Clinical Medicine Insights-Pediatrics最新文献

{"title":"Severe Disseminated Varicella Zoster in an Immunocompetent Adolescent: A Case Report.","authors":"Kelan Queenan, Ronald Williams","doi":"10.1177/11795565261447102","DOIUrl":"10.1177/11795565261447102","url":null,"abstract":"<p><p>We present the case of an immunocompetent, fully vaccinated 17-year-old female who developed severe, disseminated varicella-zoster virus (VZV) reactivation with visceral involvement, Ramsay Hunt Syndrome, and complications of suspected superimposed bacterial cellulitis, chronic pain, as well as postherpetic neuralgia. We aim to highlight the importance of early recognition and multidisciplinary management of varicella-zoster virus in immunocompetent patients to minimize disease complications. All data were obtained from the electronic medical record with permission from the patient and her parent. The patient underwent serial dermatologic examinations and a comprehensive immunologic workup. Positive VZV PCR testing of the lesion and blood confirmed active VZV infection. Despite an intensive multi-drug antiviral regimen, she developed suspected clinical drug resistance-although resistance testing was not performed-progressing to disseminated varicella with hepatic involvement. Inpatient complications included Ramsay Hunt Syndrome, suspected superimposed bacterial cellulitis, opioid withdrawal, and chronic pain. While outpatient, she developed postherpetic neuralgia and psychosocial impairment, preventing her from completing her academic year. This case illustrates a rare, but severe presentation of disseminated varicella-zoster virus with visceral involvement and concomitant Ramsay Hunt Syndrome in a healthy adolescent. It underscores the importance of considering VZV in the differential diagnosis of pediatric rash and neuropathy in all patients, irrespective of immune status.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565261447102"},"PeriodicalIF":1.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821885","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":"Exercise-Related Spontaneous Pneumomediastinum Following Ballet in a Pediatric Patient: A Case Report.","authors":"Aykut Yucal, Ferhat Demir, Melike Yucal, Asrın Meriç Demir","doi":"10.1177/11795565261447109","DOIUrl":"10.1177/11795565261447109","url":null,"abstract":"<p><p>Spontaneous pneumomediastinum (SPM) is a rare condition characterized by the presence of free air within the mediastinum without trauma or invasive procedures. Although it is usually benign and self-limiting, it can cause acute chest pain in children. We present a 12-year-old female patient with exercise-related spontaneous pneumomediastinum whose symptoms began 3 hours after taking a ballet class focused primarily on stretching and posture. Physical examination was normal, vital signs were stable, and there was no subcutaneous crepitus. The patient was treated with analgesics and rest on an outpatient basis; complete radiographic resolution was achieved within 1 week, and symptoms completely regressed. This case report highlights that activities such as ballet can be a rare trigger for SPM, the diagnostic value of lateral radiography, and the safety of conservative management in clinically stable pediatric patients.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565261447109"},"PeriodicalIF":1.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821838","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":"Severe Recurrent Polyhydramnios as a Prenatal Signal of MAGED2-Related Bartter Syndrome: A Clinical Perspective.","authors":"Offra Engel, Hagit Eisenberg, Julia Barda, Keren Yosovich, Maital Kaidar, Liat Gindes, Ehud Banne","doi":"10.1177/11795565261447087","DOIUrl":"10.1177/11795565261447087","url":null,"abstract":"<p><p>Severe, rapidly progressive polyhydramnios with a structurally normal fetus remains a diagnostic challenge. We describe 2 consecutive pregnancies in the same mother that were complicated by massive polyhydramnios culminating in extreme preterm delivery and intra-uterine fetal demise. Trio whole-exome sequencing identified a previously unreported hemizygous MAGED2 variant (c.1330G>A; p.Gly444Ser), confirming antenatal Bartter syndrome (ABS, type V). This case underscores 3 practical messages: (1) an X-linked MAGED2 defect should be considered early when polyhydramnios recurs without anatomical anomalies and standard chromosomal microarray is normal; (2) timely genomic testing enables targeted counseling, antenatal management (eg, indomethacin) and discussion of pre-implantation diagnosis; and (3) dismissing genetic etiologies on the basis of mild maternal factors (eg, well-controlled gestational diabetes) risks missed diagnoses.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565261447087"},"PeriodicalIF":1.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821866","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":"Oral Health in Children With Congenital Heart Diseases: A Comprehensive Narrative Review.","authors":"Wafaa Saleh, Ghada A Elhusseiny, Hamad Alharbi","doi":"10.1177/11795565261432835","DOIUrl":"10.1177/11795565261432835","url":null,"abstract":"<p><p>Congenital heart disease (CHD) is the most common congenital anomaly among live births, and can present in different forms. Due to significant improvements in the surgical treatment of CHDs, the population of children with CHDs is increasing. Studies have shown that these children have worse oral health than their healthy counterparts. This is mainly due to a lack of oral hygiene measures, a lack of fluoride exposure, insufficient water intake, sugar intake, and the effect of cardiac medications. Due to poor oral health, they also have a prevalence of caries and gingival diseases, and need comprehensive dental treatment. This narrative review was motivated by a lack of clear guidelines for dentists, pediatric cardiologists, and parents on preventing poor oral health in children with CHDs. A comprehensive search strategy was employed, utilizing databases such as PubMed, Scopus, Web of Science, and Google Scholar, to identify relevant literature on oral manifestations and dental management of children with CHDs. We highlighted the necessity of the multidisciplinary team for optimal dental management of children with CHDs. In addition, we discussed optimal dental management strategies to improve their overall health outcomes and quality of life.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565261432835"},"PeriodicalIF":1.7,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784976","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 Qualitative Analysis of Pediatricians' Perspectives Regarding Barriers, Facilitators, and Strategies for Providing Timely Autism Spectrum Disorder Screening and Diagnosis.","authors":"Mallika Mathur, Jinni Tang, Christine Markham, Sandra McKay, Ruosha Li, Deepali Ernest, Allison Marshall, Shreela Sharma","doi":"10.1177/11795565261431178","DOIUrl":"10.1177/11795565261431178","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorder (ASD) is a developmental disorder that has increased in prevalence over the years. Diagnosis and subsequent intervention by the age of 3 is essential for development. However, recent estimates indicate that less than 50% of children receive an evaluation by age 3. Underserved populations are more likely to receive an evaluation at an older age. Several barriers in the diagnostic process have been identified; however, limited studies have aimed at understanding the specifics of these barriers among underserved populations and whether current strategies are beneficial for all children.</p><p><strong>Objectives: </strong>The aim of this study was to identify barriers and strategies, as reported by pediatricians serving underserved populations, to enhance timely screening and diagnosis of ASD.</p><p><strong>Design: </strong>A qualitative study was conducted.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with general pediatricians and subspecialists (N = 14) practicing in the Greater Houston area, Texas. Thematic analysis was conducted using inductive reasoning.</p><p><strong>Results: </strong>Participants were majority White (50%), female (79%), practicing in hospital-based settings (64%), with 3 to 5 years of professional experience (64%) and a mean age of 50 years. Three themes were identified (1) barriers causing delays in ASD screening and diagnosis; (2) individualized approaches in pediatric care to address barriers, and (3) recommendations to improve timely ASD screening and diagnosis.</p><p><strong>Conclusion: </strong>The results of this study identified potential strategies to overcome access, availability, and knowledge barriers; however, the lack of standardization across the health system results in the continued reporting of significant barriers. Using a health equity approach is key to ensure improvements in timely screening and diagnosing by tailoring strategies to the population being served. Health systems should work on expanding and evaluating identified strategies. Additionally, improve education for providers and parents to address parental hesitancy, increase attendance with routine well-child checks, and improve ASD evaluation referrals.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565261431178"},"PeriodicalIF":1.7,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646969","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":"Epilepsy Treatment Outcome and Associated Factors in Children and Adolescents in a Resource-limited Setting: A Retrospective Cohort Study.","authors":"Mulugeta Sitot Shibeshi, Kefyalew Taye Gari","doi":"10.1177/11795565261431141","DOIUrl":"10.1177/11795565261431141","url":null,"abstract":"<p><strong>Background: </strong>Seizure control is the main goal of epilepsy treatment. However, achieving satisfactory seizure control in resource-poor settings is challenging. This study aimed to assess treatment outcomes and associated factors among children and adolescents with epilepsy.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 270 children and adolescents with epilepsy aged 2 to 18 years at a pediatric neurology clinic in southern Ethiopia. Patients and/or parents were interviewed, medical records of the patients were reviewed, and data on demographic, clinical characteristic, and seizure control were collected. Controlled seizure was defined as seizure freedom for two consecutive years. Logistic regression analysis was performed to determine factors associated with seizure control.</p><p><strong>Results: </strong>The mean age of the study subjects was 8.98 ± 3.84 years, and 70% were male. The majority (60.4%) were children under the age of 10. Complete seizure freedom for at least 2 years was observed in 55.2% of the study participants, and a reduction in seizure frequency was observed in an additional 20% of them. The presence of neuropsychiatric comorbidities, absence of seizure control in the first 3 months of treatment, polytherapy, lack of response to the first anti-seizure medication, and poor treatment adherence were associated with poor seizure control.</p><p><strong>Conclusions: </strong>A large proportion of children and adolescents with epilepsy had poor treatment outcome. Stakeholders should take appropriate measures to address modifiable risk factors, including ensuring a continuous supply of anti-seizure medications and enhancing treatment adherence, to improve treatment outcomes.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565261431141"},"PeriodicalIF":1.7,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595407","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":"SARS-CoV-2 in Infants: Clinical Patterns, Laboratory Findings, and Implications for Pediatric Care in Viral Outbreaks.","authors":"Marwh G Aldriwesh, Norah F Abukhalid, Sarah M Alotaibi, Raneem M Alghamdi, Shomoukh S Alotaibi, Winnie Philip, Raniah S Alotibi","doi":"10.1177/11795565261425648","DOIUrl":"10.1177/11795565261425648","url":null,"abstract":"<p><strong>Background: </strong>The emergence of COVID-19 has placed unprecedented pressure on healthcare systems worldwide. Although the clinical features of COVID-19 are well-documented in adults, limited data are available regarding its impact on infants, particularly across different age groups.</p><p><strong>Objectives: </strong>To compare the clinical presentation, laboratory findings, and outcomes of infants aged ⩽6 months with those aged >6 months diagnosed with COVID-19.</p><p><strong>Design: </strong>Retrospective cross-sectional study.</p><p><strong>Methods: </strong>This study was conducted at a tertiary pediatric hospital in Saudi Arabia. Data were extracted from electronic medical records of 388 infants with confirmed COVID-19 between March 2020 and December 2022. Demographic information, clinical signs and symptoms, laboratory parameters, and clinical outcomes were analyzed and compared between the two age groups using appropriate statistical methods.</p><p><strong>Results: </strong>Among 388 infants diagnosed with COVID-19, 54.6% were aged ⩽6 months. Less than half of the cohort was symptomatic, with fever (41.0%), cough (37.1%), and rhinorrhea (20.1%) being the most common symptoms. Gastrointestinal symptoms differed significantly by age: infants >6 months had higher rates of diarrhea than those ⩽6 months (58.6% vs 41.4%, <i>P</i> = .028). Most infants had normal white blood cell (WBC) counts (76.5%), though WBC abnormalities varied by age group: leukopenia was more frequent in infants ⩽6 months, while leukocytosis was more common in older infants (<i>P</i> = .009). Elevated C-reactive protein was observed in 63.0% of tested infants, and hyperglycemia was detected in 83.6%. COVID-19-related mortality was low (1.03%), primarily affecting infants ⩽3 months with pre-existing comorbidities.</p><p><strong>Conclusion: </strong>SARS-CoV-2 infection in infants was generally mild, with low rates of complications and mortality. However, infants aged ⩽6 months demonstrated greater clinical vulnerability compared to older infants. These findings underscore age-specific differences in clinical presentation and support the need for tailored risk assessment and management approaches in pediatric care.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565261425648"},"PeriodicalIF":1.7,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445461","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":"Hydroxyurea in Sickle Cell Disease: Coagulation and Activation in an Observational Study.","authors":"Munira Borhany, Hafiza Tuba Iqbal, Madiha Abid, Sidra Zafar","doi":"10.1177/11795565251403177","DOIUrl":"10.1177/11795565251403177","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease (SCD) is characterized by a chronic hypercoagulable state. Hydroxyurea (HU) is known to reduce the frequency of vaso-occlusive events and transfusion requirements in affected individuals.</p><p><strong>Objective: </strong>To assess the impact of hydroxyurea on biomarkers of coagulation (D-dimer) and endothelial activation (soluble VCAM-1) in SCD patients in Pakistan in their steady state.</p><p><strong>Methods: </strong>A prospective observational study was conducted in patients aged ⩾ 10 years with confirmed HbSS or HbSβ-thalassemia genotypes. Biomarkers were measured at baseline and after 6 months of HU therapy.</p><p><strong>Results: </strong>Twenty-five patients (HbSS = 15 [60%], HbSβ-thalassemia = 10 [40%]) with a median (IQR) age of 23 (16.5-27) years were enrolled. A significant decrease in D-dimer levels was observed after HU treatment: from a median of 1243 to 830 ng/mL (<i>P</i> = .028), reflecting a 33% reduction. Soluble VCAM-1 levels showed no statistically significant change (532.6 vs 492.9 ng/mL, <i>P</i> = .381). HbF increased from 20.1% (12.6-27.5) to 28% (20-39) (<i>P</i> < .001), with a strong positive correlation with HU treatment (<i>r</i> = .845).</p><p><strong>Conclusion: </strong>This study demonstrates that HU therapy in Pakistani SCD patients significantly reduces D-dimer levels, suggesting reduced thrombotic activity. While the endothelial marker VCAM-1 showed no significant change, the rise in HbF is consistent with known HU effects.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565251403177"},"PeriodicalIF":1.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379154","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":"Stridor as an Initial Manifestation of Underlying PHACE Syndrome in an Infant: A Case Report and Comprehensive Review.","authors":"Doreswamy Chandranaik, Nikhil Rajvanshi, Taruna Yadav, Lokesh Saini, Prawin Kumar, Jagdish Prasad Goyal","doi":"10.1177/11795565251403179","DOIUrl":"10.1177/11795565251403179","url":null,"abstract":"<p><p>Stridor is a common presenting complaint in infancy. Its aetiology ranges from benign to severe, life-threatening conditions. We report here a 2-month-old child who presented with respiratory distress and stridor since 20 days of life, with intermittent worsening. On examination, there was a haemangioma on the right ear lobe. A similar lesion in the airway was suspected, and flexible bronchoscopy revealed an airway haemangioma in the larynx extending up to the carina. Further workup was performed given haemangioma in the facial region that led to a diagnosis of the Posterior fossa malformations, Arterial anomalies, and Coarctation of the aorta, along with other cardiac defects and Eye abnormalities (PHACE) syndrome. Following oral propranolol, there was a significant improvement in symptoms. This case highlights that airway haemangioma should be suspected in infants presenting with stridor and haemangioma, especially in the facial area. Once the diagnosis is confirmed, the child should be further evaluated for underlying PHACE syndrome.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565251403179"},"PeriodicalIF":1.7,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272449","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":"Health Impact of Technology Use and Associated Factors Among Children Aged 7 to 17 years in Dessie Town, Ethiopia, 2022.","authors":"Debrnesh Goshiye, Fekadeselassie Belege, Gebyaw Biset, Jemberu Nigussie, Moges Workneh, Molla Kassa, Setegn Mihret, Sisay Gedamu, Zinet Abegaz","doi":"10.1177/11795565251403178","DOIUrl":"10.1177/11795565251403178","url":null,"abstract":"<p><strong>Background: </strong>Children's engagement in digital technology is increasing world wide due to the development of new portable and instantly accessible technology. It is important to review existing knowledge to understand how children use of digital technology affects their well-being and health. This study aimed to assess the health impact of technology use and associated factors among children aged 7 to 17 years in Dessie town, Ethiopia, in 2022.</p><p><strong>Methods: </strong>A community based cross sectional study was conducted in Dessie town, in 2022. A semi structured questionnaire was used to interview parents with children aged 7 to 17 years. Data entry was done using Epi data 3.1 and analyzed using SPSS version 23. Logistic regression was used to identify association between the dependent and independent variables.</p><p><strong>Result: </strong>The response rate was 97.8%. Approximately 17.9% and 37.6% of the participants found to exhibit inattentive behavior and poor sleep quality respectively. Child age, grade level, duration of technology use, parents' duration of technology use, and their feeling about their child technology use showed statistically significant associations with poor sleep quality. Additionally, child age, grade level, mothers' education level and parents duration of technology use were significantly associated with inattentive behavior in children.</p><p><strong>Conclusion: </strong>Children technology use impacts child sleep quality and attention in Dessie town. Since parents alone cannot address all issues related to children's technology use, it is recommended that the governments, schools and health care providers assist parents by providing clear instructions and information, and by encouraging companies to reduce the addictive qualities of their devices.</p>","PeriodicalId":45027,"journal":{"name":"Clinical Medicine Insights-Pediatrics","volume":" ","pages":"11795565251403178"},"PeriodicalIF":1.7,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12906388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207921","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}