Academic Pediatrics最新文献

{"title":"What I Didn’t Learn in Residency","authors":"Javier Arredondo Montero MD, PhD","doi":"10.1016/j.acap.2025.102891","DOIUrl":"10.1016/j.acap.2025.102891","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 102891"},"PeriodicalIF":2.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668953","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":"Children and Firearms in the United States: Parent and Child Reports on Firearms Use, Storage, and Training","authors":"David C. Schwebel PhD ,&nbsp;D. Leann Long PhD ,&nbsp;Anna Johnston MA ,&nbsp;Casie H. Morgan PhD","doi":"10.1016/j.acap.2025.102890","DOIUrl":"10.1016/j.acap.2025.102890","url":null,"abstract":"<div><h3>Objective</h3><div>To explore reasons for having firearms, plus firearms storage, training, and use, among firearm-exposed children aged 10–12, and evaluate parent-child agreement in reporting.</div></div><div><h3>Methods</h3><div>Survey research was conducted as part of a larger randomized trial. Children aged 10–12, all exposed to firearms and living in the Southeastern United States, and a parent were recruited from community sources. They independently responded to surveys via tablet about family demographics (parents) and firearms use, storage, and training (parents and children). Descriptive data were examined and parent-child comparisons made.</div></div><div><h3>Results</h3><div>One hundred sixty-three parent-child dyads participated. Consistent with inclusion criteria, both parents (M<!--> <!-->=<!--> <!-->4.4, SD<!--> <!-->=<!--> <!-->5.1) and children (M<!--> <!-->=<!--> <!-->5.3, SD<!--> <!-->=<!--> <!-->11.9) reported high numbers of firearms in the home, with protection (82% parents; 73% children) the most common reason. Both parents (76%) and children (78%) reported children knew where some firearms were stored, but about half (parents 55%; children 41%) reported children were unaware of the storage location for all. Over half of parents (55%) and many children (30%) reported some firearms were kept unlocked. Most parents (81%) and children (73%) reported children had firearm safety training from adult family, but few (&lt;10%) from community or online sources. Both parents (44% hunt; 68% shoot) and children (47%; 60%) reported children hunt and shoot at least annually, occasionally unsupervised.</div></div><div><h3>Conclusions</h3><div>Understanding how children engage with firearms guides effective prevention. Results reveal children regularly engage in hunting and shooting, occasionally unsupervised; children are sometimes unaware where firearms are stored in their own homes; and children rarely have formal firearms safety training.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 102890"},"PeriodicalIF":2.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668923","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":"Circles","authors":"Maren E. Olson MD, MPH, MEd","doi":"10.1016/j.acap.2025.103117","DOIUrl":"10.1016/j.acap.2025.103117","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 103117"},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668924","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":"Comparing Two Training Approaches to Scaling Up the Safe Environment for Every Kid (SEEK) Approach","authors":"Howard Dubowitz MD, MS ,&nbsp;Rose Belanger PhD ,&nbsp;Laurence Magder PhD ,&nbsp;Hannah Kim ,&nbsp;Lisa Saldana PhD ,&nbsp;Lawrence Palinkas PhD","doi":"10.1016/j.acap.2025.103115","DOIUrl":"10.1016/j.acap.2025.103115","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the impact of 2 common continuing medical education training modalities—independent online (IND) and a Maintenance of Certification-4 activity (MOC)—and primary care practice characteristics on scaling up (ie, the adoption, implementation, and sustainment) of the Safe Environment for Every Kid (SEEK) approach.</div></div><div><h3>Methods</h3><div>This longitudinal, multisite study involved 44 practices across the United States, 25 of whom were randomized to one of 2 training modalities. We ascertained the extent to which primary care professionals (PCPs) in each practice completed the assigned training (ie, “dose”). Practice personnel were surveyed up to 4 times over a 2-year period regarding their views on changing their practice, evidence-based practices, and their leadership. Predictors included training modality and dose and practice characteristics. Outcomes were startup, fidelity, and sustainment regarding SEEK.</div></div><div><h3>Results</h3><div>Only 31% of MOC and 25% of IND practices had most (≥75%) PCPs complete their training; 15% and 17% had an intermediate status with 50%–74%. Approximately half the practices achieved startup and most implemented SEEK with fidelity and sustained this for 2 years. There were few differences between the IND versus MOC practices; more training was associated with greater fidelity, especially in the IND practices. Practices that had greater baseline commitment and sense of efficacy were more likely to start implementing SEEK and do so with fidelity.</div></div><div><h3>Conclusions</h3><div>The findings support the simpler IND training approach and the value of sound preparation to foster commitment and a sense of efficacy. Improved strategies for encouraging PCPs to complete such training are needed. The study offers a valuable example of evaluating widely used training modalities as well as the scaling up of an evidence-based practice such as SEEK.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 103115"},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668948","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":"Clinician and Care Manager Perspectives on Addressing Chronic School Absenteeism in Primary Care Settings","authors":"Michelle Shankar MD, MHS ,&nbsp;Pearl Teiko BA ,&nbsp;Eleanor Wertman MPH ,&nbsp;Jessica Haughton MPH, MA ,&nbsp;Kori B. Flower MD, MS, MPH ,&nbsp;Michael J. Steiner MD, MPH ,&nbsp;Rushina Cholera MD, PhD","doi":"10.1016/j.acap.2025.102889","DOIUrl":"10.1016/j.acap.2025.102889","url":null,"abstract":"<div><h3>Objectives</h3><div>To characterize primary care clinician and care manager perceptions and practice regarding chronic absenteeism.</div></div><div><h3>Methods</h3><div>In this qualitative study, we developed a semistructured interview guide using the Consolidated Framework for Implementation Research. We conducted Zoom interviews (July to August 2023) with primary care clinicians and care managers affiliated with a child-focused alternative payment model serving Medicaid- and Children’s Health Insurance Program-enrolled children in a 5-county region of central North Carolina. Interviews were recorded, transcribed, and analyzed iteratively using a rapid qualitative analytic approach.</div></div><div><h3>Results</h3><div>We interviewed 12 participants including 6 clinicians and 6 care managers serving families across urban, rural, academic, and community settings. Key themes included a lack of systematic and universal approaches to discussing school attendance, limited infrastructure for school-health system collaboration resulting in caregiver burden, importance of family engagement, and leveraging unique spheres of influence for multidisciplinary collaboration.</div></div><div><h3>Conclusions</h3><div>Clinicians and care managers support addressing chronic absenteeism but perceive provider, patient, and system-level barriers to identifying and addressing underlying needs. Perceived facilitators include leveraging strong relationships with families and multidisciplinary collaboration. Health system efforts to operationalize chronic absenteeism as a health metric and to coordinate services across health, education, and social sectors may improve long-term health and academic outcomes.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 102889"},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668925","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":"Changes in Screen Time Behaviors from Before (2019) to After (2022) the COVID-19 Pandemic Among Brazilian Adolescents","authors":"Bruno da Costa PhD ,&nbsp;Marcus V.V. Lopes PhD ,&nbsp;Gabrielli T. de Mello PhD ,&nbsp;Bruno N. Oliveira MSc ,&nbsp;Jean-Philippe Chaput PhD ,&nbsp;Kelly Silva PhD","doi":"10.1016/j.acap.2025.102885","DOIUrl":"10.1016/j.acap.2025.102885","url":null,"abstract":"<div><h3>Objective</h3><div>Compare prepandemic (2019) and postpandemic (2022) engagement in five screen-based activities (studying, working, watching videos, playing video games, and using social media/chat applications) among independent samples of Brazilian adolescents using a repeated cross-sectional design; and 2) Examine within-individual changes in these same screen-based activities over the same period using a repeated cross-sectional study with a nested cohort.</div></div><div><h3>Methods</h3><div>Data were collected in 2019 and 2022, involving a total of 2008 adolescents who participated in the repeated cross-sectional study, with 333 forming a nested cohort sample. Zero-inflated multilevel gamma regression models and multilevel linear models were used to analyze the data.</div></div><div><h3>Results</h3><div>In the repeated cross-sectional analysis, adolescents spent more minutes per day in 2022 versus 2019 for studying (+21.3 minutes; 95% CI: 11.0, 31.6), watching videos (+12.8 minutes; 95% CI: 1.1, 24.5), and playing video games (+22.9 minutes; 95% CI: 12.8, 33.1). The longitudinal analysis revealed significant average daily increases from 2019 to 2022 in studying (+53.8 minutes; 95% CI: 34.7, 72.9) and working (+130.2 minutes; 95% CI: 110.4, 149.9). For these same adolescents, significant decreases were observed for watching videos (−26.4 minutes; 95% CI: −48.0, −4.9) and playing video games (−28.6 minutes; 95% CI: −46.2, −11.8). Social media use remained stable.</div></div><div><h3>Conclusions</h3><div>Screen time (ST) among Brazilian adolescents was higher in 2022 compared to 2019, with increases in studying, working, watching videos, and playing video games. Longitudinal data indicated a shift from recreational ST to educational and work-related ST. These findings highlight the need for targeted interventions to promote balanced ST and mitigate potential negative health impacts.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 102885"},"PeriodicalIF":2.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627685","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":"Effect of Price on Women, Infants, and Children-Eligible Caregiver Participation in a Produce Program: A Randomized Trial","authors":"Priyanka Joshi MD, MSHP ,&nbsp;Brittany J. Van Remortel MD, MPH ,&nbsp;Janakiram Rameswaran MSN, MPH, CPNP-AC ,&nbsp;Danielle L. Cullen MD, MPH, MSHP","doi":"10.1016/j.acap.2025.102884","DOIUrl":"10.1016/j.acap.2025.102884","url":null,"abstract":"<div><h3>Objective</h3><div>This pilot randomized trial examined the associations between price, participation of women, infants, and children (WIC)-eligible families in a produce delivery program and reported healthy eating behaviors.</div></div><div><h3>Methods</h3><div>Fifty caregivers of WIC-eligible children from an urban primary care center enrolled in an 8-week produce delivery program. Participants received free produce boxes for the first 4 weeks and were randomized to a cost of $5 or $10 per box for the remaining 4 weeks. Weekly orders were tracked, and longitudinal surveys were conducted to assess the program's impact on healthy eating.</div></div><div><h3>Results</h3><div>Forty-three caregivers (86%) participated in the study. An average of 35.3 (SD 5.74) participants ordered weekly during the free period with a significant drop-off to 18.3 (SD 0.96) ordering weekly during the paid period (<em>P</em>&lt;.001); most (73%) participants paid with SNAP benefits. There was no significant difference in average orders between the $5 and $10 groups (12.25 [SD 4.4] vs 14.5 [SD 5.63], <em>P<!--> </em>=<!--> <!-->.19). Participation was significantly associated with an increase in reported produce access (53% vs 97%, <em>P</em>&lt;.001) and ability to eat healthy (34% vs 61%, <em>P<!--> </em>=<!--> <!-->.04).</div></div><div><h3>Conclusions</h3><div>Our study found that participation in a delivery-produce program decreased significantly with introduction of cost and use of food assistance benefits to purchase produce was common among sustained participants. Participants reported improvements in healthy eating and ability to access produce. Future study is needed to further evaluate price points to optimize program sustainability and participation and the impact of produce delivery programs on childhood produce intake.</div></div><div><h3>Clinical Trial Registration</h3><div>ClinicalTrials.gov, NCT05153577</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 102884"},"PeriodicalIF":2.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621112","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":"Population-Based Surveillance of Suicidality Among Adolescents Who do not Endorse Suicide Risks and Implications for Screening","authors":"Eunice M. Areba PhD, RN ,&nbsp;Michelle A. Mathiason MS ,&nbsp;Patricia I. Jewett PhD ,&nbsp;Lindsay A. Taliaferro PhD, MPH ,&nbsp;Iris W. Borowsky MD, PhD","doi":"10.1016/j.acap.2025.102886","DOIUrl":"10.1016/j.acap.2025.102886","url":null,"abstract":"<div><h3>Objective</h3><div>Suicide screening guidelines based on findings from aggregated data conceal subpopulation vulnerabilities. Risk factors for a suicide attempt (SA), such as suicidal ideation (SI), may differ in frequency or be absent in certain ethnoracial youth subgroups. Thus, accurate identification of suicide risk remains a challenge, and guidelines are inconsistent.</div></div><div><h3>Methods</h3><div>This cross-sectional study used data from the 2019 and 2022 waves of the Minnesota Student Survey of eighth, ninth, and 11th graders. Students in 12 ethnoracially diverse groups self-reported their race and ethnicity, past-year SI and SA, and past 2-week symptoms of depression and anxiety. We used stratified chi-squared tests by sex and ethnoracial group for bivariate analyses. Logistic regression models adjusted for food insecurity, unstable housing, and mental health treatment, examined odds of SA.</div></div><div><h3>Results</h3><div>About 3.0% of male students attempted suicide in the past year. Of these youth, 35.9% denied depressive symptoms, 39.8% denied anxiety symptoms, and 14.8% denied SI, especially Somali (47.8%) and multiracial (26.3%) male students. Among the 7.3% of female students who attempted suicide during the preceding year, 25.4% denied depressive symptoms, 24.6% denied anxiety symptoms, and about 8.0% denied SI, especially Somali (29.7%) and Black (12.5%) female students. Students who reported depressive or anxiety symptoms, especially male students, had increased odds of SA.</div></div><div><h3>Conclusions</h3><div>A higher proportion of males, certain Black subgroups, and multiracial students reported a past-year SA without endorsing symptoms of depression, anxiety, or SI. Future research should assess for whom screening tools work, mitigate screening limitations, and normalize minoritized experiences.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 102886"},"PeriodicalIF":2.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621113","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":"Disparities in Caregiver-Reported Knowledge, Attitudes, Behaviors, and Clinical Guidance Regarding Primary Prevention of Peanut Allergy","authors":"Christopher Warren PhD ,&nbsp;Alanna Stinson MD ,&nbsp;Waheeda Samady MD ,&nbsp;Lucy Bilaver PhD ,&nbsp;Sai Nimmagadda MD ,&nbsp;Ruchi Gupta MD, MPH","doi":"10.1016/j.acap.2025.102874","DOIUrl":"10.1016/j.acap.2025.102874","url":null,"abstract":"<div><h3>Objective</h3><div>Significant differences have been observed in the prevalence of peanut allergy across different US racial and ethnic groups. We aimed to characterize current patterns of infant peanut introduction across racial, ethnic, and socioeconomic strata, and their clinical, behavioral, and attitudinal correlates.</div></div><div><h3>Methods</h3><div>Surveys assessing parental knowledge, attitudes, and infant feeding behavior were administered to a US population-based sample of 3062 parents/caregivers of children aged 7 to 42 months. Complex survey-weighted test statistics estimated differences across relevant racial/ethnic, household income, and caregiver educational attainment strata.</div></div><div><h3>Results</h3><div>Cumulative rates of peanut introduction in the first 11 months of age were significantly higher among White, non-Hispanic caregivers (F<!--> <!-->=<!--> <!-->7.7; <em>P</em>&lt;.001), caregivers with higher annual household incomes (F<!--> <!-->=<!--> <!-->5.6; <em>P</em>&lt;.001), and caregivers reporting higher educational attainment (F<!--> <!-->=<!--> <!-->2.5; <em>P<!--> </em>=<!--> <!-->.002). Similar racial, ethnic, and socioeconomic differences emerged regarding perceived safety of peanut introduction during the first year, as well as the perceived effectiveness of early dietary introduction for peanut allergy prevention. Caregivers reporting lower household incomes and educational attainment were less likely to think peanut introduction during the first year was safe or effective in peanut allergy prevention than those reporting higher socioeconomic status. Similarly, caregivers of non-Hispanic Black children, those with lower incomes, and those with lower educational attainment were less likely to report receiving timely guidance from their child’s primary care provider regarding peanut allergy prevention.</div></div><div><h3>Conclusions</h3><div>Differences in the timing of peanut introduction may contribute to observed racial, ethnic, and socioeconomic disparities in peanut allergy prevalence. Equitable food allergy prevention guidance from providers could address these disparities.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 102874"},"PeriodicalIF":2.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621111","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":"Caregiver and Pediatric Clinician Perspectives on Artificial Intelligence for Language Services.","authors":"Gabriella Ficerai-Garland, Peyton Groves, Elena A Puccio, Sabrina Bruno, Henry Hoffman, Nadia Pineda Villegas, María Cecilia Q Dancisin, Alisa Khan, K Casey Lion, Diego Chaves-Gnecco, Mona Diab, Maya I Ragavan","doi":"10.1016/j.acap.2025.102887","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102887","url":null,"abstract":"<p><strong>Objective: </strong>Children and caregivers who use languages other than English (LOE) for pediatric healthcare experience inequities and poorer overall health. Advancement of large language models has raised questions about future use of artificial intelligence (AI) for language access. This study explored perspectives of caregivers who use LOE and pediatric clinicians on using AI to address unmet needs in healthcare translation and interpretation.</p><p><strong>Methods: </strong>We conducted semi-structured individual interviews with caregivers of pediatric patients who use LOE and pediatric clinicians about the use of AI language technologies in healthcare. A phone interpreter or fluent team member was used for LOE interviews. Recordings were transcribed, translated as needed, coded, and analyzed using inductive thematic analysis.</p><p><strong>Results: </strong>20 caregivers using 11 different LOE and 22 clinicians participated. Themes were consistent across participants, though clinicians were more familiar with the concept of AI. Participants reported use of technologies (e.g., Google Translate) for written communication and situations where verbal interpretation was perceived to be inadequate. They were concerned about AI accuracy, privacy, and loss of empathy, but hoped it could provide real-time document translation and more convenient verbal communication. Ease of use, validation, and equitable creation and access were critical for use.</p><p><strong>Conclusions: </strong>Caregivers and clinicians were open to using AI to fill gaps in translation and interpretation; however, robust validation of AI technology and complementary use with human interpreters and translators is needed. Future research, practice, and policy should focus on integrating AI while investing in human translation and interpretation.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102887"},"PeriodicalIF":3.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585546","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}