div></div><div><h3>Methods</h3><div>We conducted an observational and retrospective study in a tertiary care centre of the metropolitan country of India from January 2019 to November 2020. We evaluated the prevalence of iron overload in NTDT patients, the relationship between number of PRC transfusions, serum ferritin levels, hepatic and cardiac iron as measured by validated R2 magnetic resonance imaging with T2∗ MRI values.</div></div><div><h3>Results &amp; discussion</h3><div>Total of 56 NTDT patients were 8–12 years old with a mean age of 9.38 years. Majority of our study participants were beta thalassemia intermedia 45 (80.4 %) followed by HbE/β thalassemia 7(12.5 %) and 2 each (3.6 %) as HbH disease and Delta Beta Thalassemia. Magnetic resonance Imaging (T2∗ MRI) was done in 56 patients. Of these 35(62.5 %) had hepatic overload and 9 (16.1 %)) had cardiac overload. The mean serum ferritin level was 556.93 ng/ml. There was a negative correlation between the number of PRC transfusion, and liver T2∗ MRI values (r = −0.209, P = 0.123) as well as cardiac T2∗MRI T2∗ (r = −0.231, P = 0.087). Since T2∗ MRI values are inversely proportional to iron overload, the higher the number of PRC transfusions, the lower were the T2∗ values. We found that liver iron overload was present in half of the participants (n = 17, 53.13 %) even those who were never transfused or received less than 10 units.</div></div><div><h3>Conclusion</h3><div>Our study shows that there is a high prevalence of liver iron overload in NTDT patients. Serum Ferritin is an unreliable indicator, whereas T2∗ MRI values are better for assessing iron overload in NTDT patients.</div></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"10 3","pages":"Article 100458"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470686","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":"Impact of a respiratory panel on the diagnosis and management of acute chest syndrome in pediatric patients with sickle cell disease: A single-center retrospective study","authors":"Yaoping Zhang ,&nbsp;Stelios Kasikis ,&nbsp;Susannah Vanderpool ,&nbsp;Paula Ogrodnik ,&nbsp;Nikolaos Spyrou ,&nbsp;Margaret R. Hammerschlag","doi":"10.1016/j.phoj.2025.100464","DOIUrl":"10.1016/j.phoj.2025.100464","url":null,"abstract":"<div><h3>Background</h3><div>Acute chest syndrome (ACS) is a common sickle cell disease (SCD) complication. Infectious pathogens are the most common causes of ACS followed by pulmonary infarction and fat embolism. Infectious pathogens responsible for ACS include viruses and atypical bacteria (<em>Mycoplasma pneumoniae</em> and <em>Chlamydia pneumoniae</em>). The implementation of the BioFire® FilmArray® Respiratory Pathogen Panel (RPP) at our institution since 2017 provided an opportunity to more accurately investigate the infectious pathogens responsible for ACS in children with SCD.</div></div><div><h3>Material and methods</h3><div>This study was a single-center retrospective review of electronic medical records of children with SCD, less than 21 years of age, who were admitted with a diagnosis of ACS.</div></div><div><h3>Results</h3><div>Nighty-five episodes of ACS in 64 patients admitted to our hospital from January 2013 to March 2021 were identified. Episodes were assigned to pre-RPP (n = 50) and RPP (n = 45) cohorts. Within the RPP cohort, an infectious etiology was identified in 44 % (20/45) of episodes compared to 18.75 % (3/16) of the pre-RPP cohort. The two most common pathogens identified were rhino/enterovirus and influenza, found in 11 % of episodes each. <em>M. pneumoniae</em> was identified in only 2 episodes in the RPP cohort.</div></div><div><h3>Conclusion</h3><div>Implementation of the RPP enabled more accurate identification of the causes of ACS. The majority of cases were due to viral infections. Pneumococcal and <em>M. pneumoniae</em> infections were uncommon. Based on these findings we suggest that empiric antibiotic be limited to ceftriaxone. Azithromycin should only be used if the RPP is positive for <em>M. pneumoniae</em> or <em>C. pneumoniae</em>.</div></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"10 3","pages":"Article 100464"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335916","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":"Administration of high dose methotrexate monitoring a single serum methotrexate level at 72 hours","authors":"Saksham Singh ,&nbsp;Prakruthi Kaushik ,&nbsp;A.R. Arun Kumar ,&nbsp;Nuthan Kumar ,&nbsp;Shalaka Mahajan","doi":"10.1016/j.phoj.2025.100456","DOIUrl":"10.1016/j.phoj.2025.100456","url":null,"abstract":"<div><h3>Background</h3><div>When administering high dose Methotrexate (HD-MTX), in children with high-risk Acute lymphoblastic leukemia (ALL), serial monitoring of serum Methotrexate (MTX) levels till they are less than &lt;0.4 μmol/L at 42 hrs is regarded as standard of care in avoiding HD-MTX toxicity. We studied the feasibility of administering HD-MTX in children with high-risk Acute lymphoblastic leukemia (ALL), with a single monitoring level of serum MTX level at 72 h.</div></div><div><h3>Materials and methods</h3><div>This is a retrospective study from patients treated at the Department of Paediatric Oncology from January to December 2019 at a regional cancer centre in South India. Patients aged &lt;15 years with diagnosis of B (high risk) or T lineage Acute lymphoblastic leukemia (ALL) and Lymphoblastic Non-Hodgkin lymphoma (NHL) who received HDMTX were included in the study. A solitary serum MTX level was done at 72 h after starting the infusion. The most common side effects of HD-MTX were noted and correlated with age, sex, grade of nutrition, dose of Methotrexate (3g versus 5g) and Methotrexate levels at 72 h (&lt;0.05 versus &gt;/ = 0.05 μmol/L). Data was entered in excel sheet and analyzed by appropriate statistical tests. P &lt; 0.05 was taken as significant.</div></div><div><h3>Results</h3><div>Children who received higher dose of MTX (5g/m²) were found to have significantly more episodes of diarrhea, thrombocytopenia and hyperbilirubinemia as opposed to 3g/m2 (p = 0.02,0.043 and 0.035 respectively). There was no significant difference in clinical toxicities in those whose 72-h serum MTX levels were &lt;/&gt;0.05 μmol/L. However, patients with delayed excretion had significantly higher levels of serum transaminases and increase in creatinine.</div></div><div><h3>Conclusion</h3><div>The results of our study showed that prolonged hydration along with extended leucovorin rescue with single level of serum MTX at 72 h is feasible, but the impact on efficacy is unknown and this way of HD-MTX administration needs to be validated in larger studies along with comparisons with levels at other time points.</div></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"10 2","pages":"Article 100456"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270857","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":"Co-occurrence of ovarian Yolk Sac Tumor and pancreatic solid pseudopapillary neoplasm in a pediatric patient: A case report","authors":"A. Roggero ,&nbsp;L. Piro ,&nbsp;D. Paoloni ,&nbsp;F. Palo ,&nbsp;S. Avanzini ,&nbsp;V. Capra ,&nbsp;P. De Marco ,&nbsp;S. Sorrentino ,&nbsp;E. Arkhangelskaya ,&nbsp;J. Ferro ,&nbsp;V.G. Vellone ,&nbsp;M. Conte","doi":"10.1016/j.phoj.2025.100457","DOIUrl":"10.1016/j.phoj.2025.100457","url":null,"abstract":"<div><h3>Background</h3><div>Multiple malignant neoplasms in pediatric patients are rare, posing diagnostic and therapeutic challenges. This case report details a 12-year-old girl with a Yolk Sac Tumor (YST) found to have a Solid Pseudopapillary Neoplasm (SPN) of the pancreas, highlighting management complexities.</div></div><div><h3>Case report</h3><div>A 12-year-old girl presented with pelvic pain and dysuria. Imaging revealed a right ovarian mass, confirmed as YST. A partial ovariectomy was performed. Persistent abdominal pain led to further investigation, revealing a pancreatic lesion and residual ovarian mass. Multidisciplinary management included salpingo-oophorectomy and distal pancreatectomy, achieving complete tumor resection. Genetic testing, including Whole Exome Sequencing of 400 cancer predisposition genes, found no significant variants.</div></div><div><h3>Conclusion</h3><div>The synchronous occurrence of YST and SPN in pediatric patients, without pathogenic variants, is extremely rare. Management involved surgery, chemotherapy for YST, and individualized SPN treatment. Long-term follow-up is essential due to the malignancy potential of both tumors.</div></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"10 2","pages":"Article 100457"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270859","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":"Introducing article numbering to Pediatric Hematology Oncology Journal","authors":"","doi":"10.1016/j.phoj.2025.100475","DOIUrl":"10.1016/j.phoj.2025.100475","url":null,"abstract":"","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"10 2","pages":"Article 100475"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366763","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}