Clinical and Experimental Pediatrics最新文献

{"title":"Rising incidence of central precocious puberty in Thailand: a nationwide population-based study before, during, and after the COVID-19 pandemic (2018-2024).","authors":"Pattara Wiromrat, Preamrudee Poomthavorn, Ratikorn Chaisiwamongkol, Chaiyawat Suppasilp, Ouyporn Panamonta, Ratchaneewan Sinitkul","doi":"10.3345/cep.2026.00983","DOIUrl":"10.3345/cep.2026.00983","url":null,"abstract":"<p><strong>Background: </strong>Nationwide data on the incidence of central precocious puberty (CPP) and premature thelarche (PT), a benign variant of pubertal development, are limited.</p><p><strong>Purpose: </strong>To evaluate trends in CPP and PT incidence among Thai children before, during, and after the COVID-19 pandemic.</p><p><strong>Methods: </strong>This cross-sectional population-based study used National Health Security Office (NHSO) claims data from 2018 to 2024. CPP and PT were identified using ICD-10-TM (International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Thai Modification) codes. Annual incidence rates (AIRs) were calculated for each NHSO-insured population, while incidence rate ratios (IRRs) were estimated using quasi-Poisson regression.</p><p><strong>Results: </strong>A total of 6,782 girls and 189 boys with CPP, and 1,594 girls with PT, were included. Among girls, the CPP AIR increased from 15.0 per 100,000 person-years in 2018 to 51.7 in 2021 and remained elevated during 2022-2024 (44.1-47.7). The IRR was 2.27 (95% confidence interval [CI], 1.82-2.83) for pandemic versus prepandemic, and 1.06 (95% CI, 0.89-1.26) for postpandemic versus pandemic period. An age-stratified analysis showed the greatest increase among girls aged 8 to <9 years. Among boys, the CPP AIR remained low and stable (0.6-1.0 per 100,000 person-years). The female-to-male IRR was 43.0 (95% CI, 33.5-55.3). The incidence of PT in girls increased from 7.2 in 2018 to 14.6 per 100,000 person-years in 2024, with the largest increase observed among those aged 7 to <8 years.</p><p><strong>Conclusion: </strong>The incidence of CPP among Thai girls increased during the COVID-19 pandemic and remained elevated thereafter, whereas the incidence of PT increased gradually. Both trends were most pronounced in peripubertal age groups. Further studies are required to determine whether these patterns reflect pandemic-related factors or an earlier onset of puberty.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":"69 9","pages":"733-742"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881322","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":"Anti-GD1b-positive sensory ataxic Guillain-Barré syndrome with bulbar involvement and Bickerstaff brainstem encephalitis-like features in an adolescent: a case report.","authors":"Hamza Reaz Aziz, Kirsh Kumar, Nabiha Naveed, Saira Awan","doi":"10.3345/cep.2026.00717","DOIUrl":"10.3345/cep.2026.00717","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"743-747"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833205","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":"Effect of lifestyle interventions on pediatric obesity: a lifestyle medicine systematic review.","authors":"Jung Eun Choi, Hee Jeoung Lim, Kyung Hee Kim, Hae Soon Kim","doi":"10.3345/cep.2026.00927","DOIUrl":"10.3345/cep.2026.00927","url":null,"abstract":"<p><p>Childhood and adolescent obesity are major public health concerns with adverse cardiometabolic outcomes. Lifestyle interventions are the cornerstone of management; however, their effects are often evaluated as single components rather than being within an integrated framework. Lifestyle medicine recently emerged as a comprehensive approach emphasizing multiple health behaviors. This study aimed to evaluate the effects of lifestyle interventions on anthropometric and cardiometabolic outcomes in children and adolescents with overweight or obesity and interpret these findings within the framework of lifestyle medicine. A systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) 2020 guidelines. PubMed and Web of Science were searched for studies published from January 2019 to March 2026. Eligible studies examined children and adolescents with overweight or obesity who were receiving lifestyle interventions, including physical activity, dietary modification, or multicomponent approaches. The primary outcomes were anthropometric measures, while the secondary outcomes were cardiometabolic parameters. Sixteen studies were ultimately included. Lifestyle interventions were associated with improvements in anthropometric and cardiometabolic outcomes. All 5 exercise-based intervention studies reported improved anthropometric or cardiometabolic outcomes, particularly following high-intensity interval training. Among the 8 dietary intervention studies, 7 reported significant improvements, whereas one found no significant intergroup differences. All 3 multicomponent lifestyle intervention studies demonstrated favorable anthropometric and cardiometabolic outcomes. This analysis demonstrates that lifestyle interventions effectively treat pediatric obesity, with multicomponent approaches showing the greatest benefit. These findings support the importance of integrated lifestyle strategies consistent with lifestyle medicine principles. Further long-term studies are needed to confirm these findings.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"686-693"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841611","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":"Red cell distribution width and reticulocyte hemoglobin content as predictors of iron depletion in children with cyanotic congenital heart disease.","authors":"Hanyudh Prichayudh, Kanhatai Chiengthong, Khwaunrat Whaidee, Navaporn Phiphattanatikanunt, Vidhavas La-Orkhun, Pornthep Lertsapcharoen","doi":"10.3345/cep.2026.00241","DOIUrl":"10.3345/cep.2026.00241","url":null,"abstract":"<p><strong>Background: </strong>Iron-deficiency anemia is challenging to diagnose in patients with cyanotic congenital heart disease (CCHD) because of the high hemoglobin concentration as a compensatory mechanism for cyanosis.</p><p><strong>Purpose: </strong>This study aimed to identify predictive parameters of iron depletion status and assess the prevalence of iron deficiency in patients with CCHD.</p><p><strong>Methods: </strong>A descriptive study enrolled patients with CCHD aged 6 months to 15 years between September 2022 and September 2023. Participants were categorized into iron depletion and iron sufficiency groups defined by a serum ferritin level <30 ng/mL or transferrin saturation <15%. The clinical characteristics and laboratory parameters were compared between groups. The Youden index was used to determine the optimal cutoff points, maximizing both sensitivity and specificity for the red cell indices.</p><p><strong>Results: </strong>Among the 110 enrolled patients with CCHD, 28 (25.5%) had iron depletion. While hemoglobin (Hb) and hematocrit (Hct) levels were comparable between groups, the iron-depleted group exhibited significantly lower reticulocyte hemoglobin content (CHr) and higher red cell distribution width (RDW). A multivariate analysis identified an RDW ≥18.8% (odds ratio [OR], 7.79; P=0.001) and CHr <28 pg (OR, 4.97; P=0.004) as independent predictors of iron depletion. The diagnostic accuracy improved to 85.4% when these parameters were combined.</p><p><strong>Conclusion: </strong>Iron depletion is highly prevalent in patients with CCHD. Because conventional parameters, such as Hb and Hct, fail to differentiate iron status owing to compensatory mechanisms, CHr and RDW serveas effective predictive tools. This combination offers a practical diagnostic alternative, especially in resource-limited settings, where standard iron studies are unavailable.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"706-712"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621594","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":"A commentary on \"Rising incidence of central precocious puberty in Thailand: a nationwide population-based study before, during, and after the COVID-19 pandemic (2018-2024)\".","authors":"Won Kyoung Cho","doi":"10.3345/cep.2026.02348","DOIUrl":"10.3345/cep.2026.02348","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"704-705"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833200","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":"Linking pediatric obesity to youth-onset type 2 diabetes: integrated longitudinal and cross-sectional evidence from population-based studies worldwide.","authors":"Ashraf T Soliman, Fawzia Alyafei, Nada Alaaraj, Noor Hamed, Shayma Mohamed, Ahmed Elawwa","doi":"10.3345/cep.2026.01228","DOIUrl":"10.3345/cep.2026.01228","url":null,"abstract":"<p><p>Youth-onset type 2 diabetes mellitus (T2DM) is a rapidly growing pediatric metabolic disorder that parallels the global childhood obesity epidemic. Despite multiple population-based registries and a global meta-analysis documenting near-universal obesity at the time of a T2DM diagnosis, no integrated synthesis spanning 25 years and including diverse populations has been performed. Here we conducted a systematic review of PubMed and Scopus (January 2000 to March 2025) using longitudinal data from population-based registries in the USA (SEARCH), Canada (Manitoba), England and Wales (National Paediatric Diabetes Audit), Israel, Australia, and New Zealand as well as cross-sectional burden from a global meta-analysis (53 studies, n=8,942) and national audits. Study quality was appraised using the Newcastle-Ottawa Scale and A Measurement Tool to Assess Systematic Reviews v2. All registries showed a temporally parallel increase in the incidence of pediatric obesity and youth-onset T2DM. In the USA, the T2DM incidence rose 79% (3.8 → 6.8 per 100,000/yr, 2002-2018); in Manitoba, it nearly doubled (16.0 → 31.1 per 100,000/yr, 2009-2018); and Israel showed a 441% rise (0.63 → 3.41 per 100,000/yr, 2008-2019). The global pooled obesity prevalence at the T2DM diagnosis was 75.3% (95% confidence interval, 72.1%-78.5%), with approximately 41,600 new youth cases annually worldwide. Once-weekly semaglutide 2.4 mg (STEP TEENS trial) reduced the average body mass index by 16.1% at 68 weeks with concurrent glycemic improvement, while bariatric surgery achieved 95% T2DM remission at 3 years in adolescents (Teen-LABS cohort). Multicontinental evidence confirmed a robust temporally consistent obesity-T2DM link; obesity precedes T2DM at the population level and is present in approximately 75% of affected youths at diagnosis worldwide. Weight-reduction interventions, particularly glucagon-like peptide-1 receptor agonists and bariatric surgery, offer meaningful glycemic benefits; however, primary prevention of childhood obesity remains the most powerful strategy to arrest this epidemic.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"622-635"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593799","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":"Association between sodium content of intravenous immunoglobulin and electrolyte changes and clinical course of Kawasaki disease.","authors":"Yoshitaka Watanabe, Naomi Yagi, Toya Hattori, Chisato Oyake, Shota Endo, Maria Yoshimi, Takayoshi Kyoda, Hirokazu Ikeda","doi":"10.3345/cep.2026.00619","DOIUrl":"10.3345/cep.2026.00619","url":null,"abstract":"<p><strong>Background: </strong>Intravenous immunoglobulin (IVIG) formulations used to treat Kawasaki disease differ markedly in sodium content; however, the clinical significance of this factor remains unclear.</p><p><strong>Purpose: </strong>Here we investigated whether sodium content influences electrolyte changes and short-term clinical outcomes of Kawasaki disease.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 744 children with first-episode Kawasaki disease treated with 2-kg IVIG in 2010-2020. The patients were categorized into high-sodium (Glovenin-I or Venilon-I) and low-sodium (Venoglobulin IH) groups. Serum electrolytes, total protein, and immunoglobulin G levels were measured before and after IVIG administration. Outcomes included additional IVIG administration and the presence of coronary artery lesions.</p><p><strong>Results: </strong>Compared to the low-sodium group, the high-sodium group had significantly increased serum sodium (2.9±3.2 mEq/L vs. 1.7±2.7 mEq/L) but significantly decreased serum potassium (-0.13±0.50 mEq/L vs. -0.03±0.49 mEq/L) levels after IVIG therapy. After its administration, hyponatremia occurred more often in the low-sodium group (4.4% vs. 0.3%), whereas hypokalemia occurred more frequently in the high-sodium group (9.9% vs. 5.5%). Total protein, immunoglobulin G, and albumin levels were higher in the low-sodium group. The rates of additional IVIG use and coronary artery lesions did not differ significantly between groups.</p><p><strong>Conclusion: </strong>Our findings demonstrate that the sodium content of IVIG contributes to distinct changes in electrolyte and protein concentrations during the acute phase of Kawasaki disease. However, these biochemical differences were not associated with short-term clinical outcomes. Awareness of formulation-specific profiles may help clinicians interpret laboratory findings appropriately during IVIG therapy.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"639-645"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377338","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":"Efficacy and safety of home-based fiberoptic blanket versus hospital-based light-emitting diode phototherapy for neonatal jaundice: a retrospective cohort study from Thailand.","authors":"Chayatat Ruangkit, Thanyathorn Thaninjeerawat, Saitarn Klaidangklum, Saowalak Prasopa, Pongsakorn Atiksawedparit, Sasivimon Soonsawad","doi":"10.3345/cep.2026.00703","DOIUrl":"10.3345/cep.2026.00703","url":null,"abstract":"<p><strong>Background: </strong>Home phototherapy (HPT) is an alternative to inpatient phototherapy (IPT) for the treatment of neonatal jaundice; however, comparative data remain limited on the effectiveness of phototherapy (PT) devices across care settings.</p><p><strong>Purpose: </strong>To compare the efficacy and safety of HPT using a fiberoptic light-emitting diode (LED) PT blanket with those of IPT using overhead LED PT in neonates with jaundice.</p><p><strong>Methods: </strong>This retrospective cohort study included neonates born at ≥35 weeks' gestation who were prescribed treatment for jaundice at a tertiary academic medical center in Thailand between August 1, 2023, and December 31, 2025. Infants who underwent either HPT or IPT were included. The bilirubin reduction, treatment success, and adverse event rates were compared between groups.</p><p><strong>Results: </strong>A total of 100 PT sessions (89 neonates) were analyzed, including 55 HPT sessions (50 infants) and 45 IPT sessions (43 infants). Some infants received both treatment modalities during separate sessions, and each session was analyzed according to the administered PT modality. The mean bilirubin reduction rate was significantly lower in the HPT versus IPT group (0.18±0.10 mg/dL/hr vs. 0.29±0.08 mg/dL/hr, P<0.001). This finding remained consistent in uni- and multivariate multilevel mixed-effects linear regression analyses, accounting for repeated PT sessions, intergroup crossover, and potential confounders (coefficient, -0.116; 95% confidence interval, -0.146 to -0.086; P<0.001). Treatment success was achieved in all infants except for one in the HPT group who experienced an increase in total serum bilirubin following treatment that subsequently resolved after conversion to IPT. No serious PT-related complications were observed in either group.</p><p><strong>Conclusion: </strong>In routine clinical practice, fiberoptic home PT was safe but less effective than hospital-based LED PT at reducing bilirubin levels, supporting its use in carefully selected neonates with appropriate monitoring and follow-up.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"655-664"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377334","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":"Peters anomaly: a rare etiology of corneal clouding in the newborn.","authors":"Gregory Ison, Srividya Naganathan","doi":"10.3345/cep.2026.00794","DOIUrl":"10.3345/cep.2026.00794","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"680-682"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437946","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":"Virtual reality for managing pain and fear and anxiety during pediatric needle procedures: an umbrella review.","authors":"Thomas Saliba, Guillaume Fahrni","doi":"10.3345/cep.2026.01221","DOIUrl":"10.3345/cep.2026.01221","url":null,"abstract":"<p><p>Needle-involving procedures often cause significant pain and anxiety, particularly in the pediatric population. Virtual reality (VR) has emerged as a nonpharmacological tool for alleviating these effects. However, the methodological quality and consistency of current meta-analyses of VR tools remain unclear. Here we performed an umbrella review to evaluate published meta-analyses that assessed the ability of VR to reduce pain, fear, and anxiety during medical procedures involving needles. A systematic search following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) 2020 guidelines was performed of the PubMed, Web of Science, Embase, ScienceDirect, and Cochrane Library databases in May 2026. Study methodological quality was assessed using A MeaSurement Tool to Assess systematic Reviews, version 2 (AMSTAR 2). The primary study overlap was quantified using the corrected covered area (CCA) and visualized using the GROOVE (Graphical Representation of Overlap of OVErviews) approach. An umbrella meta-analysis was performed using a metaumbrella analysis tool, with sensitivity analyses varying for inter- and intrastudy variance estimators and correlations. Eleven meta-analyses were included, containing 49 unique primary studies. The CCA was 15.7%, indicating very high overlap. The AMSTAR 2 ratings were predominantly low or critically low, with only one high-confidence review. The umbrella meta-analysis demonstrated statistically significant reductions in pain (I²=90.5%), fear (I²=91.1%), and anxiety (I²=89.9%), with a significant publication bias for pain and fear. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) classification was \"very weak\" for all 3 outcomes. Although available meta-analyses consistently suggest that VR reduces procedural pain, fear, and anxiety in children, the evidence base is undermined by high heterogeneity, substantial primary study overlap, and predominantly low methodological quality. VR may serve as an additional distraction tool for selected pediatric needle procedures; however, current evidence is insufficient to recommend it as a replacement for established analgesic strategies.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"609-621"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593804","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}