Iranian Journal of Child Neurology最新文献

{"title":"Identification of a Novel Variant in CC2D1A Gene Linked to Autosomal Recessive Intellectual Disability 3 in an Iranian Family and Investigating the Structure and Pleiotropic Effects of this Gene.","authors":"Zahra Rashvand, Hossein Najmabadi, Kimia Kahrizi, Hossein Mozhdehipanah, Mohammad Moradi, Zohreh Estaki, Khadijeh Taherkhani, Nooshin Nikzat, Reza Najafipour, Mir Davood Omrani","doi":"10.22037/ijcn.v18i1.42188","DOIUrl":"10.22037/ijcn.v18i1.42188","url":null,"abstract":"<p><strong>Objectives: </strong>Intellectual disability (ID) represents a significant health challenge due to its diverse and intricate nature. A multitude of genes play a role in brain development and function, with defects in these genes potentially leading to ID. Considering that many of these genes have yet to be identified, and those identified have only been found in a small number of patients, no complete description of the phenotype created by these genes is available. <i>CC2D1A</i> is one of the genes whose loss-of-function mutation leads to a rare form of non-syndromic ID-3(OMIM*610055), and four pathogenic variants have been reported in this gene so far.</p><p><strong>Materials & methods: </strong>n the current study, two affected females were included with an initial diagnosis of ID who were from an Iranian family with consanguineous marriage. Whole-exome sequencing was used to identify the probable genetic defects. The Genotypic and phenotypic characteristics of the patients were compared with a mutation in the <i>CC2D1A</i> gene, and then the structure of the gene and its reported variants were investigated.</p><p><strong>Results: </strong>The patients carried a novel homozygous splicing variant (NM_017721, c.1641+1G>A) in intron 14, which is pathogenic according to the ACMG guideline. Loss-of-function mutations in <i>CC2D1A</i> have severe phenotypic consequences such as ID, autism spectrum disorder (ASD), and seizures. However, missense mutations lead to ASD with or without ID, and in some patients, they cause ciliopathy.</p><p><strong>Conclusion: </strong>This study reports the fifth novel, probably pathogenic variant in the <i>CC2D1A</i> gene. Comparing the clinical and molecular genetic features of the patients with loss-of-function mutation helped to describe the phenotype caused by this gene more precisely. Investigating the <i>CC2D1A</i> gene's mutations and structure revealed that it performs multiple functions. The DM14 domain appears more pivotal in triggering severe clinical symptoms, including ID, than the C2 domain.</p>","PeriodicalId":14537,"journal":{"name":"Iranian Journal of Child Neurology","volume":"18 1","pages":"25-41"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aicardi-Goutières Syndrome Type 1: A Novel Missense Variant and Review of the Mutational Spectrum.","authors":"Behnoosh Tasharrofi, Parvaneh Karimzadeh, Mostafa Asadollahi, Sepideh Hasani, Morteza Heidari, Mohammad Keramatipour","doi":"10.22037/ijcn.v18i3.43274","DOIUrl":"10.22037/ijcn.v18i3.43274","url":null,"abstract":"<p><strong>Objectives: </strong>Mutations in the TREX1 gene cause Aicardi-Goutières syndrome (AGS) 1, associated with a spectrum of autoimmune and neurodegenerative manifestations. AGS 1, the most severe neonatal type of AGS, is characterized by abnormal neurologic findings, visual inattention, hepatosplenomegaly, thrombocytopenia, skin rash, restlessness, and fever.</p><p><strong>Materials & methods: </strong>The present study described two affected siblings from an Iranian family whose phenotypes overlap with intrauterine infections. They had almost similar presentations, including developmental delay, microcephaly, no fix and follow epileptic seizures and the same pattern of brain CT scan involvements. Following clinical and paraclinical assessments, whole-exome sequencing was employed to determine the disease-causing variant, and subsequently, PCR-Sanger sequencing was performed to indicate the segregation pattern of the candidate variant in family members.</p><p><strong>Results: </strong>Genetic analysis revealed a novel homozygous missense variant (c.461A>C; p.D154A) in the TREX1 gene in affected family members. Sanger sequencing of other family members showed the expected zygosities.</p><p><strong>Conclusion: </strong>This study identifies a novel mutation in the TREX1 gene in this family and highlights the efficiency of next-generation sequencing-based techniques for obtaining a definite diagnosis in patients with early-onset encephalopathy.</p>","PeriodicalId":14537,"journal":{"name":"Iranian Journal of Child Neurology","volume":"18 3","pages":"117-129"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational Therapy in Kleefstra Syndrome.","authors":"Shakiba Ghaffari, Minoo Kalantari","doi":"10.22037/ijcn.v18i3.43716","DOIUrl":"10.22037/ijcn.v18i3.43716","url":null,"abstract":"<p><p>Kleefstra Syndrome (KS) is a rare genetic neurodevelopmental disorder caused by a microdeletion in chromosomal region 9q34.3 or a mutation in the euchromatin histone methyltransferase 1 (EHTM1) gene. Patients with KS show a range of clinical symptoms, including delay in motor and speech development, intellectual disability, autistic-like features, childhood hypotonia, and distinctive facial dysmorphic features. The patient is a four-year-old girl who was initially diagnosed with developmental motor delay by a pediatric neurologist and referred to an occupational therapy clinic at the age of six months. The initial assessment showed hypotonia and difficulties with rolling. Occupational therapy intervention was based on principles of neurodevelopmental treatment and sensory integration (SI) with cognitive integration and activities of daily living (ADL) training. With continuous occupational therapy services over more than three years, she overcame many disabilities and improved in occupational performance skills such as gross and fine motor skills as well as cognitive abilities, although her verbal communication skills were not effective. The patient's progress was as follows: she began rolling over at seven months, achieved independent sitting at ten months, crawled at eighteen months, stood with support at twenty months, and took her first steps at twenty-six months. The predominant problem was speech delay, which was noticeable in this syndrome. When a patient is being referred because of KS, occupational and speech therapy assessments should be accurately implemented.</p>","PeriodicalId":14537,"journal":{"name":"Iranian Journal of Child Neurology","volume":"18 3","pages":"143-149"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presumed Fourth Nerve Palsy in a Healthy and Asymptomatic Child with COVID-19 Infection.","authors":"Mohammad Yaser Kiarudi, Mohammad Sharifi, Ahmad Gharouni, Tayebe Shiravi","doi":"10.22037/v18i3.42705","DOIUrl":"10.22037/v18i3.42705","url":null,"abstract":"<p><p>COVID-19 can cause a wide range of ocular manifestations. The most common ocular manifestation is conjunctivitis. Neuro-ophthalmic presentations of COVID-19 are rare. Case reports suggest that COVID-19 infection can cause cranial nerve palsy, including nerves that regulate ocular movements. The present studypresented a case of fourth nerve palsy in a healthy and asymptomatic COVID-19-infected child. A healthy 10-year-old boy was referred to our eye clinic with a complaint of recent abnormal head posture and squint. His past medical history was unremarkable, and he had not received any medication or vaccinations within the last few weeks. No history of ocular or head trauma was observed. The patient was afebrile and had no respiratory symptoms. A comprehensive ocular examination was performed. All examinations, including slit-lamp, pupils, eyelids, and optic nerve heads, were normal. In ocular motor evaluations, left eye hyperdeviation was observed. Because of the history of COVID-19 in the mother of the child, he was referred to an infectious disease specialist and was tested for SARS-COV-2 with a nasopharyngeal swab specimen. The test was positive and SARS-COV-2 was detected. In addition, the patient was referred to a pediatric neurology department. Brain and orbital MRI was performed, and it was unremarkable. The post-viral fourth nerve palsy is uncommon, and post-COVID-19 has not been reported before. Clinicians should consider this infection in any recent strabismus in pediatrics. The children rarely complain of diplopia, and a recent abnormal head posture may be a sign of acquired strabismus.</p>","PeriodicalId":14537,"journal":{"name":"Iranian Journal of Child Neurology","volume":"18 3","pages":"137-141"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D3 Supplementation and Aquatic Exercise Combination as a Safe- Efficient Therapeutic Strategy to Ameliorate Interleukin-6 and 10, and Social Interaction in Children with Autism.","authors":"Fahimeh Adibsaber, Soleyman Ansari, Alireza Elmieh, Babak Barkadehi","doi":"10.22037/ijcn.v18i3.43021","DOIUrl":"10.22037/ijcn.v18i3.43021","url":null,"abstract":"<p><strong>Objectives: </strong>Increasing evidence demonstrated that there are altered levels of both pro-and anti-inflammatory cytokines in autism spectrum disorder (ASD) and pointed out that immune dysfunction may also relate to social deficits. This study aimed to investigate the effect of aquatic exercise combined with vitamin D supplementation on social interaction and two related cytokines (Interleukin-6 and Interleukin-10) in children with ASD.</p><p><strong>Materials & methods: </strong>Forty boys with ASD (mean age: 10.90; age range: 6-14 years) were randomly assigned to the three interventions (groups 1, 2, and 3) and one control group (each 10 participants). Participants in the group 1 and 3 received a 10-week aquatic exercise program. Subjects in groups 2 and 3 took orally 50,000 IU of vitamin D3/week. This study evaluated the serum levels of IL-6 and IL-10, as well as the participants' social interaction at baseline and post-intervention.</p><p><strong>Results: </strong>Compared to the control group, all three interventions improved social skills scores (p< 0.001). Surprisingly, the combination strategy could significantly reduce IL-6 and increase IL-10 serum levels in children with ASD.</p><p><strong>Conclusion: </strong>Aqua-based exercise programs combined with vitamin D supplementation are recommended to benefit children with ASD and improve social and communication dysfunction.</p>","PeriodicalId":14537,"journal":{"name":"Iranian Journal of Child Neurology","volume":"18 3","pages":"91-102"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Melatonin on Sleep Disorders in Children with Cerebral Palsy A Randomized Clinical Trial.","authors":"Hamid Reza Goldouzi, Javad Akhondian, Mehran Beiraghi Toosi, Hassan Mehrad Majd, Shima Shekari, Meisam Babaei","doi":"10.22037/ijcn.v18i1.41949","DOIUrl":"10.22037/ijcn.v18i1.41949","url":null,"abstract":"<p><strong>Objectives: </strong>Cerebral palsy (CP) is one of the most common causes of serious physical disability in childhood and is a persistent movement disorder before the age of three. This disorder can negatively affect both the child and their family. In recent years, the use of melatonin as a safe, effective, and cheap drug has been expanding in improving the sleep disorders of these children. Therefore, this study aimed to investigate melatonin's effect on sleep disorders in children with CP.</p><p><strong>Materials & methods: </strong>This double-blind clinical trial was conducted on children aged 2 to 12 years with CP who were referred to the pediatric neurology clinic for sleep problems. The participants were included in the study by convenience sampling. After obtaining informed consent from parents, patients were divided randomly into two intervention (melatonin) and control (placebo) groups. In the intervention group, patients received oral melatonin tablets, and in the control group, patients received a placebo (3 mg oral lactose) 30 minutes before going to sleep.</p><p><strong>Results: </strong>The results of this study showed no significant relationship between age and gender with sleep disorders in children with CP (P>0.05). A significant effect of melatonin on sleep disorders was found in children with CP. The greatest effect of melatonin is the time required to start falling asleep. Melatonin was associated with decreased time needed to fall asleep and increased sleep duration.</p><p><strong>Conclusion: </strong>The results of the study demonstrated that sleep disorders are prevalent among children with CP. Therefore, proper and timely treatment of these children is crucial. According to the present study's findings, melatonin effectively improves the time of falling asleep and these children's sleep duration.</p>","PeriodicalId":14537,"journal":{"name":"Iranian Journal of Child Neurology","volume":"18 1","pages":"51-59"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Primary Epidural Extraskeletal Ewing Sarcoma in Cervical Spine of an Infant: Case Report and Review of the Literature.","authors":"Sousan Mousavi, Ehsan Keykhosravi, Hamid Rezaee, Paria Dehghanian, Farnoosh Ebrahimzadeh, Amin Tavallaii, Mehran Beiraghi Toosi","doi":"10.22037/ijcn.v18i4","DOIUrl":"10.22037/ijcn.v18i4","url":null,"abstract":"<p><p>Ewing sarcoma (ES) is a highly malignant tumor originating from bones, exceptionally long bones. ES arising from the epidural extramedullary space, primarily the cervical region, is highly unlikely. There have been only six cases of cervical epidural extraskeletal Ewing sarcoma (EEES) in children reported in the literature, all of whom were older than seven years old. Four of seven cases, including the one mentioned in this study, were male (57%). Herein, we report a 1.5-year-old girl who presented with quadriparesis without cognitive impairment and had initially undergone a metabolic disorder evaluation. The spine MRI revealed a mass in the C2-T6 region, and she underwent a biopsy of the tumor via laminectomy. Microscopic examination confirms a diagnosis of ES based on immunohistochemistry. This is the first literature that presents an infant with EEES.</p>","PeriodicalId":14537,"journal":{"name":"Iranian Journal of Child Neurology","volume":"18 4","pages":"127-134"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gestational Diabetes Mellitus and its Effects on the Developing Cerebellum: A Narrative Review on Experimental Studies.","authors":"Mohammad Javad Saeedi Borujeni, Pilar Codoner Franch, Eulalia Alonso Iglesias, Marie Gombert","doi":"10.22037/IJCN.V18I2.36632","DOIUrl":"10.22037/IJCN.V18I2.36632","url":null,"abstract":"<p><p>Diabetes mellitus during pregnancy is a common complication of gestation, but its effects on the offspring's development are poorly understood. Recently, some studies reported that gestational diabetes mellitus (GDM) impairs cerebellar development, and some genetic alterations have been described as consequences. Cerebellum, one of the hindbrain derived structures in the posterior cranial fossa, plays a crucial role in cognition and behavioral functions. In recent years, some surveys stated that gestational diabetes has adverse effects on the fetus's cerebellum. Disruption of cerebellar cortex morphogenesis, reduce the volume of the cerebellum, reduce the thickness of cerebellar cortex layers, and its neuronal cells and effects on the expression of synaptophysin, insulin, and insulin-like growth factor -1 receptors are some of the maternal diabetes effects on developing cerebellum. On other hand, GDM, as a neurotoxic agent, impaired cerebellar development and could be a cause for the behavioral, functional, and structural anomalies observed in pups of diabetic mothers. Based on the literature review, most studies have pointed out that administering insulin in patients with GDM decreased the cellular and molecular alterations that induced by GDM in the developing cerebellum. Undoubtedly, screening strategies for all pregnant women are necessary.</p>","PeriodicalId":14537,"journal":{"name":"Iranian Journal of Child Neurology","volume":"18 2","pages":"9-22"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11015721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Levofloxacin-Induced Oromandibular Dystonia in a 9-Year-Old Patient.","authors":"Mohammadreza Ghazavi, Zahra Allameh","doi":"10.22037/ijcn.v18i3.18054","DOIUrl":"10.22037/ijcn.v18i3.18054","url":null,"abstract":"<p><p>Extrapyramidal symptoms (EPS) that include akathisia, dystonia, pseudoparkinsonism, and dyskinesia are abnormal movements commonly induced by antipsychotic medications. These symptoms are also associated with specific non-antipsychotic agents. This case report describes a case of a 9-year-old boy on antibiotics treatment that developed EPS. A 9-year-old boy presented to the emergency department of Imam Hossein Children›s Hospital with chief complaints of trismus, difficulty speaking, and tongue protrusion. One week before these presentations, he had been prescribed Tavanex® (levofloxacin) and clindamycin. His symptoms improved after the withdrawal of antibiotics and administering Biperiden, and he was discharged in good condition. On a follow-up visit one week after discharge, no remaining symptoms were present, and he was in good condition. Based on the questions in the Naranjo criteria, levofloxacin receives a score of 7 and is a probable cause of adverse drug reaction (ADR). Clindamycin, with a score of 6, is also a probable cause for this adverse drug reaction, but clinical judgment was in favor of levofloxacin as the culprit. Clinicians should be aware of the potential EPS of levofloxacin at standard doses. Effective management of adverse events is necessary to ensure patient safety and optimal outcomes.</p>","PeriodicalId":14537,"journal":{"name":"Iranian Journal of Child Neurology","volume":"18 3","pages":"151-157"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adenosine A2a Receptor Polymorphisms and Susceptibility to Anxiety Disorders.","authors":"Mohammad Keyvanloo Shahrestanaki, Haniyeh Karami, Hadi Lotfi, Milad Khorasani, Zeinab Babaei, Mohammad Salari Zare, Marzieh Kafami, Ilia Abrishami","doi":"10.22037/ijcn.v18i4.43928","DOIUrl":"10.22037/ijcn.v18i4.43928","url":null,"abstract":"<p><p>Anxiety disorders (ADs) are a group of mental disorders characterized by feelings of tension, fear, and excessive worrying in the face of life experiences. Aberrant signaling of adenosine A2a receptor (ADORA2A) is believed to be involved in the pathogenesis of ADs. Polymorphisms in the ADORA2A gene were shown to be associated with some of the patterns presented by ADs. The results of these studies have been inconsistent, making it hard to draw definitive conclusions. Therefore, this study performed a systematic review to clarify the associations between ADORA2A gene polymorphisms and ADs susceptibility. PubMed/Medline, Web of Science, and Scopus database using appropriate keywords, then screened for separation of suitable studies based on inclusion/exclusion criteria. Collectively, rs5751876 (1976T>C or previously 1083C>T) and rs35060421 (2592C>Tins) polymorphisms of ADORA2A were associated with an increased susceptibility to ADs. Moreover, rs2298383 TT genotype may be the causal regulatory factor, and ADORA2A T/C (rs2298383/rs3761422) haplotypes have significant susceptibility to ADs development. Additional research is needed to further define the role of ADORA2A gene polymorphisms in the pathogenesis of ADs.</p>","PeriodicalId":14537,"journal":{"name":"Iranian Journal of Child Neurology","volume":"18 4","pages":"9-21"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}