Pediatric Surgery International最新文献

{"title":"Clinical characteristics, pathological comorbidities, BMI-for-age Z-score, and machine learning-based exploration of postoperative enterocolitis in iIntestinal neuronal dysplasia: a 20-year retrospective study.","authors":"Qingxuan Hu, Zongye Yang, Lei Xiang, Qinxue Lu, Xufei Duan, Hongqiang Bian, Jiexiong Feng, Jun Xiao, Xuyong Chen","doi":"10.1007/s00383-026-06655-5","DOIUrl":"10.1007/s00383-026-06655-5","url":null,"abstract":"<p><strong>Purpose: </strong>Intestinal neuronal dysplasia (IND) is a congenital enteric neuropathy characterized by abnormalities of the enteric nervous system, most commonly involving hyperplasia of the submucosal plexus and the presence of giant ganglia. This study aimed to characterize the clinical features of IND, evaluate postoperative enterocolitis (POEC), and explore the utility of machine learning (ML) approaches for POEC risk prediction.</p><p><strong>Methods: </strong>Patients diagnosed with IND who underwent pull-through surgery at our institution between 2005 and 2025 were retrospectively reviewed. Clinical characteristics and postoperative outcomes were analyzed. POEC was retrospectively assessed with reference to established HAEC diagnostic criteria. Multiple feature-selection strategies and five machine learning algorithms were combined to construct and evaluate 101 predictive models using out-of-fold area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>A total of 84 patients with isolated IND who underwent pull-through surgery were included. The mean age at symptom onset was 2.57 ± 3.59 years and the mean age at surgery was 5.11 ± 4.22 years. Of these, 77.4% underwent laparoscopic pull-through surgery, 57.1% were male, and constipation was the most common presenting symptom (67.9%). Mixed IND with IMG and/or HG accounted for 64.3% of cases. POEC occurred in 10 patients (11.9%) during follow-up. Female patients and those with mixed IND had significantly lower BMI-for-age Z-scores (BMIZ). Conventional statistical analyses identified no significant individual factors associated with POEC, whereas exploratory machine learning analyses consistently ranked BMIZ among the potentially important predictive features.</p><p><strong>Conclusion: </strong>In this study, we characterized the clinical and pathological features of children with isolated intestinal neuronal dysplasia over a 20-year period. Patients were predominantly male, frequently presented with constipation, and most exhibited mixed IND rather than pure IND. Nutritional impairment was common, with female patients and those with mixed IND showing lower BMIZ values. Machine learning analyses consistently identified BMIZ as a potential predictive feature associated with postoperative enterocolitis, highlighting the potential role of nutritional status in postoperative risk stratification.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025619","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":"Prevalence of hypothermia prior to trauma center arrival and associated mortality in pediatric traumatic brain injury patients.","authors":"Teresa M Bell, Jodi Raymond, Andrea N Davis, Mathew P Landman, Laurie Ackerman","doi":"10.1007/s00383-026-06650-w","DOIUrl":"10.1007/s00383-026-06650-w","url":null,"abstract":"<p><strong>Objective: </strong>Hypothermia is a component of the trauma \"lethal triad\" but often goes untreated. The prevalence of prehospital hypothermia in pediatric traumatic brain injury (TBI) patients is unknown. We aimed to examine how frequently hypothermia occurred during prehospital care by emergency medical services (EMS), at outside transferring hospitals (OSH), and during interfacility transport (IF) prior to trauma center arrival.</p><p><strong>Methods: </strong>This was a retrospective cohort study of patients < 18 years old treated for TBI and admitted to the intensive care unit at a level 1 pediatric trauma center. Body temperature was categorized as normal (≥ 36 °C), mild (34-36 °C), moderate (32-34 °C), or severe (< 32 °C) hypothermia using EMS, OSH, IF, and arrival ED measurements.</p><p><strong>Results: </strong>Among 171 patients, 40.4% experienced prehospital hypothermia. Mortality was higher in hypothermic patients (49.3%) compared with normothermic patients (15.7%; p < 0.001). Hypothermia was more frequent in children < 2 years (55.1%), non-accidental trauma (42%), and transfers (66.7%). Temperature was undocumented in 84.6% of EMS, 28.1% of IF, and 33.3% of OSH encounters. Patients without documented temperatures often arrived at the trauma center with temperatures below 34 °C.</p><p><strong>Conclusions: </strong>Prehospital hypothermia is common and strongly associated with mortality in pediatric TBI, yet frequently unassessed. Routine prehospital temperature monitoring should be prioritized.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond scalar thresholds: leveraging medical vision foundation models for pediatric surgical risk stratification.","authors":"Yiru Zhao, Yuhan Zou, Wei Xiong, Zekai Yu","doi":"10.1007/s00383-026-06652-8","DOIUrl":"10.1007/s00383-026-06652-8","url":null,"abstract":"","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008810","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 liver fibrosis in children with intestinal failure and prolonged parenteral nutrition.","authors":"Phoenix Wy Wong, Fanny Yeung, Patrick Hy Chung, Kenneth Ky Wong","doi":"10.1007/s00383-026-06633-x","DOIUrl":"10.1007/s00383-026-06633-x","url":null,"abstract":"<p><strong>Background: </strong>Children with intestinal failure (IF) often necessitates prolonged parenteral nutrition (PN) use, which predisposes them to IF-associated liver disease (IFALD) and fibrosis. The aim of the study is to evaluate the prevalence and severity of liver fibrosis using transient elastography (TE) on children with IF who were on prolonged PN.</p><p><strong>Methods: </strong>Patients with IF requiring PN for more than 3 months between Jan 2000 to December 2024 were included in the study. Liver fibrosis was assessed by TE and defined by a fibrosis score (FS) > = 6.8 kPa. Baseline demographics, diagnosis, operation details, PN characteristics, and outcomes were compared between the fibrosis and non-fibrosis groups.</p><p><strong>Results: </strong>37 children suffered from IF requiring prolonged PN were identified, and TE was performed in 19. 17 patients (89.5%) had massive bowel resection, and 2 (10.5%) had visceral myopathies. Necrotizing enterocolitis was the commonest cause of IF in this cohort (14, 73.7%). 8 (42.1%) remained dependent on PN at the time of TE. Median PN duration was 16 months (3-144 months). 4 patients (21.1%) had liver fibrosis on TE. The fibrosis and non-fibrosis groups (15, 78.9%) were similar in terms of baseline demographics, operative details and PN characteristics. There were 2 deaths in the fibrosis group, one from IF related liver failure and the other from respiratory failure with known cholestasis. (50% vs. 0%, p = 0.035).</p><p><strong>Conclusion: </strong>With TE measurement, the incidence of liver fibrosis in this cohort was at 21%, which appears to be higher than previously reported. They are associated with higher risk of mortality but not with known risk factors of IFALD. Further prospective studies with larger sample size will be required for proper evaluation.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perirenal fat stranding on preoperative imaging is associated with a prolonged operative time in pediatric radical nephrectomy.","authors":"Motoki Ebihara, Kyoichi Deie, Rina Matsuda, Shoichi Tsuzaka, Shotaro Taki, Shoko Ogawa, Hiroshi Kawashima","doi":"10.1007/s00383-026-06634-w","DOIUrl":"10.1007/s00383-026-06634-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether preoperative perirenal fat stranding is associated with operative time and outcomes in pediatric radical nephrectomy for primary renal tumors.</p><p><strong>Methods: </strong>We retrospectively reviewed 30 children who underwent open radical nephrectomy at a single institution between 2000 and 2025. Because posterior perirenal fat thickness showed no variability, analyses focused on perirenal fat stranding (none, type 1, and type 2). Primary outcomes were operative time and intraoperative blood loss normalized to body weight. Secondary outcomes were intraoperative complications, tumor spillage, and postoperative complications within 30 days.</p><p><strong>Results: </strong>Posterior perirenal fat thickness was 0 in all patients. Fat stranding was absent in 13 patients, type 1 in 11, and type 2 in 6. Operative time was longer in the type 2 group than in the other groups (both p < 0.05), whereas blood loss did not differ significantly. Stranding severity was not associated with secondary outcomes or preoperative tumor diameter. In age-adjusted analysis, the association with operative time was attenuated and no longer significant.</p><p><strong>Conclusion: </strong>Preoperative perirenal fat stranding is associated with prolonged operative time and may not be explained by tumor size alone. However, this association is attenuated after adjustment for age at surgery and should be interpreted cautiously.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990535","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":"Surgical management of hirschsprung disease: results of a worldwide survey.","authors":"Sage A Vincent, Vatche Melkonian, Andrea Bischoff, Kaitlin E Olson, Jill Ketzer, Alberto Peña, Luis de la Torre","doi":"10.1007/s00383-026-06568-3","DOIUrl":"10.1007/s00383-026-06568-3","url":null,"abstract":"<p><strong>Purpose: </strong>Hirschsprung disease (HD) is a rare condition. It requires well-oriented care regardless of birthplace. We aimed to understand global HD management and identify areas of consensus and variability in perioperative care.</p><p><strong>Methods: </strong>The Hendren Project distributed a survey to all members of its global network of pediatric surgeons and invited those who had performed five or more HD operations at their institution to participate. Surgeons were asked to retrospectively review their five most recent operations and answer a series of questions regarding diagnostic workup, surgical intervention, and complications.</p><p><strong>Results: </strong>105 surgeons completed the survey, representing 81 hospitals in 58 cities and 42 countries, reporting on 403 distinct patients. HD diagnosis was most often made by open transanal biopsy (52.4%). Preoperative rectal irrigations, used as medical treatment for obstruction, were administered to 84.8% of patients. Primary pull-through was performed in 58.8% of patients, and staged repair with a previously created colostomy was performed in 41.2%. Postoperative complications occurred in 23.6% of patients, most commonly stricture and reoperation.</p><p><strong>Conclusion: </strong>A global survey of pediatric surgeons identified variation in perioperative management of patients with HD, with 25% of patients experiencing surgical complications. Opportunities for quality improvement and educational efforts to improve outcomes and surgical disparities were detected.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990805","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":"Shall we score? The SHALL-WE score for optimizing sclerotherapy in superficial lymphatic malformations.","authors":"Hiromasa Takei, Mototoshi Kato, Satoko Yamagishi, Yohei Yamada, Motohiro Kano, Yoshiaki Kinoshita, Michio Ozeki, Shunsuke Nosaka, Takeshi Hirabayashi, Naonori Kawakubo, Tomoro Hishiki, Keita Terui, Tomoaki Taguchi, Shigeru Ueno, Akihiro Fujino","doi":"10.1007/s00383-026-06631-z","DOIUrl":"10.1007/s00383-026-06631-z","url":null,"abstract":"<p><strong>Purpose: </strong>No standardized tool guides the decision of when to escalate beyond sclerotherapy in lymphatic malformations (LMs). We developed the SHALL-WE score (Severity, Histology, And Location-Lymphatic malformation: When to Escalate) to define the optimal sclerotherapy threshold in superficial LMs.</p><p><strong>Methods: </strong>We analyzed 709 patients with superficial LMs from a nationwide survey in Japan. Multivariable logistic regression identified predictors of treatment success, used to construct the SHALL-WE score (0-3 points): head and neck location, non-cystic histology, and severe disease (1 point each). The optimal threshold was the session count beyond which success rates fell below the overall mean (63.0%).</p><p><strong>Results: </strong>Treatment success rates decreased with increasing score (score 0: 71.6%, 1: 64.1%, 2: 43.6%, 3: 20.0%; p < 0.001). Optimal thresholds were two sessions for score 0, one for score 1, and early escalation for scores 2-3. Patients managed within thresholds had higher success rates (71.9% vs. 51.2%; adjusted OR 1.921, 95% CI 1.340-2.753, p < 0.001).</p><p><strong>Conclusion: </strong>The SHALL-WE score defines when sclerotherapy is unlikely to succeed and treatment escalation should be considered. Prospective external validation is warranted.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The long-term follow-up outcomes and transition rates across seven representative pediatric congenital surgical conditions: disease severity drives follow-up retention.","authors":"Yumiko Tabata, Toshio Harumatsu, Yudai Tsuruno, Ayaka Nagano, Koshiro Sugita, Nanako Nishida, Chihiro Kedoin, Masakazu Murakami, Keisuke Yano, Shun Onishi, Koji Yamada, Waka Yamada, Makoto Matsukubo, Ryuta Masuya, Takafumi Kawano, Tatsuru Kaji, Satoshi Ieiri","doi":"10.1007/s00383-026-06640-y","DOIUrl":"10.1007/s00383-026-06640-y","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with congenital surgical conditions require lifelong follow-up. However, the transition from pediatric to adult care remains poorly established. This study aimed to evaluate the long-term follow-up outcomes and transition rates of seven pediatric congenital surgical conditions.</p><p><strong>Methods: </strong>This single-institution retrospective study included 337 patients born before 2008 who underwent surgery for esophageal atresia/tracheoesophageal fistula (TEF-EA, n = 30), choledochal cyst (CC, n = 53), biliary atresia (BA, n = 62), Hirschsprung's disease (HD, n = 60), high/intermediate anorectal malformation (ARM, n = 56), low ARM (n = 69), and cloacal malformation (Cloaca, n = 7). Follow-up outcomes and transition status were assessed.</p><p><strong>Results: </strong>Overall, 146 patients (43%) were lost to the follow-up, and only 10 (3%) achieved formal transition. The lost to follow-up rates were highest in High/Int ARM (61%), HD (55%), and Low ARM (54%), with median last visit ages of 15.0, 5.5, and 7.6 years. Conversely, BA (21%) and cloacal (0%) anomalies demonstrated low attrition despite early surgical ages, suggesting that disease severity drives follow-up retention. One patient with Cloaca who disengaged from follow-up died from a urinary tract infection at 35 years old.</p><p><strong>Conclusion: </strong>Follow-up attrition was paradoxically the highest among patients with favorable postoperative outcomes. Targeted transition programs focusing on ARM and HD populations are urgently needed.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990839","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":"A comparison between an early- and a late frenulotomy for neonates with problematic tongue-tie.","authors":"Junsujee Wakhanrittee, Jiraporn Khorana, Siriphut Kiatipunsodsai","doi":"10.1007/s00383-026-06645-7","DOIUrl":"10.1007/s00383-026-06645-7","url":null,"abstract":"<p><strong>Purpose: </strong>To compare breastfeeding outcomes between early and late frenulotomy in infants with problematic tongue-tie to determine optimal intervention timing.</p><p><strong>Methods: </strong>Conducted over two years at Thammasat University Hospital, this prospective cohort study divided mother-infant pairs into an early group (n = 103; <72 h postpartum) and a late group (n = 123; 7-14 days postpartum). Primary outcomes focused on exclusive breastfeeding (EBF) success at three months of age, while secondary outcomes measured LATCH scores improvement, pain reduction, and weight regain.</p><p><strong>Results: </strong>Both groups showed significant postoperative improvements. Median LATCH scores increased from 5 to 6 to 9, and latching pain decreased significantly within one week. However, the early group demonstrated a significantly higher EBF rate at three months (78.64% vs. 66.67%). Using inverse probability of treatment weighting (IPTW), early frenulotomy was associated with a higher likelihood of EBF success (RR = 1.60; p < 0.001) and superior pain reduction (RR = 1.33). No significant differences were observed in weight regain or LATCH score between groups.</p><p><strong>Conclusion: </strong>For infants with symptomatic tongue-tie, performing a frenulotomy within 72 h of birth provides greater benefits in terms of EBF success and latching pain reduction compared to delayed intervention, suggesting early correction is the preferred clinical approach.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977566","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":"Irrigation performance of a 2-mm rigid cystoscope designed for neonatal cystoscopy: a bench study.","authors":"Akio Kawami, Takahiro Jimbo, Tomohiro Aoyama, Kouji Masumoto","doi":"10.1007/s00383-026-06636-8","DOIUrl":"10.1007/s00383-026-06636-8","url":null,"abstract":"<p><strong>Purpose: </strong>Neonatal and infant cystoscopy is limited by narrow urethral caliber and the lack of sufficiently small cystoscopes with adequate irrigation. We developed a 2-mm (6 Fr) rigid cystoscope prototype and evaluated irrigation performance in a benchtop open-flow system.</p><p><strong>Methods: </strong>The prototype incorporated a 0.9-mm optical channel, a 0.7-mm working channel, and two irrigation lumens (0.48 mm each). Irrigation performance was assessed under gravity and cuff-assisted irrigation, including temperature-controlled experiments. The maximum cuff pressure of 300 mmHg was used as an upper-bound bench condition and was not intended to represent a recommended clinical setting. Outflow was measured gravimetrically, and mean flow was calculated over 60 s.</p><p><strong>Results: </strong>Gravity irrigation yielded 2.12-8.50 mL/min. Cuff-assisted irrigation increased flow from 17.39 mL/min at 150 mmHg to 40.40 mL/min at 300 mmHg (p < 0.001). At 300 mmHg, warming saline from 20 °C to 37 °C increased flow from 27.49 to 40.40 mL/min (p < 0.001). Probe insertion reduced flow by 4.4% (p = 0.157).</p><p><strong>Conclusion: </strong>The 2-mm rigid cystoscope achieved flows up to 40.4 mL/min, within the benchmark range adopted for this benchtop evaluation. These findings support benchtop technical feasibility of the irrigation design. Clinical safety and recommended irrigation pressures remain to be established in closed-system and in vivo studies.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"42 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977731","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}