Journal of Child Neurology最新文献

{"title":"Safety and Efficacy of Botulinum Toxin Type A in Children With Spastic Cerebral Palsy Aged <2 Years: A Systematic Review.","authors":"Hongyi Yang,&nbsp;Shiwei Chen,&nbsp;Jiaqi Shen,&nbsp;Yijing Chen,&nbsp;Minlin Lai,&nbsp;Linfei Chen,&nbsp;Suzhen Fang","doi":"10.1177/08830738231183484","DOIUrl":"https://doi.org/10.1177/08830738231183484","url":null,"abstract":"<p><p>In this study, we reviewed the safety and efficacy of botulinum toxin type A (BoNT-A) injection with respect to motor development in children with spastic cerebral palsy aged <2 years. Randomized controlled trials of BoNT-A published between July 1993 and May 2021 were searched in PubMed, WANFANG, CNKI (Chinese National Knowledge Infrastructure), and Cochrane Library Central Register of Controlled Trials using keywords \"Botulinum Toxin,\" \"cerebral palsy,\" \"nao xing tan huan,\" \"nao tan,\" and \"rou du du su.\" The 11-item PEDro Scale was used to rate the quality of all the identified studies. Twelve studies, involving 656 subjects, met the inclusion criteria, and of these, 2 involved patients aged <2 years. Treatment safety was assessed based on adverse event (AE) number and frequency, and efficacy was assessed based on spasticity, range of movement, and motor development. We observed that 3 self-limiting adverse events that were frequently reported included weakness, dysesthesia of the skin, and pain at the injection site. Moreover, there was a significant decrease in the incidence of spasticity and a notable improvement in the range of movement of BoNT-A-treated patients. Therefore, BoNT-A injection shows great safety and efficacy in the treatment of children with cerebral palsy aged <2 years.</p>","PeriodicalId":15319,"journal":{"name":"Journal of Child Neurology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10061394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Thalamus L-Sign to Differentiate Periventricular Leukomalacia From Neurometabolic Disorders.","authors":"Sabahattin Yuzkan,&nbsp;Merve Emecen Sanli,&nbsp;Merve Balci,&nbsp;Pakize Cennetoglu,&nbsp;Ihsan Kafadar,&nbsp;Burak Kocak","doi":"10.1177/08830738231168973","DOIUrl":"10.1177/08830738231168973","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the diagnostic value of the thalamus L-sign on magnetic resonance imaging (MRI) in distinguishing between periventricular leukomalacia and neurometabolic disorders in pediatric patients.</p><p><strong>Methods: </strong>In this retrospective study, clinical and imaging information was collected from 50 children with periventricular leukomalacia and 52 children with neurometabolic disorders. MRI was used to evaluate the L-sign of the thalamus (ie, injury to the posterolateral thalamus) and the lobar distribution of signal intensity changes. Age, sex, gestational age, and level of Gross Motor Function Classification System (only for periventricular leukomalacia) constituted the clinical parameters. Statistical evaluation of group differences for imaging and clinical variables were conducted using univariable statistical methods. The intra- and inter-observer agreement was evaluated using Cohen's kappa. Univariable or multivariable logistic regression was employed for selection of variables, determining independent predictors, and modeling.</p><p><strong>Results: </strong>The thalamus L-sign was observed in 70% (35/50) of patients in the periventricular leukomalacia group, but in none of the patients with neurometabolic disorder (<i>P</i> < .001). The gestational age between groups varied significantly (<i>P</i> < .001). Involvement of frontal, parietal, and occipital lobes differed significantly between groups (<i>P</i> < .001). In the logistic regression, the best model included negative thalamus L-sign and gestational age, yielding an area under the curve, accuracy, sensitivity, specificity, and precision values of 0.995, 96.1%, 96%, 96.2%, and 96%, respectively. Both the lack of thalamus L-sign and gestational age were independent predictors (<i>P</i> < .001).</p><p><strong>Conclusions: </strong>The thalamus L-sign and gestational age may be useful in distinguishing between periventricular leukomalacia and neurometabolic disorders.</p>","PeriodicalId":15319,"journal":{"name":"Journal of Child Neurology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10062935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Prevalence of Collagenopathies in Preterm- and Term-Born Children With Periventricular Venous Hemorrhagic Infarction.","authors":"Norman Ilves,&nbsp;Sander Pajusalu,&nbsp;Tiina Kahre,&nbsp;Rael Laugesaar,&nbsp;Ustina Šamarina,&nbsp;Dagmar Loorits,&nbsp;Pille Kool,&nbsp;Pilvi Ilves","doi":"10.1177/08830738231186233","DOIUrl":"https://doi.org/10.1177/08830738231186233","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate genetic risk factors in term-born children with antenatal periventricular hemorrhagic infarction (PVHI), presumed antenatal periventricular venous infarction and periventricular hemorrhagic infarction in preterm neonates.</p><p><strong>Methods: </strong>Genetic analysis and magnetic resonance imaging were performed in 85 children: term-born children (≥36 gestational weeks) with antenatal periventricular hemorrhagic infarction (n = 6) or presumed antenatal (n = 40) periventricular venous infarction and preterm children (<36 gestational weeks) with periventricular hemorrhagic infarction (n = 39). Genetic testing was performed using exome or large gene panel (n = 6700 genes) sequencing.</p><p><strong>Results: </strong>Pathogenic variants associated with stroke were found in 11 of 85 (12.9%) children with periventricular hemorrhagic infarction/periventricular venous infarction. Among the pathogenic variants, <i>COL4A1/A2</i> and <i>COL5A1</i> variants were found in 7 of 11 (63%) children. Additionally, 2 children had pathogenic variants associated with coagulopathy, whereas 2 other children had other variants associated with stroke. Children with collagenopathies had significantly more often bilateral multifocal stroke with severe white matter loss and diffuse hyperintensities in the white matter, moderate to severe hydrocephalus, moderate to severe decrease in size of the ipsilesional basal ganglia and thalamus compared to children with periventricular hemorrhagic infarction/periventricular venous infarction without genetic changes in the studied genes (<i>P</i> ≤ .01). Severe motor deficit and epilepsy developed more often in children with collagenopathies compared to children without genetic variants (<i>P</i> = .0013, odds ratio [OR] = 233, 95% confidence interval [CI]: 2.8-531; and <i>P</i> = .025, OR = 7.3, 95% CI: 1.3-41, respectively).</p><p><strong>Conclusions: </strong>Children with periventricular hemorrhagic infarction/periventricular venous infarction have high prevalence of pathogenic variants in collagene genes (<i>COL4A1/A2</i> and <i>COL5A1)</i>. Genetic testing should be considered for all children with periventricular hemorrhagic infarction/periventricular venous infarction; <i>COL4A1/A2</i> and <i>COL5A1/A2</i> genes should be investigated first.</p>","PeriodicalId":15319,"journal":{"name":"Journal of Child Neurology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c4/4a/10.1177_08830738231186233.PMC10467006.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10124863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticomuscular Coherence in Children with Unilateral Cerebral Palsy: A Feasibility and Preliminary Protocol Study.","authors":"Rachana R Gangwani,&nbsp;Jasper I Mark,&nbsp;Rachel M Vaughn,&nbsp;Holly Holland,&nbsp;Deborah E Thorpe,&nbsp;Joshua J Alexander,&nbsp;Swati M Surkar,&nbsp;Jessica M Cassidy","doi":"10.1177/08830738231187010","DOIUrl":"10.1177/08830738231187010","url":null,"abstract":"<p><p><b>Objective</b> This study assessed the feasibility of corticomuscular coherence measurement during a goal-directed task in children with unilateral cerebral palsy while establishing optimal experimental parameters. <b>Methods</b> Participants (Manual Ability Classification System levels I-III) completed a submaximal isometric goal-directed grip task during simultaneous electroencephalography and electromyography (EMG) acquisition. <b>Results</b> All participants (n = 11, 6 females, mean age 11.3 ±2.4 years) completed corticomuscular coherence procedures. Of the 40 trials obtained per extremity, an average of 29 (n = 9) and 27 (n = 10) trials were retained from the more- and less-affected extremities, respectively. Obtaining measurement stability required an average of 28 trials per extremity. <b>Conclusion</b> Findings from this work support the feasibility of corticomuscular coherence measurement in children with unilateral cerebral palsy. Acquiring 28 to 40 corticomuscular coherence trials per extremity is ideal. The experimental parameters established in this work will inform future corticomuscular coherence application in pediatric unilateral cerebral palsy.</p>","PeriodicalId":15319,"journal":{"name":"Journal of Child Neurology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bc/96/10.1177_08830738231187010.PMC10466949.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10181398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Complementary and Alternative Medicine in Children with Neuromuscular Disorders Followed at Penn State Health Pediatric Muscular Dystrophy Association Care Center Clinic.","authors":"Rea Mittal,&nbsp;Caroline Maltese,&nbsp;Elizabeth Bolt,&nbsp;Dustin Paul,&nbsp;Gayatra Mainali,&nbsp;Sunil Naik,&nbsp;Sita Paudel,&nbsp;Erik Lehman,&nbsp;Ashutosh Kumar","doi":"10.1177/08830738231186490","DOIUrl":"https://doi.org/10.1177/08830738231186490","url":null,"abstract":"<p><p>The exact prevalence of complementary and alternative medicine (CAM) use is not known in pediatric patients with neuromuscular diseases followed by any of the 150 Muscular Dystrophy Association (MDA) Care Center Clinics nationwide. This study describes the prevalence and variety of CAM usage in this population, while also assessing the prevalence of caregiver disclosure of CAM use and caregiver perception of provider support for CAM. Fifty-two caregivers of pediatric patients seen at Penn State Health's Pediatric MDA Care Center Clinic completed our online survey. Overall, 19.2% of caregivers reported CAM use by their child. Less than half of caregivers reported discussing CAM use with their child's neurologist (41.5%); however, a majority of respondents reported interest in using CAM for their child in the future (52.8%). Understanding the prevalence of CAM usage and disclosure in pediatric MDA clinics may facilitate safer use of CAM in this community.</p>","PeriodicalId":15319,"journal":{"name":"Journal of Child Neurology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10466977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10125400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Diazepam Nasal Spray in Pediatric Patients With Developmental Epileptic Encephalopathies: Results From a Long-term Phase 3 Safety Study.","authors":"Daniel Tarquinio,&nbsp;James W Wheless,&nbsp;Eric B Segal,&nbsp;Sunita N Misra,&nbsp;Adrian L Rabinowicz,&nbsp;Enrique Carrazana","doi":"10.1177/08830738231185424","DOIUrl":"https://doi.org/10.1177/08830738231185424","url":null,"abstract":"<p><p>Pediatric developmental epileptic encephalopathies are often refractory to treatment despite stable antiseizure therapy. The safety profile of diazepam nasal spray (Valtoco) as rescue therapy for seizure clusters was described in a long-term safety study. This post hoc analysis assessed safety and effectiveness within a subpopulation of patients with developmental epileptic encephalopathies. Of 163 treated patients, 64 were diagnosed with ≥1 pediatric developmental epileptic encephalopathy. Among the most common developmental epileptic encephalopathies were Rett syndrome (n = 16), Lennox-Gastaut syndrome (n = 9), and Dravet syndrome (n = 7). In the broad pediatric developmental epileptic encephalopathy group, 10.6% of seizure clusters were treated with a second dose, with similar proportions in the 3 individual encephalopathies. Across groups, treatment-emergent adverse event rates ranged from 66.7% to 100%. Only epistaxis (n = 2) was treatment-related and reported in >1 patient. In this long-term safety analysis in patients with developmental epileptic encephalopathies, diazepam nasal spray demonstrated a consistent safety profile, supporting its use in these hard-to-treat patients (ClinicalTrials.gov NCT02721069).</p>","PeriodicalId":15319,"journal":{"name":"Journal of Child Neurology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/63/ed/10.1177_08830738231185424.PMC10466939.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10125402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy, Tolerability, and Safety of Treatment With Perampanel in Pediatric Patients With Epilepsy Aged ≥4 Years: A Real-Life Observational Study.","authors":"Ting Zhao,&nbsp;Hong-Jian Li,&nbsp;Ji-Rong Feng,&nbsp;Hui-Lan Zhang,&nbsp;Jing Yu,&nbsp;Jie Feng,&nbsp;Ting-Ting Wang,&nbsp;Yan Sun,&nbsp;Lu-Hai Yu","doi":"10.1177/08830738231182536","DOIUrl":"https://doi.org/10.1177/08830738231182536","url":null,"abstract":"<p><p><b>Purpose:</b> The safety and effectiveness of perampanel in clinical settings involving Chinese pediatric patients are limited, as perampanel has only recently been approved for use in China, in September 2019. We aimed to evaluate the efficacy and tolerability of perampanel as an adjunctive therapy for pediatric patients with epilepsy aged ≥ 4 years in Xinjiang, Northwest China. <b>Methods:</b> Efficacy was assessed by measuring changes in seizure frequency at 3-, 6-, and 12-month follow-up compared with baseline. The baseline was 3 months before the addition of perampanel, and the seizure frequency was based on the patients' seizure diary. The safety and tolerability depended on the type and frequency of any adverse event during epilepsy treatment across all pediatric patients. <b>Results:</b> Overall, 67 pediatric patients from 2 different hospitals were enrolled in the study. Among the pediatric patients with seizures during the baseline period, the effective rates for all seizure types at 3, 6, and 12 months were 59.1%, 58.7%, and 57.4%, respectively. During perampanel treatment, 34 patients (50.7%) experienced at least 1 adverse reaction. <b>Conclusion:</b> Overall, this real-world retrospective study of pediatric patients validated that perampanel is an effective treatment option as an adjunctive therapy among pediatric patients with epilepsy aged ≥4 years.</p>","PeriodicalId":15319,"journal":{"name":"Journal of Child Neurology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10065088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Profile, Follow-up, and Role of Neuroimaging in Pediatric Guillain-Barré Syndrome in the COVID Era: An Ambispective Study.","authors":"Lokesh Saini,&nbsp;Deepthi Krishna,&nbsp;Pradeep Kumar Gunasekaran,&nbsp;Sarbesh Tiwari,&nbsp;Prawin Kumar,&nbsp;Jagdish Prasad Goyal,&nbsp;Daisy Khera,&nbsp;Bharat Choudhary,&nbsp;Siyaram Didel,&nbsp;Ravi Gaur,&nbsp;Veena Laxmi,&nbsp;Samhita Panda,&nbsp;Kuldeep Singh","doi":"10.1177/08830738231184089","DOIUrl":"https://doi.org/10.1177/08830738231184089","url":null,"abstract":"<p><p><b>Background:</b> To define the varied presentations of Guillain-Barré syndrome in children in the COVID era and 6 months' follow-up outcome. <b>Methods:</b> Ambispective study of 15 months' duration involving children with Guillain-Barré syndrome aged 1 month to 18 years at a tertiary care pediatric hospital. They were categorized into groups A and B based on COVID-19 serology testing. Hughes Disability Scale was used for disability assessment. Modified Rankin scale was used for improvement assessment in follow-up. <b>Results:</b> Of 19 children with Guillain-Barré syndrome, 9 (47%) were females and 10 (53%) were males. Groups A and B had children with negative (8) and positive serology (11), respectively. The most common presentation in both groups was motor weakness. Post-COVID pediatric Guillain-Barré syndrome presented with variants of Guillain-Barré syndrome rather than the classical form (<i>P</i> = .03). In group B, patients with elevated inflammatory markers had poor response to intravenous immunoglobulin, and 5 of 11 patients had good response to pulse steroids, probably depicting an inflammation-predominant pathology. <b>Conclusion:</b> Post-COVID Guillain-Barré syndrome in children presented with Guillain-Barré syndrome variants rather than the classic form. Neuroimaging is of great value in both confirming Guillain-Barré syndrome diagnosis and excluding differentials. Patients with elevated inflammatory markers and residual weakness may be given a pulse steroid trial.</p>","PeriodicalId":15319,"journal":{"name":"Journal of Child Neurology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10066806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregivers' Perspectives on the Impact of Cannabidiol (CBD) Treatment for Dravet and Lennox-Gastaut Syndromes: A Multinational Qualitative Study.","authors":"Jade Marshall,&nbsp;Hanna Skrobanski,&nbsp;Lisa Moore-Ramdin,&nbsp;Klaudia Kornalska,&nbsp;Paul Swinburn,&nbsp;Sally Bowditch","doi":"10.1177/08830738231185241","DOIUrl":"10.1177/08830738231185241","url":null,"abstract":"<p><strong>Objective: </strong>To increase understanding of the impact of cannabidiol (CBD) on outcomes beyond seizure control among individuals with Dravet syndrome or Lennox-Gastaut syndrome.</p><p><strong>Methods: </strong>Qualitative interviews were conducted with caregivers of individuals with Dravet syndrome or Lennox-Gastaut syndrome treated with plant-derived, highly purified CBD medicine (Epidiolex in the USA; Epidyolex in Europe; 100 mg/mL oral solution). Symptoms and impacts of Dravet syndrome and Lennox-Gastaut syndrome on individuals were explored, as were the effects of CBD. Data were analyzed using thematic analysis.</p><p><strong>Results: </strong>Twenty-one caregivers of individuals with Dravet syndrome (n = 14) and Lennox-Gastaut syndrome (n = 7) aged 4-22 years participated. Health-related quality of life improvements associated with CBD included cognitive function, communication, behavior, mobility, and participation in daily activities. Seizure frequency reduction was commonly reported (n = 12), resulting in caregivers having greater freedom and family life being less disrupted. Adverse events were reported by 10 caregivers.</p><p><strong>Conclusion: </strong>In addition to reduced seizure frequency, CBD may have a wide range of beneficial effects beyond seizure control that warrant further investigation.</p>","PeriodicalId":15319,"journal":{"name":"Journal of Child Neurology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/12/06/10.1177_08830738231185241.PMC10467005.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10498791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Hiccup.","authors":"Sumit Parikh","doi":"10.1177/08830738231162744","DOIUrl":"10.1177/08830738231162744","url":null,"abstract":"","PeriodicalId":15319,"journal":{"name":"Journal of Child Neurology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92154377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}