Global pediatrics最新文献

{"title":"Outcome and its predictors of children with nosocomial infection in ayder pediatric ICU, Tigray, Ethiopia","authors":"Hansa Haftu Lemma ,&nbsp;Abdikarin Ahmed Mohamed ,&nbsp;Amanuel Hadgu ,&nbsp;Teklu Gebrehiwot Gebremichael","doi":"10.1016/j.gpeds.2025.100263","DOIUrl":"10.1016/j.gpeds.2025.100263","url":null,"abstract":"<div><h3>Objective</h3><div>The main objectives of this study were to assess the outcomes and predictors of nosocomial infections in pediatric patients.</div></div><div><h3>Method</h3><div>A hospital-based retrospective observational study and a consecutive sampling technique were used to collect data. Categorical data were compared using Pearson’s Chi-square test/Fisher’s exact test. Additionally, Kaplan-Meier analysis was also used to assess survival. P-values &lt; 0.05 were considered statistically significant.</div></div><div><h3>Results</h3><div>A total of 45 patients who developed nosocomial infections were analyzed. The incidence density of nosocomial infection was 41.1 per 1000 patient-days. Most patients were male (53.3 %) and under 14 (75.6 %), with a median age of 1 year. Statistically significant variables associated with increased mortality included female gender, transfer from the ward, prolonged maintenance fluid duration (&gt;3 days), the need for mechanical ventilation, and the presence of comorbid illnesses, as indicated by chi-square analysis. Patients with nosocomial infections had a longer hospital stay (20 days vs. 10 days) and a higher mortality rate (26.7 % vs. 19.1 %) compared to those without nosocomial infections. Nosocomial infections resulted in an excess crude mortality rate of 7.5 %.</div></div><div><h3>Conclusion</h3><div>Preventive measures should be prioritized given the identified risk factors for nosocomial infections. Patients with nosocomial infections are at an increased risk of mortality.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"13 ","pages":"Article 100263"},"PeriodicalIF":0.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261376","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":"Radiofrequency echographic multi-spectrometry for early bone health: The REMS-bone study protocol (Trial acronym: REMS-bone)","authors":"Serafina Perrone ,&nbsp;Malgorzata Wasniewska ,&nbsp;Maria-Elisabeth Street ,&nbsp;Virginia Beretta ,&nbsp;Elena Scarpa ,&nbsp;Chiara Petrolini ,&nbsp;Andrea Dall’Asta ,&nbsp;Domenico Corica ,&nbsp;Tommaso Aversa ,&nbsp;Giorgia Pepe ,&nbsp;Letteria Morabito ,&nbsp;Federica Grassi ,&nbsp;Anna-Mariia Shulhai ,&nbsp;Valentina Bianco ,&nbsp;Anna Maria Papini ,&nbsp;Maria Cristina Albertini ,&nbsp;Silvia Carloni ,&nbsp;Giuseppe Maglietta ,&nbsp;Matteo Puntoni ,&nbsp;Caterina Caminiti ,&nbsp;Tullio Ghi","doi":"10.1016/j.gpeds.2025.100261","DOIUrl":"10.1016/j.gpeds.2025.100261","url":null,"abstract":"<div><h3>Background</h3><div>Bone health begins with maternal health and nutrition, which influences skeletal mass and bone mineral density (BMD) already in utero. Maximization of bone mass during skeletal growth has become the goal of primary prevention of osteopenia and osteoporosis. The amount of bone gained during growth and its subsequent rate of loss are closely linked to the final skeletal mass in adulthood. Radiofrequency Echographic Multi Spectrometry (REMS) technology has proven to be useful in the assessment of BMD in pregnant women. However, the feasibility of REMS for the assessment of bone status in newborns remains unknown. This multicenter longitudinal study aims at using REMS to evaluate skeletal status in fetuses, newborns and children until 12 months of age.</div></div><div><h3>Methods</h3><div>Two hundred mother-newborn dyads, with infants born at term of gestation, will be consecutively recruited during the prenatal period and followed up until 12 months of life. BMD will be assessed with REMS technology in mothers, fetuses, newborns and infants at 1, 3 6 and 12 months of life. In all enrolled patients, blood will be collected at specific time points and oxidative stress biomarkers, specific microRNAs, and several bone metabolites will be measured in blood, whereas endocrine disruptors will be measured in urine.</div></div><div><h3>Discussion</h3><div>This study is designed to provide robust data on the best method to identify and evaluate bone status starting from intrauterine life. The associations among BMD, maternal nutrition, early exposure to endocrine disruptors, and other investigated molecules will also be investigated in relationship with subsequent body composition and bone health.</div></div><div><h3>Trial registration</h3><div>The protocol was retrospectively registered on ClinicalTrials.gov on December 3^rd, 2024, with the ID number NCT06750523.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"13 ","pages":"Article 100261"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184638","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":"Fraser syndrome with extremely rare features of unilateral anophthalmia and penile torsion in an Afghan neonate: A case report","authors":"Turyalai Hakimi ,&nbsp;Mansoor Aslamzai","doi":"10.1016/j.gpeds.2025.100258","DOIUrl":"10.1016/j.gpeds.2025.100258","url":null,"abstract":"<div><h3>Background</h3><div>Fraser syndrome is a very rare genetic disorder with multiple organ-system abnormalities. The diagnosis is usually made on the basis of clinical examination, and management requires a multidisciplinary approach.</div></div><div><h3>Case Presentation</h3><div>We present a case of Fraser syndrome with very rare manifestations of unilateral anophthalmia and moderate penile torsion in an Afghan neonate who was born to a 16-year-old mother. Physical findings and a CT scan of the brain and eyes were used to diagnose the aforementioned syndrome. The surgical repairs of cryptophthalmos and penile torsion were planned to be performed after infancy, and the baby was discharged in good health.</div></div><div><h3>Conclusion</h3><div>Anophthalmia and penile torsion are very rare components of Fraser syndrome. Very young maternal age may play a predisposing role in the pathogenesis of Fraser syndrome. The multiple organ defects in Fraser syndrome make this entity more challenging to deal with, particularly in low-resourced settings.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"12 ","pages":"Article 100258"},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946555","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":"The impact of timing for initiating formula feeding on the short-term prognosis of very low birth weight infants","authors":"Katsumi Mizuno","doi":"10.1016/j.gpeds.2025.100259","DOIUrl":"10.1016/j.gpeds.2025.100259","url":null,"abstract":"<div><h3>Background</h3><div>For very low birth weight (VLBW) infants, breast milk, particularly mothers' own milk (MOM), is the optimal nutrition. Donor human milk (DHM) is recommended when MOM is insufficient. However, the optimal timing for transitioning from DHM to formula remains unclear. This study examines the impact of formula initiation timing on complications in VLBW infants.</div></div><div><h3>Methods</h3><div>We analyzed data from 744 VLBW infants (&lt;1500 g) who initiated enteral feeding with DHM within 24 hours of birth using a human milk bank database (2018–2024). Postmenstrual age (PMA) at formula initiation was assessed for associations with bronchopulmonary dysplasia (BPD), home oxygen therapy (HOT), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC).</div></div><div><h3>Results</h3><div>The median PMA at formula initiation was 34.6 weeks. Delayed formula initiation reduced the risk of BPD, HOT, and NEC. Compared to formula initiation before 32 weeks, odds ratios for BPD ranged from 0.186 (34–36 weeks) to 0.239 (no formula). Formula initiation at 32–34 weeks significantly lowered ROP requiring treatment (OR 0.305). Logistic regression analysis indicated a trend toward reduced NEC risk when formula initiation occurred after 34 weeks (<em>p</em> = 0.0504).</div></div><div><h3>Conclusion</h3><div>Delaying formula initiation until after 34 weeks PMA reduces complications in VLBW infants. Early enteral nutrition with MOM or DHM within 24 hours of birth is crucial, and later formula introduction may provide better outcomes. Further studies are needed to refine feeding guidelines</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"12 ","pages":"Article 100259"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924601","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":"Determinants of survival of human immune deficiency virus infected children after commencing anti-retroviral therapy in Kembata-Tembaro zone: A facility-based retrospective cohort study","authors":"Tarekegn Tessema ,&nbsp;Mitiku Desalegn ,&nbsp;Lonsako Abute ,&nbsp;Tadele Yohannes","doi":"10.1016/j.gpeds.2025.100257","DOIUrl":"10.1016/j.gpeds.2025.100257","url":null,"abstract":"<div><h3>Background</h3><div>HIV infection is one of the most significant challenges to global health faced by care providers. On the other hand, malnutrition is prevalent in developing countries; it remains a serious problem among HIV-positive children even with the provision of Anti-Retroviral Therapy (ART).</div></div><div><h3>Objective</h3><div>To explore determinants of survival of human immune deficiency virus-infected children after commencing Anti-Retroviral Therapy in Kembata-Tembaro Zone, Southern Ethiopia, 2022.</div></div><div><h3>Methods</h3><div>A facility-based retrospective cohort study was employed among 305 HIV-infected children on ART from May 5-June 4/2022 at public hospitals in Kembata-tembaro zone. The data were collected by using a checklist. Data were entered and cleaned using <em>Epi</em> info 3.5.3 and analysed using SPSS version 25.0 software. The cumulative survival time after initiation of ART was calculated using the Kaplan-Meier survival curve. A Multivariable Cox proportional model was fitted to identify factors affecting survival after initiation of ART and variables having P value≤ 0.05 were considered statistically significant predictors of mortality.</div></div><div><h3>Results</h3><div>Overall, 43(14.1 %) died with an overall survival rate of 3.3 per 1000 child-months of observation. Undernourished children had a lower survival time than well-nourished children with mean survival time of 92.7 and 62.3 months respectively. Children with advanced WHO clinical stage III or IV (AHR: 6.1; 95 %CI: 1.4, 26.7), severe wasting at the baseline (AHR: 8.7; 95 %CI: 3.2, 23.6), high viral load level (AHR: 3.5; 95 %CI: 0.15, 0.61) and fair/poor adherence to ART (AHR: 3.7; 95 %CI: 2.3, 13.5) were significantly associated with survival of HIV-positive children in this study.</div></div><div><h3>Conclusion</h3><div>a significant difference in survival time was observed between undernourished and well-nourished children with a high rate of mortality. Severe wasting, WHO clinical stage III or IV, high viral load level and fair/poor adherence were identified as the determinants of survival.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"12 ","pages":"Article 100257"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870175","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":"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":"Gross and fine motor milestones in the first two years of life - representative data for Germany","authors":"Heinz Krombholz","doi":"10.1016/j.gpeds.2025.100254","DOIUrl":"10.1016/j.gpeds.2025.100254","url":null,"abstract":"<div><h3>Aims / Background</h3><div>This paper analyzes the development of 18 gross and fine motor development steps (milestones) in the first two years of life and presents norms for children with normal birth weight and underweight children.</div></div><div><h3>Design / Method</h3><div>The data come from a research project with more than 3400 parents, mainly in Germany, who participated. Using a “citizen-science approach,” parents reported their children's developmental progress online based on a calendar that charts 14 gross and four fine motor skills from birth to the point when children manage to walk.</div></div><div><h3>Results / Conclusion</h3><div>Only small and insignificant differences in reaching milestones were found between girls and boys. In addition, no impact of kind of delivery, nutrition, size at birth, siblings, age of mothers, social status of parents, and month of birth on motor development was found. However, preterm or underweight newborns showed a significant delayed motor development compared to newborns with normal birth weight. Therefore, separate norm values are presented for the total sample and for normal birth weight and underweight children.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"12 ","pages":"Article 100254"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844305","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}