Journal of Pediatric Gastroenterology and Nutrition最新文献

{"title":"Hydrostatic low-volume enemas in infants with birth weight ≤1000 g or gestational age ≤28 weeks: A controlled interventional study.","authors":"Tabea Stock, Anne-Marie Kamp, Markus Waitz, Teresa Riedl-Seifert, Andreas C Jenke","doi":"10.1002/jpn3.70055","DOIUrl":"https://doi.org/10.1002/jpn3.70055","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the safety and efficacy of standardized minimally invasive hydrostatic low-volume saline enemas in infants with a birth weight ≤1000 g or gestational age ≤28 weeks and delayed meconium passage.</p><p><strong>Methods: </strong>Conducted at the Neonatology Department of Klinikum Kassel, Germany, this monocentric controlled interventional study included a historic control group and a prospective intervention group. Infants born between January 2019 and October 2022 were included. The control group received manual enemas using varied techniques, while the intervention group underwent standardized hydrostatic low-volume saline enemas at predefined intervals. Key outcomes assessed included gastrointestinal complications (necrotizing enterocolitis [NEC], focal intestinal perforation [FIP], and meconium plug syndrome [MPS]), morbidity, mortality, stool and feeding parameters, and staff evaluations.</p><p><strong>Results: </strong>A total of 42 infants were included in the control group and 74 in the intervention group. NEC incidence was lower in the intervention group (4.1%) compared to the control group (9.5%), as was the rate of FIP (2.7% vs. 7.1%). Morbidity showed a decreasing trend in the intervention group (6.8% vs. 16.7%), and the combined morbidity and mortality rate was significantly lower (6.8% vs. 19.1%). Despite reduced stool frequency, enteral feeding tolerance improved in the intervention group.</p><p><strong>Conclusion: </strong>An unstandardized approach to rectal interventions may increase the need for surgical interventions, whereas standardized hydrostatic low-volume saline enemas are a safe and effective alternative to conventional rectal interventions, offering improved comfort and potentially reducing intestinal morbidity in infants with a birth weight ≤1000 g or gestational age ≤28 weeks.</p><p><strong>Trial identification number: </strong>DRKS00024191 (https://drks.de/search/de/trial/DRKS00024191).</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of growth status and nutritional management of prematurely born infants after hospital discharge: A position paper of the ESPGHAN Nutrition Committee.","authors":"Nadja Haiden, Veronica Luque, Magnus Domellöf, Susan Hill, Laura Kivelä, Barbara de Koning, Jutta Kӧglmeier, Sissel J Moltu, Lorenzo Norsa, Miguel Saenz De Pipaon, Francesco Savino, Elvira Verduci, Jiri Bronsky","doi":"10.1002/jpn3.70054","DOIUrl":"https://doi.org/10.1002/jpn3.70054","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the manuscript is to provide evidence-based or expert consensus-based recommendations for growth assessment and nutritional management of preterm-born infants during the post-discharge period.</p><p><strong>Methods: </strong>The search was conducted in Pubmed, MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews using the MESH terms: infant, preterm infant, low birth weight, infant food, nutritional status, nutrients, breast feeding, infant formula, human milk, dietary supplements, vitamins, iron, vitamin D, minerals, energy intake, weaning, and baby led. Overall, 402 papers were identified and screened, from which 101 publications were included in the present position paper. In the absence of evidence, recommendations reflect the authors' combined expert opinion. Final consensus was obtained through multiple e-mail exchanges and meetings with the Committee of Nutrition of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition.</p><p><strong>Results: </strong>Continuous growth monitoring through measurements of weight, length, and HC post-discharge is recommended to identify growth faltering (GF) or undernutrition. To prevent disproportionate growth, weight-for-length z-scores should be included in the assessment when term equivalent age is reached. Infants discharged with a significant drop in weight and length, exceeding a -2 standard deviation loss, require tailored nutritional support to address long-term growth challenges and to support recovery to normal growth rates. Breastfeeding is highly recommended for all infants when feasible. Infants needing to catch up in growth should be given supplements, such as HMF For those fed with formula, an adequate protein: energy ratio, minerals, and trace elements should be supplied to facilitate catch-up growth. The start of solid foods should coincide with the infant's neurological developmental milestones, rather than adhering strictly to a set age. Vitamin D and iron supplementation (with regular ferritin monitoring) is recommended through at least 12 months CA.</p><p><strong>Conclusion: </strong>For preterm infants, close monitoring of growth after discharge and nutritional assessment is essential to identify those at high risk for GF or undernutrition and to provide individualized nutritional support when needed. These patients should either be referred to a specialized center for pediatric nutritional care or, alternatively, their general pediatrician should receive appropriate training on the subject.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of liquid bleach ingestion on children's esophageal and gastric mucosa.","authors":"Paolo Quitadamo, Angelamaria di Lauri, Rossana Albano, Valentina Laudadio, Piergiorgio Gragnaniello, Maria G Puoti, Cristina Bucci, Sara Isoldi, Francesco Cirillo, Rossella Turco, Ludovica Carangelo, Mariano Caldore","doi":"10.1002/jpn3.70063","DOIUrl":"https://doi.org/10.1002/jpn3.70063","url":null,"abstract":"<p><strong>Objectives: </strong>The ingestion of caustic substances is currently a significant health concern in pediatric age, being bleach products among the most commonly ingested. The management of children having ingested bleach is currently controversial since scientific data on their degree of toxicity toward the esophageal and gastric mucosa are currently very poor. Therefore, our study aims at comprehensively analyzing the effects of bleach ingestion in children as well as at evaluating patterns of ingestions, clinical symptom development, and endoscopic findings.</p><p><strong>Methods: </strong>This prospective observational study was carried out between January 2017 and December 2023 at the Pediatric Department of Santobono Children's Hospital in Naples. Children aged 0-18 years admitted for bleach ingestion were enrolled.</p><p><strong>Results: </strong>One hundred children with a mean age of 58.7 months were included in the study. Eighty-nine/100 (89%) children had ingested household bleaches (both chlorine- or peroxidase-based) while 11/100 (11%) had ingested homemade or industrial bleaches. The latter were significantly more likely to develop esophagogastric lesions, while children having ingested commercially available household bleaches did not report significant mucosal lesions.</p><p><strong>Conclusions: </strong>Our data suggest that the toxicity of commercially available household bleaches on the gastrointestinal tract is very low. Therefore, digestive endoscopy is generally unnecessary in case of household bleach ingestion. Conversely, a timely endoscopic evaluation and close follow-up should be performed in children who ingest homemade or industrial bleaches.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep tracking and sleep hygiene counseling improve fatigue in pediatric patients with inflammatory bowel disease.","authors":"Sydney Kuzoian, Bradley Jerson, Michael Brimacombe, Lynelle Schneeberg, Jeffrey S Hyams","doi":"10.1002/jpn3.70066","DOIUrl":"https://doi.org/10.1002/jpn3.70066","url":null,"abstract":"<p><strong>Objectives: </strong>While the presence of fatigue and inadequate sleep are well-described in children with inflammatory bowel disease (IBD), little data exist on potential sleep improvement interventions. We aimed to determine if sleep tracking and sleep hygiene counseling can result in sleep behavior change and reduced fatigue in children/adolescents with IBD.</p><p><strong>Methods: </strong>This was a single-center, prospective, randomized controlled trial. Patients 12-20 years old with IBD, in clinical remission, completed validated Pediatric Quality of Life-Multidimensional Fatigue Scales (PedsQL-MDFS). Those who were found to have impaired sleep/rest fatigue (score <60) were randomized 1:1 into two intervention groups (A and B). Both groups were asked to track their sleep for 2 weeks using a standardized sleep log. Group B also had in-person sleep hygiene counseling. Outcomes were assessed 2 weeks after intervention implementation through repeat PedsQL-MDFS, self-reported behavior change surveys, and analysis of 2-week sleep logs.</p><p><strong>Results: </strong>Sixty-six patients were enrolled. The mean age was 16.5 years, 53% male, 71% Crohn's disease, and 25% ulcerative colitis. Forty-three patients met criteria for randomization into the intervention groups. There was a significant improvement in the PedsQL-MDFS Sleep/Rest Fatigue score in both intervention groups. Sleep hygiene counseling for Group B resulted in a significant increase in patients putting their electronic screens away 30 min before bedtime.</p><p><strong>Conclusion: </strong>Sleep tracking and in-person sleep counseling positively impact sleep/rest fatigue scores and sleep behavior change. These simple interventions hold the promise of improving sleep and fatigue in children and adolescents with IBD.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of multichannel intraluminal impedance and pH monitoring values in children with cerebral palsy: A comparative multicenter study.","authors":"Cristina Lorenzo, Cecilia Zubiri, Anabella Zosi, Sandro Miculan, Daniela Neder, Ana Rocca, Judith Cohen Sabban, Roman Bigliardi, Maria Florencia Biasoli, Manuela Manterola, Maria de Los Angeles Savia, Luis Orlando Perez, Carlos Ruiz Hernández, Renata Weinschelbaum, Ana Cristina Fontenele Soares, Soraia Tahan, Veronica Plante, Christian Boggio, Soledad Arcucci, Erick Toro Monjaraz, Maria Alejandra Mortarini, Samantha Arrizabalo, Miguel Saps","doi":"10.1002/jpn3.70058","DOIUrl":"https://doi.org/10.1002/jpn3.70058","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the features of multichannel intraluminal impedance and pH monitoring (MII-pH) tracings in children with cerebral palsy (CP) and children without CP.</p><p><strong>Methods: </strong>Multicenter, retrospective, analytical study. We examined tracings of children aged 1 to 15 years old, evaluated from May 2017 to January 2024. Population included two groups: Group 1 consisted of children with CP, while control group comprised children without CP who had extra-digestive symptoms suggestive of gastroesophageal reflux disease (GERD) but normal MII-pH results. Quantitative data were analyzed using analysis of variance and t tests. Qualitative data were analyzed using contingency tables and chi-square tests.</p><p><strong>Results: </strong>We studied 245 children. CP group included 110 children with a mean age of 5.71 years (standard deviation [SD] ± 4.24), while control group included 135 children with a mean age of 5.73 years (SD ± 3.39). The CP group had fewer reflux episodes (p = 0.0015), slower mean acid clearance time (p = 0.04), lower mean baseline impedance and mean nocturnal baseline impedance (p = 1.82e-07 and p = 7.50e-07).</p><p><strong>Conclusion: </strong>Children with CP have fewer reflux episodes and longer acid clearance times compared with children without CP. Prospective studies including esophagogastroduodenoscopy findings are needed to establish MII-pH reference values in children with CP.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor Re: Sirolimus to treat chronic and steroid-resistant allograft rejection-related fibrosis in pediatric liver transplantation.","authors":"Dana Cerminara, Krupa R Mysore","doi":"10.1002/jpn3.70059","DOIUrl":"https://doi.org/10.1002/jpn3.70059","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor: Sirolimus for treating chronic and steroid-resistant allograft rejection-related fibrosis in pediatric liver transplantation.","authors":"Jesús Quintero-Bernabeu, Javier J Goñi, Maria Mercadal-Hally, Mauricio Larrate-King","doi":"10.1002/jpn3.70060","DOIUrl":"https://doi.org/10.1002/jpn3.70060","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurodevelopment and the association with early life nutrition in moderate and late preterm infants.","authors":"Anne H Lafeber, Mark Bosch, Sophie F de Roos, Cornelieke S H Aarnoudse-Moens, Nicole R van Veenendaal, Johannes B van Goudoever, Femke de Groof","doi":"10.1002/jpn3.70056","DOIUrl":"https://doi.org/10.1002/jpn3.70056","url":null,"abstract":"<p><strong>Objectives: </strong>Long-term neurodevelopment of moderate and late preterm infants (MLPTI; gestational age [GA] 32 0/7 weeks to 36 6/7 weeks) is at a lower level than that of those at term age. Increased protein and energy intakes in the first week of life have been associated with better neurodevelopment early in life, in very preterm infants. This study aimed to evaluate the neurodevelopmental outcome of MLPTI at 2 years corrected age (CA) for prematurity (i.e., after term equivalent age) and its association with nutritional intake in the first week of life.</p><p><strong>Methods: </strong>We prospectively collected nutritional data during the first week of life from 100 MLPTI (GA 32 0/7 weeks to 35 6/7 weeks). At 2 years CA, children underwent a neurodevelopmental assessment using the Bayley Scales of Infant and Toddler Development, Third edition, Dutch version (BSID-III-NL).</p><p><strong>Results: </strong>The mean BSID-III-NL (mean ± standard deviation [SD]) score was 103.1 (10.9) on the cognitive composite, 101.1 (SD ± 15.0) on the language composite, and 100.8 (SD ± 9.6) on the motor composite. Boys scored significantly lower than girls on both cognitive and language composite scores. We found no significant associations between nutritional intake in the first week of life and neurodevelopment at 2 years CA.</p><p><strong>Conclusion: </strong>Neurodevelopment at 2 years CA was within normal limits, while boys scored lower than girls. First week nutritional intakes do not seem to be associated with neurodevelopmental outcomes at 2 years CA. This study emphasizes the need for more long-term follow-up and research concerning neurodevelopment in MLPTI, especially in boys.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State-of-the-art review of blenderized diets-Status and future directions.","authors":"Sharon Weston, Anushree Algotar, Sara Karjoo, Megan Gabel, Patrice Kruszewski, Debora Duro, Senthilkumar Sankararaman, Danielle Wendel, Shweta S Namjoshi, Ruba A Abdelhadi, David Kawatu, Mark R Corkins, Timothy Sentongo","doi":"10.1002/jpn3.70048","DOIUrl":"https://doi.org/10.1002/jpn3.70048","url":null,"abstract":"<p><p>This state-of-the-art review was produced by a multidisciplinary team composed of pediatric gastroenterology and nutrition healthcare providers to provide a comprehensive overview of the use of blenderized tube feeds (BTFs). The team developed 12 vital questions to address gaps in the current understanding and practice of using BTFs, then performed a comprehensive search of literature published between 2000 and 2023 using PubMed, MEDLINE, Embase databases, and an individual search of references. There was a scarcity of well-designed randomized clinical trials, and most of the studies were prospective or retrospective observational reports from heterogeneous patient demographics, varieties of BTFs, and medical conditions. Use of BTFs was associated with improved outcomes, including higher satisfaction, reduced gastroesophageal reflux, retching, gagging, constipation, frequency of hospitalization for respiratory disease, and greater diversity of the gut microbiome. However, homemade and commercially manufactured BTFs varied in nutrient composition and physical properties, such as viscosity, which posed challenges related to ease of administration and comparison of clinical outcomes. Therefore, whereas the use of BTFs as an alternative to standard commercial formulas has become increasingly popular, further evidence is warranted to provide guidelines on best practices for usage, monitoring, and comparing clinical outcomes. Pediatric dietitians and clinician practitioners must regularly monitor children receiving BTFs to ensure nutritional adequacy, optimize safe and effective delivery, and promote optimal growth. The team proposed future directions regarding best practices for using BTFs, primarily related to clinical application and nutritional outcomes in children and adolescents.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse events are lower in unsedated transnasal esophagoscopy versus sedated esophagogastroduodenoscopy.","authors":"Yeshai T Dollin, Jacob A Mark, Rachel Andrews, Zhaoxing Pan, Courtney Ort, Robert E Kramer, Nathalie Nguyen","doi":"10.1002/jpn3.70061","DOIUrl":"https://doi.org/10.1002/jpn3.70061","url":null,"abstract":"<p><strong>Objectives: </strong>Unsedated transnasal esophagoscopy (TNE) is an innovative and minimally invasive technique becoming more commonplace in pediatric gastroenterology. The advantages include no anesthesia, decreased cost, and less time away from work and school. There is no published data evaluating postprocedure adverse events (AE) with TNE. The aim of this study was to evaluate postprocedure AE associated with TNE compared to sedated esophagogastroduodenoscopy (EGD).</p><p><strong>Methods: </strong>AE data were prospectively collected for patients ages 5-22 years who underwent endoscopy at a tertiary children's hospital between January 2015 and June 2022. Demographic data and procedural factors were collected, and AE were categorized using a standardized scoring system.</p><p><strong>Results: </strong>A total of 10,023 diagnostic EGD's on 7786 patients and 927 TNE's on 492 patients were performed. The total number of AE (Grade I-IV) observed were 196 after EGD and 1 after TNE. The total AE rate for EGD's was significantly higher than for TNE's (1.96% vs. 0.11%, p < 0.0001). The clinically significant AE (Grade II or higher) for EGD's was higher than TNE's (0.67% vs. 0%, p = 0.006). In controlling for eosinophilic esophagitis (EoE) as the indication, the total AE and the clinically significant AE for EGD's were higher than TNE's ([1.87% vs. 0.12% p < 0.001], [0.75% vs. 0% p = 0.01]).</p><p><strong>Conclusions: </strong>The postprocedure AE rate for TNE was lower than EGD both for overall and clinically significant AE. This suggests TNE is a safer approach for monitoring esophageal pathology than sedated EGD for patients who can undergo TNE.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}