Intestinal Failure (New York, N.Y.)最新文献

{"title":"Management strategies for home parenteral support related to quality of life in intestinal failure patients: A scoping review.","authors":"Anna Bjerklund, Viktoria Westerlund, Louise Bangsgaard Antonsen, Sara Andersson","doi":"10.1016/j.intf.2025.100343","DOIUrl":"10.1016/j.intf.2025.100343","url":null,"abstract":"<p><strong>Background: </strong>Quality of life in patients with chronic intestinal failure is challenged by the need for long-term home parenteral support. The aim of this study was to identify healthcare initiated home parenteral support management strategies related to quality of life in patients with intestinal failure.</p><p><strong>Methods: </strong>A systematic search was conducted across two databases (PUBMED, CINAHL) on the 27th of April 2024. Search results were mapped according to the JBI manual with the extraction tool Covidence. Non-pharmacological home parenteral support management strategies were included. Full-text screening was performed independently by four researchers, and three researchers systematically processed the data extraction pairwise.</p><p><strong>Results: </strong>A total of 18 studies were included. Eleven unique home parenteral support management strategies were identified and grouped into 3 themes: prescription, administration, and tools for self-care. <i>Infusion frequency</i> and <i>infusion volume</i> were the most frequently evaluated strategies with positive influence on quality of life. Seven other strategies with positive influence were identified and most high-quality evidence was found for <i>education and counselling</i>.</p><p><strong>Conclusion: </strong>This study indicates that management strategies of home parenteral support can play a valuable role in improving the quality of life for those depending on long-term intravenous treatment. However, there is a lack of high-quality evidence and only a few strategies have been investigated in more than two studies.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"9 ","pages":"100343"},"PeriodicalIF":0.0,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451232","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":"Infective endocarditis in children with chronic intestinal failure.","authors":"Divya Pandey, Veena Logarajah, Lay Queen Ng, Lynette Goh, Christopher Wen Wei Ho, Jonathan Choo, Pui Ling Wai, Fang Kuan Chiou","doi":"10.1016/j.intf.2025.100335","DOIUrl":"10.1016/j.intf.2025.100335","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis (IE) is a rare but serious complication in pediatric patients with chronic intestinal failure (IF) dependent on long-term parenteral nutrition (PN) via central venous access devices (CVADs). This study aimed to investigate the incidence, clinical features and outcomes of IE in children with chronic IF at a single institution.</p><p><strong>Methods: </strong>A retrospective descriptive study was conducted in pediatric patients (0-18 years) with chronic IF requiring PN for > 60 days during 2013-2024. IE was diagnosed using modified Duke criteria.</p><p><strong>Results: </strong>Five IE episodes occurred in 4 patients out of 29 with chronic IF (median follow-up 9 years). The overall incidence was 0.144 per 1000 catheter days (5155.2 per 100,000 person-years). Compared with patients without IE, those with IE had longer catheter durations (median 2941.5 vs. 443.0 days, p = 0.006); more central line-associated bloodstream infections (median 8 vs. 1, p = 0.0015); higher prevalence of catheter-related venous thrombosis (100 % vs. 12 %, p = 0.001); and were more likely to have dysmotility (75 % vs. 16 %, p = 0.02). IE resolved with antimicrobial therapy in all cases. During a median follow-up of 2.2 years, one patient died from superior vena cava obstruction, sepsis and multiorgan failure while awaiting transplantation; one achieved enteral autonomy and was weaned off PN; and two underwent successful intestinal transplantation.</p><p><strong>Conclusions: </strong>Though uncommon, IE poses significant risks in pediatric IF; early cardiac surveillance in high-risk patients may facilitate timely diagnosis and intervention.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"8 ","pages":"100335"},"PeriodicalIF":0.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129044","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":"The current state of paediatric intestinal transplantation: A global review.","authors":"Sinead Cunningham, Jonathan Hind","doi":"10.1016/j.intf.2025.100334","DOIUrl":"10.1016/j.intf.2025.100334","url":null,"abstract":"<p><p>Paediatric intestinal transplantation (ITx) has evolved from a high-risk experimental procedure into a life-saving therapy for children who have complications of intestinal failure (IF) or who cannot be stabilized by nutritional rehabilitation. Indications include complications of irreversible intestinal failure from short bowel syndrome, motility disorders, or intestinal dysplasia, with graft options ranging from isolated intestine to liver-intestine or multivisceral transplantation, including reduced-size and living donor grafts. Advances in surgical techniques, perioperative care, and immunosuppression have markedly improved survival and functional outcomes, although early and late graft loss, rejection, and infectious complications remain important challenges. Optimized immunosuppression protocols have reduced acute rejection rates, but also facilitated successful retransplantation when required. Multidisciplinary management addressing growth, neurodevelopment, and psychosocial well-being is recognized as being essential for improving long-term quality of life. Despite these advances, significant global disparities persist in access to paediatric ITx, driven by donor scarcity, financial constraints, and limited expertise in low-resource regions. Collaborative networks, telemedicine platforms, and international registries have emerged to share knowledge, standardize care, and support capacity-building. Looking forward, advancements in immunosuppression, expanded living donor programmes and international collaboration hold promise for further improving outcomes and broadening access. Increasing recognition of the benefits of earlier referral and transplantation is shifting the paradigm from viewing ITx solely as a rescue therapy toward proactive management to optimize survival, growth, and quality of life. Collectively, these developments indicate a future in which paediatric ITx offers not only life-saving treatment but also enhanced long-term health, improved quality of life, and equitable access for children worldwide.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"8 ","pages":"100334"},"PeriodicalIF":0.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129036","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":"Evolution of gastrostomy tube management in a pediatric intestinal rehabilitation program.","authors":"Nzuekoh N Nchinda, Danielle R Wendel, Patrick J Javid","doi":"10.1016/j.intf.2025.100331","DOIUrl":"10.1016/j.intf.2025.100331","url":null,"abstract":"<p><strong>Background: </strong>Many children with intestinal failure (IF) have gastrostomy tubes (G-tubes) for enteral nutrition. G-tubes are often placed at index admission and not removed until after parenteral nutrition (PN) is weaned off. This study aims to describe the evolution of G-tube management within an intestinal rehabilitation program that changed focus to prioritize oral feeding.</p><p><strong>Material and methods: </strong>This is a retrospective review of electronic medical records of pediatric patients in a regional multidisciplinary intestinal rehabilitation program between 2008 and 2024. Two distinct management eras coincided with increased emphasis on oral nutrition. Early G-tube closure (prior to PN cessation) and traditional G-tube closure (after PN cessation) cohorts were compared using t-tests.</p><p><strong>Results: </strong>Seventy-eight percent (n = 114) of children underwent G-tube placement at median age of 3 months; 75 % were performed during index admission. From 2008-2015, there were 16 G-tube closures (8 early, 8 traditional), representing 28 % of all G-tubes in this early era. From 2016-2024, there were 40 G-tube closures (23 early, 17 traditional), representing 70 % of all G-tubes in this later era. Most closures were performed surgically. Among children with early G-tube closure, 25 % attained enteral autonomy while oral intake and growth progressed.</p><p><strong>Conclusion: </strong>In an intestinal rehabilitation program with a renewed focus on oral feeding, more children underwent G-tube closure while dependent on PN and were still able to reach enteral autonomy. G-tube placement may not be necessary for all children with IF, and placement decisions should be made within a multidisciplinary intestinal rehabilitation program.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"8 ","pages":"100331"},"PeriodicalIF":0.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146128990","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":"Incidence, predictors and outcome of neonatal-onset intestinal failure.","authors":"Rishi Bolia, Shay McLaren, Sara Alremawi, Looi C Ee","doi":"10.1016/j.intf.2025.100333","DOIUrl":"10.1016/j.intf.2025.100333","url":null,"abstract":"<p><strong>Background: </strong>Neonatal-onset Intestinal Failure (IF) and Short Bowel Syndrome (SBS) are associated with significant morbidity. We aimed to estimate incidence, identify predictors and determine outcomes of neonatal IF and SBS.</p><p><strong>Materials and methods: </strong>Retrospective review of children admitted to Queensland Children's Hospital between April, 2018 to March, 2022 who received parenteral nutrition (PN) in the neonatal period. IF was defined as those who required PN> 60 days from a gastrointestinal cause. Population-based estimate of incidence was calculated using census data from the national bureau of statistics.</p><p><strong>Results: </strong>49 neonatal patients received PN, of which 21 had IF, including 16 with SBS. The population-based incidence of IF and SBS-IF were 13.7(95 % CI 10.0-17.1) and 10.51(95 % CI 5.04-15.59) per 100,000 live-births respectively. Those with IF had lower birth weight [1985(IQR 1321)g vs.3140(IQR778)g, p = 0.001], lower gestational age [34weeks(IQR7.5)vs.38weeks(IQR3),p = 0.001], shorter residual small bowel [45 cm(IQR44)vs.245 cm(IQR50),p = 0.001], more likely to have an enterostomy [17/21vs.10/28,p = 0.003] and no colon [10/21vs.3/28,p = 0.0001] compared to those without IF. On multivariate analysis, residual small bowel length [OR 0.73(95 %CI 0.57-0.93),p = 0.008] and absent colon [OR 0.84(95 %CI 0.69 - 0.92),p = 0.001] were independent predictors of IF. At follow-up, 71 % (15/21) of patients with IF, including 81 % (13/16) with SBS attained enteral autonomy with no mortality. Children who attained enteral autonomy had significantly longer residual bowel [47.5(IQR 33)cm. vs. 26 cm.,p = 0.04] as compared to those who remained on PN.</p><p><strong>Conclusion: </strong>The population-based incidence of IF and SBS-IF in Queensland, Australia was 13.7 and 10.51 per 100,000 live-births respectively. Most children with neonatal IF achieve enteral autonomy with residual small bowel length predictive of it.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"8 ","pages":"100333"},"PeriodicalIF":0.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146128979","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":"Introduction to the XIX International Intestinal Rehabilitation and Transplant Association Congress (CIIRTA 2025).","authors":"Gustaf Herlenius, Mattias Soop, Francesca Bresso, Mihai Oltean","doi":"10.1016/j.intf.2025.100332","DOIUrl":"https://doi.org/10.1016/j.intf.2025.100332","url":null,"abstract":"","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"8 ","pages":"100332"},"PeriodicalIF":0.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129003","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":"Successful parenteral nutrition weaning using a chyme re-infusion device: Case reports.","authors":"Rebecca Griffiths","doi":"10.1016/j.intf.2025.100308","DOIUrl":"10.1016/j.intf.2025.100308","url":null,"abstract":"<p><strong>Background: </strong>Chyme reinfusion involves returning chyme (partially digested food) collected in an ostomy appliance from the proximal limb of a fistula or stoma back into the distal limb. With development of a chyme reinfusion device the process can now be undertaken without manual manipulation.</p><p><strong>Case report: </strong>Two case reports are presented showing how successful chyme re-infusion can eliminate the need for parenteral nutrition, a cornerstone in the treatment of intestinal failure. The practical steps taken in the weaning process are described.</p><p><strong>Conclusion: </strong>Chyme reinfusion can be a realistic alternative to parenteral nutrition in enthusiastic individuals supported by an experienced intestinal failure dietitian and multi-disciplinary team. Positive feedback from patients in these case reports include: coming off parenteral nutrition using the pump was life changing and absolutely amazing; overall the process was very straightforward after initial issues were resolved. Notable improvements in liver function tests are also demonstrated.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"8 ","pages":"100308"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129027","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":"Measuring disease-specific quality of life in pediatric intestinal failure: Development and validation of the PIF-QoL.","authors":"Marie L Neumann, Amy Ladner, Jessica Y Allen, Swapna Kakani, Meghan H Rauen, David F Mercer","doi":"10.1016/j.intf.2025.100324","DOIUrl":"10.1016/j.intf.2025.100324","url":null,"abstract":"<p><strong>Background: </strong>Research suggests pediatric intestinal failure (PIF) patients experience impaired quality of life (QoL), but no disease-specific instrument has been available to assess this patient population. The aim of this study was to develop and validate a PIF-specific QoL assessment tool.</p><p><strong>Methods: </strong>Our team of patient-, caregiver-, and clinician researchers developed a questionnaire to assess self- and proxy-reported QoL in PIF using a community-driven study design that included a literature review and exploratory study, review by content experts, focus groups and cognitive interviews with children, and the tool's implementation at a large U.S.-based PIF center. An initial psychometric evaluation was conducted to assess validity and reliability.</p><p><strong>Results: </strong>A total of 181 caregivers of children (ages 4-18) with a history of PIF and 70 patients (ages 8-18) with a history of PIF completed the caregiver and child versions of the PIF-QoL, respectively, and were included in the internal consistency assessment. Test-retest reliability was assessed with a sample of 30 caregivers and 21 children who completed the questionnaires at two timepoints. Across both PIF-QoL versions, results suggest acceptable to good internal consistency and test-retest reliability for individual domains. One exception was the \"Food and Eating\" domain, which may warrant future refinement. Instrument internal consistency and test-retest reliability were excellent (Caregiver: α≥ 0.89, ICC= 0.90; Child: α≥ 0.83, ICC= 0.92).</p><p><strong>Conclusion: </strong>Initial empirical testing and psychometric evaluation of the PIF-QoL support its use as a practical, valid, and reliable tool for assessing self- and proxy-reported QoL of patients with PIF.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"8 ","pages":"100324"},"PeriodicalIF":0.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129014","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":"Epidemiology of US patients with short bowel syndrome-associated intestinal failure: A claims database analysis.","authors":"Ahan Ali, Gail Mitchell, Mark Gallivan, Jeff Henderson, Kishore Iyer","doi":"10.1016/j.intf.2025.100325","DOIUrl":"10.1016/j.intf.2025.100325","url":null,"abstract":"<p><strong>Background: </strong>After intestinal resection, patients with short bowel syndrome (SBS) have inadequate intestinal function, leading to malabsorption of nutrients and fluids, and in more extensive cases intestinal failure, requiring parenteral support (PS). Epidemiology analyses based on insurance claims have lacked diagnosis code specificity, leading to risks of misclassification during patient identification. The recent ICD-10 codes for SBS and intestinal failure (IF) could mitigate this. The objective of this claims-based study was to characterize the annual prevalence of patients with SBS dependent on PS, i.e. patients with SBS-associated IF (SBS-IF) from 2019 to 2021 in the USA.</p><p><strong>Methods: </strong>We conducted a retrospective claims data analysis to identify patients with SBS-IF using the Komodo Healthcare Map™ database. Inclusion criteria were at least two insurance claims for both chronic and continuous nutrition, six months apart, a malabsorption diagnosis, and either gastrointestinal surgery or congenital bowel disorder. Annual prevalence estimates were calculated using diagnosis rates from the cohort projected to the US population by age and gender.</p><p><strong>Results: </strong>In 2021, estimated US point prevalence of SBS-IF was ∼12,000 individuals, corresponding to approximately 36/million population (overall), with stable sex (2/3 female) and age distributions across years. From 2019 to 2021, prevalence increased by > 24 %. Sensitivity analyses using a broader definition produced an upper bound approaching 30,000 individuals (higher per-million rate accordingly).</p><p><strong>Conclusions: </strong>This claims-based algorithm requiring sustained PS plus clinical face-validity signals (malabsorption and relevant surgical/congenital history) yielded consistent, contemporary estimates of SBS-IF prevalence in the US, supporting downstream epidemiology and health-services analyses.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"8 ","pages":"100325"},"PeriodicalIF":0.0,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129016","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":"Surveillance practices of pediatric intestinal failure patients by North American intestinal rehabilitation programs.","authors":"Christina Belza, Glenda Courtney-Martin, Yaron Avitzur, Paul W Wales","doi":"10.1016/j.intf.2025.100323","DOIUrl":"10.1016/j.intf.2025.100323","url":null,"abstract":"<p><strong>Introduction: </strong>Advancements in the survival of pediatric intestinal failure (IF) has resulted in a larger population of children requiring long-term parenteral nutrition (PN). Monitoring to prevent or address complications is vital in IF management, but currently there is no consensus on what to monitor or frequency. Our objective was to determine surveillance practices in North American (Canada and the United States) intestinal rehabilitation programs (IRPs).</p><p><strong>Material and methods: </strong>A cross-sectional survey was completed using a questionnaire developed by our center. Surveys were emailed to centers identified from the American Society of Parenteral and Enteral Nutrition IF working group. Data collected included program demographics and surveillance of liver and renal function, venous patency, bone health, macro- and micronutrients, growth, neurocognitive development, and quality of life (QoL). Descriptive analysis was performed on pooled responses with programs stratified into those with greater and lesser than 50 patients on home PN.</p><p><strong>Results: </strong>Twenty-five of 49 programs (51 %) responded with a total representation of 2995 patients including 971 patients on PN. Twenty IRPs (79.2 %) perform routine abdominal ultrasounds, however only 2 programs report evaluation of renal function. Eighteen IRPs (72 %) monitor venous patency and 56 % have schedule to evaluate bone health. Five programs (20 %) report formal neurocognitive follow up and 25 % monitor child and family QoL.</p><p><strong>Conclusion: </strong>There is wide variation in surveillance practices among Canada and US based pediatric IRPs. Data to support surveillance practices is needed. A consensus surveillance schedule could ensure early recognition and mitigation of complications to help improve outcome in this population.</p>","PeriodicalId":520517,"journal":{"name":"Intestinal Failure (New York, N.Y.)","volume":"7 ","pages":"100323"},"PeriodicalIF":0.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146128584","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}