Global pediatrics最新文献

{"title":"Validation of the viet-modified screening tools for the assessment of malnutrition in pediatrics (V-mSTAMP)","authors":"Thi Thu Lieu Nguyen ,&nbsp;Thu Huyen Doan ,&nbsp;Ngoc Anh Doan ,&nbsp;Thi Phuong Duong ,&nbsp;Thi Thanh Xuan Le ,&nbsp;Thi Huong Le ,&nbsp;Thi My Thuc Luu","doi":"10.1016/j.gpeds.2025.100256","DOIUrl":"10.1016/j.gpeds.2025.100256","url":null,"abstract":"<div><h3>Background</h3><div>The Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) is designed for hospitalized children aged 2 weeks to 16 years. The modified version, Viet-Modified STAMP (V-mSTAMP), has been adapted for Vietnamese pediatric patients to address local nutritional risks and dietary patterns.</div></div><div><h3>Aims</h3><div>To validate the modified Screening Tool for the Assessment of Malnutrition in Pediatrics for use in Vietnamese pediatric patients.</div></div><div><h3>Methods</h3><div>The study validated the STAMP through a cross-sectional study at the National Children's Hospital, Vietnam. It involved 200 hospitalized children, using STAMP and V-mSTAMP for screening; the Subjective Global Nutrition Assessment (SGNA) and a nutritional standardized method which is a collaborative effort between the Academy of Nutrition and Dietetics (AND) and the American Society for Parenteral and Enteral Nutrition (ASPEN) for nutritional assessment; and comparing V-mSTAMP effectiveness with other reference standards.</div></div><div><h3>Results</h3><div>The average age of the patients was 10.8 ± 7.2 years. The V-mSTAMP screened 50.5 % of patients at no risk, 15 % at medium risk, and 34.5 % at high risk of malnutrition, with sensitivity ranging from 88.3 % to 94.2 % and specificity ranging from 61.3 % to 84.9 % compared to various standards. The area under the ROC curve ranged from 0.7 to 0.9. The agreement between V-mSTAMP and STAMP was 86.5 % (kappa = 0.7), and the internal reliability of V-mSTAMP showed 98 % agreement (kappa = 0.89).</div></div><div><h3>Conclusion</h3><div>Our study indicated the V-mSTAMP demonstrated high sensitivity and specificity when compared to the reference standards, with good reliability. Thus, the V-mSTAMP is an effective method for screening malnutrition in Vietnamese pediatric patients.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"12 ","pages":"Article 100256"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anorectal manometry under adequate sedation or anesthesia as a highly reliable diagnostic tool for Hirschsprung's disease in neonates and young infants: A multicenter retrospective study","authors":"Yohei Sanmoto ,&nbsp;Atsuki Naoe ,&nbsp;Yudai Goto ,&nbsp;Mikihiro Inoue ,&nbsp;Kouji Masumoto","doi":"10.1016/j.gpeds.2025.100255","DOIUrl":"10.1016/j.gpeds.2025.100255","url":null,"abstract":"<div><h3>Background</h3><div>Hirschsprung's disease is a congenital disorder characterized by the absence of enteric ganglion cells. The diagnostic gold standard for Hirschsprung's disease is a rectal mucosal biopsy; however, its accuracy in neonates and young infants remains limited. Although less invasive, the diagnostic performance of anorectal manometry (ARM) in these populations remains controversial. We evaluated the diagnostic performance of ARM in patients with Hirschsprung's disease by age group.</div></div><div><h3>Methods</h3><div>This multicenter retrospective study compared the diagnostic outcomes of ARM and biopsy across three age categories: neonates (&lt;28 days), infants ≤6 months, and children aged &gt;6 months. Additionally, logistic regression analysis was performed to assess changes in the probability of accurate diagnosis and exclusion of Hirschsprung's disease by ARM with increasing age.</div></div><div><h3>Results</h3><div>Overall, 113 patients were included in this study. The median patient age (range) at the time of ARM was 103 (3–3913) days. Most patients (83.2 %) underwent ARM under intravenous sedation or inhalation anesthesia. ARM revealed higher sensitivity than did biopsy in neonates (100 % vs. 45.5 %, <em>P</em> = 0.012) and infants aged ≤6 months (97.1 % vs. 79.6 %, <em>P</em> = 0.022). With increasing age, the probability of accurate diagnosis for Hirschsprung's disease by ARM significantly decreased (<em>P</em> = 0.031), although the probability of accurate exclusion showed no significant change (<em>P</em> = 0.35).</div></div><div><h3>Conclusion</h3><div>ARM, when performed under appropriate sedation or anesthesia, yields superior sensitivity for diagnosing Hirschsprung's disease in young children than does biopsy. However, diagnostic accuracy decreases with age, requiring careful interpretation in patients aged &gt;6 months.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"12 ","pages":"Article 100255"},"PeriodicalIF":0.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A charter of children's rights in the context of primary care","authors":"Milena Lo Giudice ,&nbsp;Mattia Doria ,&nbsp;Laura Reali","doi":"10.1016/j.gpeds.2025.100251","DOIUrl":"10.1016/j.gpeds.2025.100251","url":null,"abstract":"","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"12 ","pages":"Article 100251"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical imaging features of sturge-weber syndrome in a 10-month-old infant: A case report","authors":"Biruk T. Mengistie ,&nbsp;Chernet T. Mengistie ,&nbsp;Michael A. Negussie ,&nbsp;Solyana Bereded ,&nbsp;Eden H. Hagos ,&nbsp;Abebe M. Woldeyohannes","doi":"10.1016/j.gpeds.2025.100253","DOIUrl":"10.1016/j.gpeds.2025.100253","url":null,"abstract":"<div><div>Sturge-Weber Syndrome (SWS) is a rare, non-inherited neurocutaneous disorder characterized by facial capillary malformations, leptomeningeal angiomatosis, and ocular abnormalities such as glaucoma. While its hallmark imaging findings are well-documented, atypical presentations, especially in early infancy, remain underreported. This case report describes a 10-month-old male infant with a rare and severe presentation of SWS. The patient exhibited hallmark features, including a port-wine stain, glaucoma, and leptomeningeal enhancement, alongside atypical imaging findings such as diffuse bilateral cerebral atrophy, asymmetric pial angiomatosis, bilateral choroid plexus enlargement, and tortuous perimedullary veins. Neurological symptoms included recurrent tonic-clonic seizures starting within the first year of life, alongside persistent ophthalmologic complications. Advanced imaging played a pivotal role in identifying these unusual features, underscoring the variability in SWS presentations and the need for comprehensive neuroimaging in young patients. This report highlights the importance of early diagnosis, multidisciplinary management, and vigilant follow-up to address the diverse challenges posed by SWS, while expanding the documented spectrum of its manifestations.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"12 ","pages":"Article 100253"},"PeriodicalIF":0.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776963","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":"Antenatal substance exposure and infants’ telomere length: A scoping review","authors":"Holly Wei ,&nbsp;Lori A. Devlin ,&nbsp;Yan Cao ,&nbsp;Aaron Wei ,&nbsp;Christiana M. Keinath ,&nbsp;Rose Mary Xavier","doi":"10.1016/j.gpeds.2025.100252","DOIUrl":"10.1016/j.gpeds.2025.100252","url":null,"abstract":"<div><h3>Background</h3><div>Antenatal substance exposure due to maternal substance use during pregnancy has increased significantly, leading to suboptimal health outcomes for infants. Telomere length (TL) is a biological aging marker that may be affected by antenatal substance exposures. A comprehensive review of relevant studies is crucial for providing insights into the etiology of infant developmental outcomes.</div></div><div><h3>Objectives</h3><div>This scoping review, guided by the PRISMA guideline, aims to identify and summarize the existing research on the relationships between infants’ antenatal substance exposure and TL.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted using PubMed, Cochrane, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO. Search terms included antenatal, prenatal, infant, and various psychotropic substances. The review included studies examining the associations between antenatal substance exposure and TL. The last literature search was conducted on April 16, 2023.</div></div><div><h3>Results</h3><div>Seven articles met the inclusion criteria, addressing diverse substances such as alcohol, opioids, and tobacco. Among the seven studies, one evaluated the influence of antenatal alcohol exposure, one assessed antenatal opioid exposure, and five investigated antenatal tobacco exposure. The findings across the articles were varied, with five reporting indirect correlations and two reporting direct correlations between antenatal substance exposure and the TL in exposed infants.</div></div><div><h3>Conclusions</h3><div>This scoping review identified a significant gap in the current literature about the associations between antenatal substance exposure and TL in infants. The diverse findings emphasize the need for further research to explore whether TL could serve as a potential biomarker for predicting the effects of substance exposure on offspring. This study lays the foundation for future investigation and contributes to understanding the complex relationship between antenatal substance exposure and telomere biology in infants.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"12 ","pages":"Article 100252"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739622","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":"Knowledge of human papillomavirus vaccine as a determinant of uptake among guardians of adolescent girls: A single hospital in nairobi, kenya","authors":"Irene Nzisa ,&nbsp;Rose Kamenwa ,&nbsp;James Orwa ,&nbsp;Pauline Samia","doi":"10.1016/j.gpeds.2025.100249","DOIUrl":"10.1016/j.gpeds.2025.100249","url":null,"abstract":"<div><div>Cervical cancer is one of the most common preventable cancers, causing significant morbidity and mortality in women, especially in Sub-Saharan Africa. Despite the availability of free HPV vaccination, the proportion of adolescent girls vaccinated against HPV remains low.</div></div><div><h3>Methods</h3><div>Our aim was to identify knowledge and factors influencing HPV vaccine uptake among parents of adolescent girls and to determine the proportion of adolescent girls vaccinated within three months after the provision of additional information on cervical cancer and HPV vaccine. We undertook a mixed methods study design, with an initial cross-sectional part followed by a prospective cohort study among guardians of adolescent girls aged 9–18 years attending Aga Khan University Hospital Nairobi, Kenya. Guardians of adolescent girls who had not received the HPV vaccine were provided with standardized written information regarding cervical cancer, HPV vaccine availability, and utility. Guardians were then contacted three months later to evaluate subsequent HPV vaccine uptake.</div></div><div><h3>Results</h3><div>A total of 432 guardians participated in the study. The majority (94.7 %) knew about cervical cancer, 84.9 % of them had heard about the HPV vaccine, and 48 % were aware of the free vaccination campaign. Only 13.2 % (<em>n</em> = 57) of the participants reported that their daughters had been vaccinated prior to this study. Factors associated with vaccine uptake included the level of knowledge (<em>p</em> ≤ 0.001) and the age of the parents (<em>p</em> = 0.030). Reasons commonly cited for not taking the vaccine included lack of information (73 %), lack of awareness (45 %), safety concerns (13 %) and concerns about affordability (7 %). A total of 306 participants were followed up three months later, and 9.2 % (<em>n</em> = 28) of them reported that their daughters had been vaccinated.</div></div><div><h3>Conclusion</h3><div>The knowledge of the HPV vaccine was good at 67 %. However, uptake of the HPV vaccine was low in this study population despite providing them with additional information about the HPV vaccine. Higher levels of parental knowledge and older age were associated with a greater likelihood of HPV vaccine uptake. Innovative methods to reassure hesitant parents about HPV vaccination for their daughters are urgently needed in the Kenyan general population.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"12 ","pages":"Article 100249"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619295","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":"Neonatal resuscitation skill among health care providers in Eastern Africa: A systematic review and meta-analysis","authors":"Addis Eyeberu,&nbsp;Elias Yadeta,&nbsp;Haymanot Mezmur,&nbsp;Aboma Motuma,&nbsp;Adera Debella","doi":"10.1016/j.gpeds.2025.100248","DOIUrl":"10.1016/j.gpeds.2025.100248","url":null,"abstract":"<div><h3>Background</h3><div>Neonatal resuscitation skills involve providing ventilation, clearing airways, performing chest compressions, and administering necessary interventions to stabilize newborns in distress. Although basic neonatal resuscitation has been shown to improve newborn survival rates, asphyxia-related neonatal mortality remains high. This is partly due to inadequate skills among healthcare providers, who also exhibit varying expertise in newborn resuscitation across the region. Therefore, this study aimed to assess the pooled level of neonatal resuscitation skills among healthcare providers and identify associated factors.</div></div><div><h3>Methods</h3><div>Articles were searched from major databases. Data were analyzed using Stata version 18 statistical software. The overall estimates with a 95 % confidence interval were estimated using a random effect model.</div></div><div><h3>Results</h3><div>A total of 7038 healthcare providers were included in this study. The overall pooled result revealed that the level of neonatal resuscitation skills among healthcare providers in Eastern Africa was 48 % [95 % CI: 34–62]. The highest and lowest pooled level of neonatal resuscitation skills was observed among studies conducted in Ethiopia 57 % (95 % CI: 38–74) and Somalia 14 % (95 % CI: 8–22) respectively. Trained in neonatal resuscitation (OR = 1.87, 95 % CI: 1.26, 2.48), age above 35 (OR = 0.16, 95 % CI:0.14, 0.42), and having good knowledge (OR = 2.08, 95 % CI: 1.31, 2.86) were significantly associated with neonatal resuscitation skill.</div></div><div><h3>Conclusions</h3><div>The level of neonatal resuscitation skills in Eastern Africa is generally low. Factors such as receiving training in neonatal resuscitation, possessing adequate knowledge, and being over the age of 35 were significantly associated with neonatal resuscitation skills. Therefore, strengthening both short-term and long-term training programs, along with regular updates on neonatal resuscitation protocols, can enhance healthcare providers' skills in this critical area.</div></div><div><h3>Implications for Clinical Skill</h3><div>Identifying and addressing skill gaps in neonatal resuscitation can enhance clinical competency among healthcare providers, leading to improved neonatal survival rates. Additionally, this study can inform the development of training programs, influence policies, and foster quality improvement initiatives in healthcare facilities.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"11 ","pages":"Article 100248"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580642","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":"Risk factors of preterm birth in greater Accra regional hospital, ridge","authors":"Immanuel Adom-Miah ,&nbsp;Williams Ampadu Oduro ,&nbsp;David Boateng Appiah ,&nbsp;Theodocea Nortey","doi":"10.1016/j.gpeds.2025.100247","DOIUrl":"10.1016/j.gpeds.2025.100247","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to investigate the sociodemographic, psychological, cultural, environmental, and occupational risk factors associated with preterm birth at the Greater Accra Regional Hospital.</div></div><div><h3>Study Design</h3><div>A case-control study.</div></div><div><h3>Methods</h3><div>The study employed a case-control design and used the Chi-square test to assess associations between various risk factors and preterm birth. Sociodemographic, psychological, cultural, environmental, and occupational factors were examined to determine their relationship with preterm birth.</div></div><div><h3>Results</h3><div>The findings revealed a significant association between depression and preterm birth, with a Chi-square value of 12.115 and a p-value of 0.001. Moderate exercise was also associated with preterm birth, showing a significant relationship (p-value of 0.039). However, the mothers’ occupation, including posture at work, hours spent in a specific position, and exposure to heat, chemicals, dust, or smoke, did not demonstrate significant associations with preterm birth.</div></div><div><h3>Conclusions</h3><div>The study emphasizes the need for enhanced maternal and child healthcare efforts in the country and underscores the importance of public education, particularly regarding the role of partner support in reducing the risk of preterm birth.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"11 ","pages":"Article 100247"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143561890","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":"Determinants of essential newborn care for institutional births in Bangladesh: Findings from the 2019 MICS Survey","authors":"Syeda Sumaiya Efa ,&nbsp;Syed Nafi Mahdee ,&nbsp;Md Fuad Al Fidah","doi":"10.1016/j.gpeds.2025.100246","DOIUrl":"10.1016/j.gpeds.2025.100246","url":null,"abstract":"<div><h3>Background</h3><div>Millions of newborns die globally during the neonatal period. Essential newborn care (ENC) is designed to lower neonatal morbidity and mortality. The current study investigated the association between sociodemographic, antenatal, and delivery care factors that may impact ENC practices for institutional birth in Bangladesh.</div></div><div><h3>Methods</h3><div>The current study utilized publicly available, nationally representative data. A total of 404 participants were considered for analysis. A logistic regression model was developed, with significant variables identified by chi-square tests. A p-value &lt;0.05 was considered statistically significant (α=0.05).</div></div><div><h3>Results</h3><div>Almost half of the participants were &lt;20 years old (241, 59.7 %), half had secondary level education (205, 50.7 %), and one-third were from the poorest wealth quintile (123, 30.4 %). The prevalence of proper ENC was 57 (14.1 %). In 383 (94.8 %) cases, instruments were utilized to cut the umbilical cord, with 271 (67.1 %) showing no application of substances to the cord stump. Following birth, 396 (98.0 %) newborns underwent drying, while 294 (72.8 %) were immediately wrapped. Delayed bathing was observed in 131 (32.4 %) cases, with 359 (89.9 %) initiating breastfeeding. Proper ENC was associated with assistance by skilled birth attendant (SBA) (<em>p</em> = 0.004) and residence (<em>p</em> = 0.047). Higher odds of proper ENC were found among those who received assistance by SBA (AOR: 2.39; 95 % CI: 1.32–4.32; <em>p</em> = 0.004) and belonging to the middle class (AOR: 2.90; 95 % CI: 1.26–6.68; p-value=0.012).</div></div><div><h3>Conclusion</h3><div>Proper ENC in institutional birth is not widely practiced in Bangladesh. Targeted health promotional activities and policies, especially assistance by a SBA and raising awareness among mothers of the poorest families, can help to improve ENC practices during institutional birth.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"11 ","pages":"Article 100246"},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350534","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 present and the future of point-of-care ultrasound in Pediatric Care","authors":"G. Bausani ,&nbsp;AMC Musolino ,&nbsp;L. Reali","doi":"10.1016/j.gpeds.2025.100245","DOIUrl":"10.1016/j.gpeds.2025.100245","url":null,"abstract":"","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"11 ","pages":"Article 100245"},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377027","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}