Boletín médico del Hospital Infantil de México最新文献

{"title":"[MIA 2.0, Comprehensive asthma management, guidelines for Mexico].","authors":"Désirée E S Larenas-Linnemann, Jorge A Jorge A, Arturo Cortés-Telles, Elsy M Navarrete-Rodríguez, Blanca E Del Río-Navarro, Ricardo Lemus-Rangel, Rodrigo F Del Río-Hidalgo, Ulises N García-Ramírez, Mario Soto-Ramos, Federico I Hernández-Rocha, Eulogio Muñoz-Miranda, Iván Zamarrón-Reyes, Catalina Casillas-Suárez, Irlanda Alvarado-Amador, Marcos A Jiménez-Chobillón, Abril D Alemán-Ortega, Roberto Camargo-Ángeles, Armando Campos-Rivera, José L Carrillo-Alduenda, Víctor M Carrillo-Rodríguez, Francisco J Cuevas-Schacht, Roberto Dávalos-Valenzuela, Karina Díaz-Jiménez, Ma de Lourdes Rodríguez-Aguilera, Elizabeth Estrada-Reyes, Yair H González-Tuyub, Emilia M Hidalgo-Castro, Carlos Juárez-Ortíz, Ma de la Luz López-Vázquez, Adriana Del C Luna-Castañeda, Nora E Martínez-Aguilar, Anabell D Méndez-García, Carol V Moncayo-Coello, Ernesto Onuma-Takane, Jorge Vazquez-García, Ma Mayela Villarreal-de la Rosa, Benjamín Zepeda-Ortega, Andrés Sánchez-González, Luis C Hinojos-Gallardo, Adela Reyes-Herrera","doi":"10.24875/BMHIM.M25000042","DOIUrl":"10.24875/BMHIM.M25000042","url":null,"abstract":"<p><strong>Background: </strong>In 2020, a multidisciplinary group developed Integrated Asthma Management (MIA), guidelines for asthma in Mexico, based on international asthma guidelines. Since then, several concepts and treatments have been updated.</p><p><strong>Objective: </strong>To create a current version of MIA, strongly based on evidence, and to add the management of severe asthma exacerbations.</p><p><strong>Methodology: </strong>MIA 2.0 uses the ADAPTE method. The MIA 2.0 guideline development group consists of a core group (experts in pulmonology-allergology-methodology) and representatives of 16 institutions/societies of specialties that manage asthma. The international reference guidelines (selected with AGREE-II) were: GINA 2024, GEMA 5.4, BTS/SIGN 2024 and Australian Asthma Handbook 2021. MIA 2.0 covers diagnosis, treatment, severe asthma, exacerbations and special groups. Key clinical questions were formulated for I) diagnosis, II) treatment steps 1-4, III) severe asthma and IV) exacerbations.</p><p><strong>Results: </strong>Based on evidence in reference guidelines, safety, cost and local reality, the core group developed responses to the clinical questions. Through a Delphi process, the MIA 2.0 development group suggested adjustments until consensus was reached.</p><p><strong>Conclusion: </strong>A document was generated with multiple figures and algorithms, about asthma management including exacerbations treatment, adjusted for Mexico broadly based among different societies that participated in its development.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 2","pages":"1-50"},"PeriodicalIF":0.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149228","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":"Initial steps in the selection of a child development screening instrument in the peruvian context.","authors":"Carla P Cortez-Vergara, Gisely Hijar-Guerra, Blanca Távara-Campos, María E Ugaz-Villacorta","doi":"10.24875/BMHIM.24000156","DOIUrl":"10.24875/BMHIM.24000156","url":null,"abstract":"<p><strong>Background: </strong>The foundational elements for optimal well-being and health are established during the early stages of life. When progress does not meet expectations, it is necessary to explore possible disorders, health conditions, or other probable factors affecting it. Health professionals in our country must have access to developmental screening instruments that facilitate early detection of these potential risks and delays, thus enabling timely intervention.</p><p><strong>Methods: </strong>After a pre-selection of the evidence and adequate training of a multi-sectoral panel, a virtual deliberative dialog was held with key stakeholders and decision-makers to determine the most appropriate development screening instrument for the Peruvian context. The evidence was analyzed and discussed in light of the established criteria. In addition, factors pertaining to implementation on a national level were discussed.</p><p><strong>Results: </strong>A set of instruments were obtained and prioritized in the following order: Evaluation of Child Development (EDI, Spanish acronym) ranked first, followed by the Abbreviated Developmental Scale Third Edition (EAD-3, Spanish acronym) and the Ages and Stages Questionnaire (ASQ-3, Spanish acronym), based on the established criteria. The primary components implicated in the execution of this evaluation on a national scale were subsequently identified.</p><p><strong>Conclusions: </strong>This deliberative dialog has enabled a first approach to the selection of a development screening instrument on the national level, providing valuable information to guide the implementation process.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 1","pages":"25-35"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633532","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":"Association between development level and nutritional status in children under 5 years of age in primary care.","authors":"Miguel Á Villasis-Keever, Antonio Rizzoli-Córdoba, Blanca B Mares-Serratos, Karla E Falcón-Millán, Edwin O Vargas-Ávila, Christian A Delaflor-Wagner, Daniel Aceves-Villagrán, Hortensia Reyes-Morales, José A García-Aranda","doi":"10.24875/BMHIM.25000004","DOIUrl":"10.24875/BMHIM.25000004","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition is a risk factor for childhood development disorders. Although undernutrition is recognized as a public health problem, the impact of overweight/obesity on childhood development remains unknown. The objective is to determine the effects of undernutrition, overweight, and obesity on development in children aged between 1 and 59 months in rural/urban areas of Mexico.</p><p><strong>Methods: </strong>The Childhood Development Evaluation (EDI, for its acronym in Spanish) test was administered to children 1-59 months of age who visited primary care units in Guanajuato State, Mexico, between 2013 and 2015. The World Health Organization classification (weight/height ratio) was used for nutritional status. Logistic regression adjusted by sex, age, rural/urban, and level of marginalization, used to calculate odds ratios (OR) to stablish the association between nutritional status and developmental outcomes.</p><p><strong>Results: </strong>34,972 participants were included. 50.3% were male, 39.5% had a very low level of marginalization, 58.6% lived in urban areas, and 55.0% were beneficiaries of a conditional cash transfer program. Age distribution: 31.9% between 1 and 12 months old; 17.5% between 13 and 24 months old; 16.3% between 25 and 36 months old; and 34.3% between 37 and 59 months old. Overall 85.8% of participants had normal nutritional status, whereas 9.1% were identified as malnourished, and 5.0% were classified as overweight or obese. 79.1% had typical development. The OR for atypical development was 1.820 (95% confidence interval [95% CI], 1.671-1.981) for mild undernutrition; 2.796 (95% CI: 2.195-3.562) for moderate undernutrition; 14.903 (95% CI: 8.149-27.257) for severe undernutrition; and 1.160 (95% CI: 1.030-1.307) for overweight/obesity.</p><p><strong>Conclusion: </strong>Undernutrition and overweight/obesity are factors that increase the risk of developmental problems in children < 5 years of age.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 1","pages":"66-72"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633513","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":"Tribute to Dr. Luis Velásquez Jones.","authors":"Mara Medeiros","doi":"10.24875/BMHIME.M24000072","DOIUrl":"https://doi.org/10.24875/BMHIME.M24000072","url":null,"abstract":"","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 1","pages":"5-6"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596251","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":"Parental knowledge and caregiving practices related to early childhood development.","authors":"Antonio Rizzoli-Córdoba, Alicia Lebrija-Hirschfield, Laura A Hernández-Trejo, Christian A Delaflor-Wagner, Miguel Á Villasis-Keever","doi":"10.24875/BMHIM.25000005","DOIUrl":"10.24875/BMHIM.25000005","url":null,"abstract":"<p><strong>Background: </strong>Early childhood development (ECD) is a critical period for achieving milestones in cognitive, motor, and socioemotional development. Parental knowledge of ECD influences the manner in which children are stimulated, as evidenced in previous studies, particularly in developing countries. This study examined parents' understanding of ECD, their stimulation and caregiving practices, and the sources of information that they utilize in the Mexican context.</p><p><strong>Methods: </strong>A descriptive cross-sectional field study was conducted using a questionnaire validated by a panel of experts and a pilot test. A total of 536 mothers and fathers from socioeconomic levels C-, D+, and D/E residing in three Mexican cities were surveyed using non-probability convenience sampling. The questionnaire inquired about respondents' knowledge, stimulation practices, and sources of information related to ECD.</p><p><strong>Results: </strong>In all, 60% of the surveyed parents did not consider the first 3 years of life as a relevant learning stage. Although 44.3% of mothers and 37.6% of fathers identified early learning (at 0-3 months), few socioemotional activities were considered relevant. Only 33% were familiar with the term \"early stimulation,\" and television was the most consulted medium (30%).</p><p><strong>Conclusions: </strong>It is necessary to raise awareness among parents about the importance of play, as well as socioemotional and communicative activities in ECD. The quality of information disseminated through mass media should be improved and public policies to strengthen parental education should be promoted.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 Supl 1","pages":"101-112"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633495","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":"Cost-effectiveness of silver diamine fluoride for the prevention and control of early childhood caries: a scoping review.","authors":"Carmen D Macedo-Jaramillo, Estefany García-Cruz, Paulina De La Portilla-Robles, Daniela I Guadarrama-García","doi":"10.24875/BMHIM.24000090","DOIUrl":"10.24875/BMHIM.24000090","url":null,"abstract":"<p><p>Early childhood caries (ECC) is the presence of one or more decayed, missing, or filled teeth in children up to 71 months of age. Among the recommendations proposed by the World Health Organization to counteract this condition is the application of silver diamine fluoride (SDF). The aim of this research was to analyze the available information on the cost-effectiveness of SDF as a public health intervention in the prevention and control of ECC. This scoping review included articles published in English between 2008 and 2023 about the cost-effectiveness of SDF for pre-schoolers. Scientific journal databases (PubMed, Free Medical Journal, Science Direct, Springer Link, and Google Scholar) were searched using the following keywords: ECCs, effectiveness, cost, SDF, economic evaluation, caries, pre-school, infant, and minimal invasive treatment. The information extracted included author, year, objective, population, design, perspective of the analysis, options to be compared, time horizon, discount rate, costs, and effectiveness. We identified a total of 526 articles. Of these, 514 were excluded due to lack of relevance to the study objective, and 5 were duplicates. The final sample comprised 7 articles. The reported costs of SDF treatments from the perspective of healthcare practitioners ranged from $0.7 to $1,456, with an incremental cost-effectiveness ratio ranging from -$7.73 to -$518.50. SDF is a cost-effective treatment for public health interventions to prevent and control ECC in pre-schoolers.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 2","pages":"98-106"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109676","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":"Pediatric arrhythmias: a comprehensive integrative review, symptom-based conceptual framework, and practical care guide.","authors":"Ana C Cepeda-Nieto, Corazón de J Roblero-Aguilar, Janetzy Martínez-López, Norma A Balderrábano-Saucedo","doi":"10.24875/BMHIM.24000059","DOIUrl":"10.24875/BMHIM.24000059","url":null,"abstract":"<p><p>Pediatric arrhythmia encompass a diverse array of conditions, ranging from asymptomatic cases to severe life-threatening episodes. Effective management of these conditions, especially for non-specialist physicians, is crucial to improving patient outcomes and reducing the risk of sudden cardiac death (SCD). This integrative review aims to synthesize the present evidence on the strategies for diagnosing and treating pediatric arrhythmias, providing a practical, symptom-based guide for non-specialist physicians. Following Cooper's methodological framework, we conducted a comprehensive literature search using electronic databases (PubMed/MEDLINE and Cochrane Library) up to August 7, 2024. Inclusion criteria focused on studies published between 2019 and 2024, involving pediatric patients aged 2-18 years with several types of arrhythmias, excluding those with congenital heart disease or other systemic conditions. Quality appraisal was performed using the GRADE and CONSORT methodologies. From 176 initially selected studies, 69 met the inclusion criteria. The evidence was synthesized into a symptom-based conceptual framework, categorizing arrhythmias into asymptomatic, paroxysmal tachycardia, and those associated with low cardiac output or syncope. Common arrhythmias, such as sinus arrhythmia, sinus bradycardia, and wandering atrial pacemaker typically do not require treatment. In contrast, conditions, such as supraventricular tachycardia, ventricular tachycardia, and inherited arrhythmias (e.g., long QT syndrome, Brugada syndrome) necessitate specific diagnostic and therapeutic strategies. This review provides a practical guide for non-specialist physicians to diagnose and manage pediatric arrhythmias, aiming to improve patient outcomes and reduce SCD incidence in children. Future research should focus on pediatric-specific studies and the development of novel therapeutic interventions.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 2","pages":"67-97"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109682","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":"COVID-19 infection and intense physical activity in hypokalemic periodic paralysis.","authors":"Francisco Cammarata-Scalisi, Esteban San Martín, Antonio Cárdenas-Tadich, Maykol Araya-Castillo, Carolina Peralta-Aros, Víctor Olivares, Enrico Bertini, Colin E Willoughby, Michele Callea","doi":"10.24875/BMHIM.24000070","DOIUrl":"10.24875/BMHIM.24000070","url":null,"abstract":"<p><strong>Background: </strong>Hypokalemic periodic paralysis (HPP) is a rare genetic neuromuscular disorder characterized by an autosomal dominant inheritance pattern and a variable clinical phenotype. It is associated with low potassium levels due to defects in muscle ion channels. HPP can be life-threatening, but it can be completely reversed if diagnosed and treated promptly and correctly. Pathogenic variants in a heterozygous in the CACNA1S or SCN4A genes lead to HPP.</p><p><strong>Clinical case: </strong>We present a 16-year-old male with a clinical history of flaccid paralysis associated with hypokalemia following intense physical activity and subsequent COVID-19 infection. During this evaluation, his 12-year-old maternal half-brother exhibited similar symptoms related to intense physical exercise. The affected mother, maternal aunt, and maternal grandfather have variable clinical histories. Genetic testing identified a heterozygous pathogenic variation in the CACNA1S gene (c.2700G>A; p.Arg900Ser) in the patient, his mother, and maternal half-brother.</p><p><strong>Conclusion: </strong>The availability of a positive family history facilitates diagnostic guidance and provides insight into the factors triggering crises. Education is the first step in contributing to prevention and management. Furthermore, understanding the etiological cause is crucial for offering available therapeutic options and providing family genetic counseling.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 4","pages":"252-257"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882109","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":"Hemoptisis como síntoma inicial de carcinoma mucoepidermoide pulmonar en un niño.","authors":"Héctor Nuñez-Paucar, Noé Atamari-Anahui, Carla Cruzado-Villanueva, Víctor Gómez-Ponce","doi":"10.24875/BMHIM.24000136","DOIUrl":"https://doi.org/10.24875/BMHIM.24000136","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary mucoepidermoid carcinoma is a rare neoplasm in children. Nonspecific symptoms such as hemoptysis may delay diagnosis because they are confused with other respiratory diseases.</p><p><strong>Clinical case: </strong>A 9-year-old male patient presented recurrent episodes of cough and hemoptysis. The patient had two similar episodes associated with wheezing in previous months and was treated as an asthma attack. Radiological studies and bronchoscopy reported a lung mass obstructing the left main bronchus, causing atelectasis and involvement of the left lung. Transthoracic biopsy was positive for a salivary gland tumor. Treatment was surgical (left pneumonectomy). Histopathological and immunohistochemical studies reported low-grade mucoepidermoid carcinoma. He did not receive chemotherapy. After two years of follow-up, the patient was asymptomatic, and we did not see any recurrence.</p><p><strong>Conclusions: </strong>Pulmonary mucoepidermoid carcinoma is rare in children. Hemoptysis and signs of bronchial obstruction may mimic other respiratory diseases, causing a delay in diagnosis. Treatment is surgical, with a good prognosis during follow-up.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 5","pages":"323-327"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147792","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":"Persistent hyperinsulinemic hypoglycemia of infancy treated at the Hospital Infantil de Especialidades de Chihuahua.","authors":"Claudia E Peña-Varela, Nancy L Salazar-Flores, Reyna G Ramos-Porras, Karina A Martínez-Cervantes, Lilia T Avena-Portillo, Luisa B Gámez-González","doi":"10.24875/BMHIM.24000102","DOIUrl":"10.24875/BMHIM.24000102","url":null,"abstract":"<p><strong>Background: </strong>Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) affects between 0.5% and 5% of pediatric patients. This condition is caused by a dysfunction of pancreatic β-cells, leading to tumors and hyperinsulinism, which result in persistent hypoglycemia. These episodes are often resistant to conventional treatment and require interventions to reduce insulin production and increase glucose levels, thereby restoring metabolic balance.</p><p><strong>Clini calcases: </strong>We present three cases of PHHI. The first is a four-day-old Rarámuri patient with persistent hypoglycemia, diagnosed after a pancreatectomy and biopsy. The second case is a three-day-old Rarámuri patient with persistent hypoglycemia and a pancreatic lesion detected by scintigraphy, with PHHI confirmed after pancreatectomy. The third case is a three-day-old female patient with hypoactivity and persistent hypoglycemia, who was also diagnosed with PHHI after a pancreatectomy.</p><p><strong>Conclusions: </strong>While clinical presentation and biochemical findings raise high diagnostic suspicion, histopathological confirmation is essential. Early diagnosis is key to preventing long-term sequelae. PHHI should be considered in the differential diagnosis of hyperinsulinemic hypoglycemia, such as prematurity, intrauterine growth restriction, low birth weight, maternal diabetes, tyrosinemia type 1, or Beckwith-Wiedemann syndrome. These cases highlight the complexity of PHHI and its unusual presentation in the Rarámuri ethnic group, underscoring the importance of culturally sensitive medical care.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"82 4","pages":"258-262"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882116","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}