Neonatology最新文献

{"title":"Non-invasive intermittent positive pressure ventilation - addressing the \"Achilles Heel\" of systematic reviews on non-invasive ventilation in premature infants - an argument for more contemporaneous, well-conducted trials.","authors":"Hannah Farley, Charles C Roehr, Shalini Ojha","doi":"10.1159/000546573","DOIUrl":"https://doi.org/10.1159/000546573","url":null,"abstract":"","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145382","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":"Accuracy and Safety of a Continuous Noninvasive Blood Pressure Monitor in Neonates.","authors":"R Brandon Hunter, Michele S Saruwatari, Nathan Daniel Bliss, Sarah Kim, Rodica Monica Turcu, Brooke Ann Krbec, Kamran Yusuf, Anoop Rao, Xina Quan, Lamia Soghier","doi":"10.1159/000546187","DOIUrl":"https://doi.org/10.1159/000546187","url":null,"abstract":"<p><strong>Background: </strong>Accurate and continuous blood pressure (BP) monitoring in neonates is crucial in the Intensive Care Unit. Invasive arterial lines, oscillometric cuffs, and current noninvasive continuous BP monitoring devices have significant limitations. The Boppli® device is a novel, continuous, noninvasive BP device that requires no calibration, designed for neonates. Aim &amp; Methods: This prospective, multicenter study evaluated the performance, usability, and safety of the Boppli device in neonates <5 kg. We compared Mean Arterial Pressure (MAP), Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) measurements from the Boppli with IAL reference values by calculating average values of Mean Average Error (MAE) and Standard Deviation (SD) for each patient, then averaging those means. Safety and usability were evaluated by analysis of adverse events and survey data, respectively.</p><p><strong>Results: </strong>The Boppli device demonstrated good performance, meeting the FDA requirements of MAE and SD of the entire cohort: MAE (SD) 0.7 (5.3) mmHg for MAP, -0.8 (7.7) mmHg for SBP, and 1.4 (4.7) mmHg for DBP. Patients with elevated MAPs, Asian ethnicity, and lower extremity IALs were the subgroups with MAE >±5 mmHg. Various subgroups had standard deviations >8 mmHg attributed to low sample sizes. The device received high usability scores from clinicians and parents. No serious adverse events were reported.</p><p><strong>Conclusions: </strong>The Boppli device is a promising alternative for continuous noninvasive BP monitoring in neonates, offering good accuracy and usability. The device, which received 510(k) clearance in September of 2023, was well-received by clinicians and parents, with a low risk profile.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-19"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103445","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 Pneumothorax and Neonatal Outcomes among Very Preterm Infants: A Multicenter Cohort Study.","authors":"Mengya Sun, Hong Jiang, Liang Zhao, Yun Cao, Lin Yuan, Liyuan Hu, Shoo K Lee, Lizhong Du, Jie Yang, Xianghong Li","doi":"10.1159/000546364","DOIUrl":"10.1159/000546364","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to evaluate whether the incidence of pneumothorax is associated with adverse neonatal outcomes in very preterm infants.</p><p><strong>Methods: </strong>This multicenter cohort study included all infants with a gestational age of 24-31 weeks, admitted to the tertiary neonatal intensive care units of the Chinese Neonatal Network, from 2019 to 2022. Pneumothorax was diagnosed via chest X-ray or lung computed tomography. The primary outcome was a composite measure of mortality and/or any severe neonatal morbidity. Multivariable logistic or linear regression analyses were performed to assess the association between pneumothorax and neonatal outcomes. Propensity score matching was used to ensure the robustness of the results.</p><p><strong>Results: </strong>Among the 37,917 infants in the study, 465 (1.2%) developed pneumothorax. Pneumothorax was significantly associated with a higher risk of mortality and/or severe neonatal morbidity (adjusted odds ratio = 3.15, 95% confidence interval: 2.36, 4.20). Pneumothorax exposure was also independently associated with increased mortality, severe intraventricular hemorrhage, moderate or severe bronchopulmonary dysplasia, and the need for invasive ventilation and its duration. Additionally, pneumothorax was associated with an increased length of hospital stay among survivors (adjusted odds ratio = 7.62, 95% confidence interval: 4.33, 10.91). The usage of high-frequency invasive mechanical ventilation before pneumothorax and pneumothorax treated with an intercostal chest drain seemed to have the most significant harmful effect (adjusted odds ratios were 3.34 and 3.27, respectively).</p><p><strong>Conclusion: </strong>Our study underscores the significant impact of pneumothorax on increasing mortality and severe morbidities in very preterm infants.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096538","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":"POCUS for Vascular Access in Neonatology Is Here to Stay.","authors":"Almudena Alonso-Ojembarrena, Ignacio Oulego-Erroz","doi":"10.1159/000546404","DOIUrl":"10.1159/000546404","url":null,"abstract":"","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096539","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 of Two Neonatal Encephalopathy Scores with Neurophysiology in Newborns with Suspected Hypoxic-Ischemic Encephalopathy.","authors":"Emily M Herzberg, Sara V Bates, Jason Boulanger, Ivana Culic, Mohamed El-Dib, Hoda El-Shibiny, Munish Gupta, Anne Hansen, Terrie Inder, Kyoung E Joung, Carol Keohane, Jessica R Landers, Silvia Patrizi, Arnold Sansevere, Brian H Walsh, Bo Zhang, Janet S Soul","doi":"10.1159/000545422","DOIUrl":"10.1159/000545422","url":null,"abstract":"<p><strong>Introduction: </strong>Severity of hypoxic-ischemic encephalopathy (HIE) is traditionally assessed by neurologic exam; however, electroencephalography (EEG) is a more standardized, reproducible measure of neonatal encephalopathy (NE). We aimed to compare two numeric NE scores with neurophysiological measures of encephalopathy, to describe EEG patterns in newborns with low NE scores, and to assess evolution of NE scores within 6 h after birth.</p><p><strong>Methods: </strong>We retrospectively analyzed associations between two NE scores, amplitude-integrated EEG (aEEG), and conventional-video EEG (cEEG) in 321 newborns in a 14-center collaborative NE Registry.</p><p><strong>Results: </strong>There was a significant association between both NE scores and aEEG/cEEG (p < 0.001), with higher scores in newborns with more abnormal aEEG background patterns. A minority of newborns with low NE scores (<4) had abnormal aEEG/cEEG, but all were treated with therapeutic hypothermia (TH). Most newborns with serial NE scores (74%) had evolution of encephalopathy; more newborns had decreasing/improving (48%) than increasing/worsening (26%) NE scores. Newborns with improving versus worsening scores were more likely to have a first NE score completed before 1 h after birth.</p><p><strong>Conclusion: </strong>Both NE scores showed a significant correlation with neurophysiology, but NE scores have limitations. Since HIE evolves in most newborns, serial NE exams are recommended with the initial or at least confirmatory NE exam completed at >1 h of age. aEEG/cEEG may be particularly useful for identifying more substantial NE warranting TH treatment in newborns with mild NE by exam. Data from this study support standardized use of neurophysiology in evaluating asphyxiated, encephalopathic newborns.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061345","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":"Medical Needs of Very-Low-Birth-Weight Preterm Infants Post-Discharge: A Population-Based Study in Taiwan.","authors":"Jui-Hsing Chang, Chia-Huei Chen, Chun-Chih Peng, Chia-Ying Lin, Hung-Yang Chang, Chyong-Hsin Hsu, Wai-Tim Jim","doi":"10.1159/000546115","DOIUrl":"10.1159/000546115","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to explore the outcomes, home use of medical assistive devices, and interdisciplinary medical needs of very-low-birth-weight (VLBW) infants at a corrected age of 2 years.</p><p><strong>Methods: </strong>Analyses were performed using perinatal, neonatal, and 2-year follow-up data from VLBW infants registered in the Taiwan Premature Infant Follow-up Network (TPFN) between 2011 and 2017. Basic information, survival, and disease conditions during hospitalization were recorded. Medical needs at discharge, outcomes at a corrected age of 2 years, active involvement in outpatient healthcare services, and referrals were investigated.</p><p><strong>Results: </strong>From 2011 to 2017, a total of 9,243 VLBW preterm neonates were enrolled in the TPFN. Of these neonates, 140 had severe congenital anomalies, 8,044 survived to discharge, and 6,150 returned for follow-up evaluation. At discharge, 10.2% of infants received home oxygen therapy (HOT), and 6.5% used home monitoring devices. Among the infants diagnosed with chronic lung disease, 26.6% received HOT. At a corrected age of 2 years, the most common interventions and recommended referrals were rehabilitative treatments (34.5%), followed by early intervention system services (16.5%), ophthalmology/otolaryngology management (4.4%), neurological follow-up (4.1%), and mental health assessment and treatment (2.5%).</p><p><strong>Conclusion: </strong>After hospital discharge, VLBW preterm infants exhibit substantial healthcare needs, with significant demands of HOT, rehabilitation, and early intervention services by a corrected age of 2 years. These findings highlight the importance of coordinated outpatient care and long-term follow-up to address the developmental and medical challenges faced by this vulnerable population.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048967","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":"Dexmedetomidine as a Promising Neuroprotective Sedoanalgesic in Neonatal Therapeutic Hypothermia: A Systematic Review and Meta-Analysis.","authors":"Enrico Cocchi, Juleda Shabani, Arianna Aceti, Gina Ancora, Luigi Corvaglia, Federico Marchetti","doi":"10.1159/000546017","DOIUrl":"10.1159/000546017","url":null,"abstract":"<p><strong>Introduction: </strong>Hypoxic-ischemic encephalopathy (HIE) is a leading cause of neonatal mortality and neurodevelopmental disabilities. Therapeutic hypothermia (TH) is the standard of care, but optimized sedoanalgesic strategies remain critical. Dexmedetomidine shows promise as an alternative to traditional sedatives, but its role in this context remains systematically under-explored. This meta-analysis aimed to address this gap by assessing the safety and efficacy of dexmedetomidine in neonates undergoing TH for HIE.</p><p><strong>Methods: </strong>A systematic search of Medline, Scopus, Embase, WOS, ClinicalTrials, and Cochrane Library identified studies published from January 2014 to October 2024. Studies focusing on dexmedetomidine in neonatal TH with relevant outcomes were included. Selection followed PRISMA guidelines, with independent quality assessments. The protocol was registered in PROSPERO (CRD42024605817). Results are presented as meta-analyses or evidence-based discussions when pooling was unfeasible.</p><p><strong>Results: </strong>Seven studies involving 609 neonates were included: four cohort studies (n = 486) and three case series (n = 123). Dexmedetomidine provided comparable sedation to traditional agents (MD = -0.01 [-0.68 to 0.66], p = 0.99) and significantly reduced seizure risk (OR: 0.31 [0.10 to 0.98], p < 0.05) with a non-inferior safety profile. Trends suggested shorter duration of mechanical ventilation and time to full enteral feeding. Substantial heterogeneity in dosing protocols highlights the need for standardization.</p><p><strong>Conclusions: </strong>Dexmedetomidine appears to be a safe and promising sedative in neonatal TH for HIE, with potential neuroprotective, respiratory, and gastrointestinal benefits. Despite limited evidence and the absence of randomized clinical trials, its non-inferior efficacy and safety warrant further exploration and urge the development of standardized dosing protocols.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028477","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":"Comparing Malposition and Complications Associated with Ultrasound-Guided versus Radiography-Guided Central Catheter Tip-Position in Neonates: A Systematic Review and Meta-Analysis.","authors":"Adel Mohamed, Nada Mohsen, Gonzalo Solis-Garcia, Nehad Nasef, Prakesh Shah","doi":"10.1159/000545772","DOIUrl":"10.1159/000545772","url":null,"abstract":"<p><strong>Introduction: </strong>There is a growing interest in ultrasound-guided central catheter (CC) tip-position, driven by its potential to improve accuracy and reduce complications. We aimed to systematically review and meta-analyze studies that reported complications associated with ultrasound-guided versus radiography-guided CC tip-position in neonates.</p><p><strong>Methods: </strong>We searched Medline, Cochrane, Embase, CINAHL, and <ext-link ext-link-type=\"uri\" xlink:href=\"http://clinicaltrials.gov\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">clinicaltrials.gov</ext-link> for randomized controlled trials (RCTs) and non-randomized controlled studies (NRSs) comparing the complications of ultrasound- versus X-ray-guided CC tip-position in neonates up to June 2024. RCTs and NRSs were analyzed separately. The outcomes included malposition, number of X-rays, procedure time, catheter manipulation, cardiac tamponade, extravasation, occlusion, and sepsis rates. Subgroup meta-analysis based on catheter type was performed. Statistical analyses were conducted using Review Manager 5.4.1 and R 4.1.0, and the GRADE methodology was applied to assess evidence certainty.</p><p><strong>Results: </strong>Eight studies (4 RCTs and 4 NRSs, N = 1,322 neonates) were included. Ultrasound-guided catheter tip-position significantly reduced malposition rates (3 RCTs, N = 181, RR: 0.51, 95% CI: 0.37 to 0.70; 4 NRSs, N = 1,110, RR: 0.25, 95% CI: 0.11 to 0.57) and decreased the need for X-rays (2 RCTs, N = 112, MD: -1.22, 95% CI: -2.32 to -0.11; 2 NRSs, N = 401, MD: -0.31, 95% CI: -0.47 to -0.15). No significant differences were found in procedure time, catheter manipulation, or sepsis rates. All evidence was of low certainty per grade.</p><p><strong>Conclusions: </strong>The use of ultrasound-guided CC tip-position in neonates is associated with a reduction in malposition rates and radiation exposure (low certainty evidence). Further research is needed to confirm the benefits of ultrasound-guided CC tip-position in neonates.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047600","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":"Changes in Fetal Hemoglobin Associated with Erythrocyte Transfusions Are Clinically Relevant in SpO2 Targeting: A Retrospective Cohort Observational Study.","authors":"Thomas E Bachman, Truong An Nguyen, Leos Tejkl, Richard Plavka","doi":"10.1159/000545306","DOIUrl":"10.1159/000545306","url":null,"abstract":"<p><strong>Introduction: </strong>There is a broad awareness of shifts in the oxygen hemoglobin dissociation (ODC) relationship associated with fetal hemoglobin (HbF) changes. However, quantification of the shift has been limited. Aim was to quantify the shift of partial oxygen tension (PO2) associated with HbF and with changes after transfusion of adult erythrocytes (TAE) in preterm infants.</p><p><strong>Methods: </strong>This is a single-center, retrospective observational analysis of blood gas samples. The shifts of ODC and PO2 related to HbF were evaluated in two models. Either HbF or TAE status (0, 1, ≥2) were used as the independent variable. Multivariate analysis was used to correct for confounding effects (gestational age, postnatal age, source of blood gas sample as well as pH, SO2, and PCO2).</p><p><strong>Results: </strong>There were 3,452 blood gas observations analyzed from 2,464 infants whose median gestational age was 334 weeksdays (IQR 296-363). With SpO2 between 90 and 95%, the ODC was shifted to the left (13 mm Hg, 1.3 kPa). After adjusting for confounding variables, the number of TAEs (0, 1, ≥2), was highly significantly related to a shift (p < 0.001), consistent with the percent HbF level (p < 0.001). Based on the multivariate model (i.e., holding confounding parameters constant), with a SpO2 of 92% the PaO2 could be expected to shift markedly higher with 2 or more TAEs in an extremely preterm infant (7.3 mm Hg, 0.97 kPa).</p><p><strong>Conclusion: </strong>While preliminary, these data suggest that in vulnerable preterm infants a change to a slightly lower SpO2 target range following TAE could maintain equivalent PaO2 exposure.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756957","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":"Investigating the Mechanisms of Reduced Blood Transfusions after Delayed Umbilical Cord Clamping: The TITANS Causal Mediation Analysis.","authors":"Sol Libesman, Anna Lene Seidler, Ava G Tan-Koay, Peter S Cunningham, Kristy Robledo, Sam Cruise, Makayla Wadsworth, Martin Kluckow, Andrew W Gill, Koert de Waal, William Tarnow-Mordi, Helen G Liley","doi":"10.1159/000545526","DOIUrl":"10.1159/000545526","url":null,"abstract":"<p><strong>Introduction: </strong>Delaying clamping of the umbilical cord (deferred cord clamping [DCC]) in preterm infants reduces mortality and the need for blood transfusions. The mechanisms leading to these benefits are not well understood. The TITANS study investigates potential mediators of the reduction in blood transfusions in infants who received DCC.</p><p><strong>Materials and methods: </strong>Additional patient data was sourced from Australian and New Zealand sites from the Australian Placental Transfusion Study (APTS). APTS randomized preterm infants <30 weeks' gestation to receive DCC (60 s) or immediate cord clamping. We examined whether placental transfusion or initial severity of illness mediated the reduced requirement for blood transfusions for infants randomized to DCC. Peak hematocrit in the first 7 days (Hct) was used as an indicator of placental transfusion quantity. Cumulative blood sampled, mechanical ventilation, and arterial sampling lines were used as indicators of severity of illness. We quantified the natural indirect effect of peak Hct and then for all mediators in a joint model with sequential mediation.</p><p><strong>Results: </strong>Data from 1,260 (of 1,401) Australian and New Zealand APTS infants were obtained. The effect of DCC on subsequent blood transfusion was mediated through peak Hct (indirect effect OR = 0.85, 95% CI: 0.79-0.93; p < 0.001), which accounted for 37% of the total effect. Indicators of severity of illness did not mediate the effect independently of peak Hct.</p><p><strong>Conclusion: </strong>Peak Hct mediated some, but not all, of the effect of DCC on blood transfusion, whereas markers of severity of illness were not independent mediators.</p>","PeriodicalId":94152,"journal":{"name":"Neonatology","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756960","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}