Early human development最新文献

{"title":"Oxygen saturation targets in neonatal care: A narrative review","authors":"Tri C. Nguyen ,&nbsp;Rajeshwari Madappa ,&nbsp;Heather M. Siefkes ,&nbsp;Michelle J. Lim ,&nbsp;Kanya Mysore Siddegowda ,&nbsp;Satyan Lakshminrusimha","doi":"10.1016/j.earlhumdev.2024.106134","DOIUrl":"10.1016/j.earlhumdev.2024.106134","url":null,"abstract":"<div><div>Optimal oxygenation requires the delivery of oxygen to meet tissue metabolic demands while minimizing hypoxic pulmonary vasoconstriction and oxygen toxicity. Oxygen saturation by pulse oximetry (SpO₂) is a continuous, non-invasive method for monitoring oxygenation. The optimal SpO₂ target varies during pregnancy and neonatal period. Maternal SpO₂ should ideally be ≥95 % to ensure adequate fetal oxygenation. Term neonates can be resuscitated with an initial oxygen concentration of 21 %, while moderately preterm infants require 21–30 %. Extremely preterm infants may need higher FiO₂, followed by titration to desired SpO₂ targets. During the NICU course, extremely preterm infants managed with an 85–89 % SpO₂ target compared to 90–94 % are associated with a reduced incidence of severe retinopathy of prematurity (ROP) requiring treatment, but with higher mortality. During the later stages of ROP progression, studies suggest that higher SpO₂ targets may help limit progression. A target SpO₂ of 90–95 % is generally reasonable for term infants with respiratory disease or pulmonary hypertension, with few exceptions such as severe acidosis, therapeutic hypothermia, and possibly dark skin pigmentation, where 93–98 % may be preferred. Infants with cyanotic heart disease and single-ventricle physiology have lower SpO₂ targets to avoid pulmonary over-circulation. In low- and middle-income countries (LMICs), the scarcity of oxygen blenders and continuous monitoring may pose a challenge, increasing the risks of both hypoxia and hyperoxia, which can lead to mortality and ROP, respectively. Strategies to mitigate hyperoxia among preterm infants in LMICs are urgently needed to reduce the incidence of ROP.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"199 ","pages":"Article 106134"},"PeriodicalIF":2.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial - Neonatal Update 2024","authors":"Sabita Uthaya ,&nbsp;Vimal Vasu","doi":"10.1016/j.earlhumdev.2024.106133","DOIUrl":"10.1016/j.earlhumdev.2024.106133","url":null,"abstract":"","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"199 ","pages":"Article 106133"},"PeriodicalIF":2.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal bioethics, AI, and genomics","authors":"John D. Lantos","doi":"10.1016/j.earlhumdev.2024.106130","DOIUrl":"10.1016/j.earlhumdev.2024.106130","url":null,"abstract":"<div><div>Artificial intelligence (AI) and synthetic biology will transform civilization. The only question is how. In this paper, I explore some recent developments in medical AI, genomics, and synthetic biology. I speculate about the implications of these technologies for the practice of medicine and conclude that they will fundamentally alter our ideas of health, disease, medicine, and what it means to be human. I have three conclusions. First, AI and synthetic biology will force us to examine whether humanistic skills can be uniquely human and, if so, whether they are skills or natural gifts. AI will offer opportunities to examine what we mean by empathy, how we develop skills in communication, and when the human touch is essential for healing. Second, these technologies will change the ways that we will assess the value of doctors' work. Skills that can be mechanized will be devalued and delegated to machines. Doctors will either need to learn new skills or become irrelevant. Finally, AI and synthetic biology will force us to deeply examine what it means to be human. For humans to remain uniquely valuable, we will need to develop those aspects of our humanity that cannot be mechanized. Doctors will need to carefully attune themselves to the non-physical aspects of disease and suffering. Ultimately, AI and synthetic biology will force us to redesign both or systems of medical education and the systems of health care delivery in ways that meet both the medical and non-medical needs of patients.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"198 ","pages":"Article 106130"},"PeriodicalIF":2.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The three-dimensional course of cranial development of very preterm infants during the first year of life","authors":"P. Santander ,&nbsp;A. Quast ,&nbsp;J. Hubbert ,&nbsp;P. Meyer-Marcotty ,&nbsp;K.O. Hensel ,&nbsp;C. Bergmann ,&nbsp;S. Schmidt ,&nbsp;J.K. Dieks","doi":"10.1016/j.earlhumdev.2024.106131","DOIUrl":"10.1016/j.earlhumdev.2024.106131","url":null,"abstract":"<div><h3>Background</h3><div>Cranial measurements are crucial for evaluating preterm general development because they are a surrogate tool for evaluating brain growth. Usually, they are based on tape-measured head circumference; however, a three-dimensional (3D) approach expands the diagnostic spectrum to the evaluation of cranial volume and shape.</div></div><div><h3>Aims</h3><div>Very preterm (vPT) infants face multiple risks and obstacles in their early development. In this study, we analyze the risk for cranial anomalies of vPT compared with term-born (TB) infants during the first year of life.</div></div><div><h3>Study design and subjects</h3><div>In this single-centre prospective cohort study, 23 vPT and 24 TB healthy infants were assessed. At term equivalent age (TEA) of vPT and time of birth of TB, and 1, 3, 6 and 12 months of postmenstrual age, respectively, a 3D head scan was performed and cephalometrically evaluated regarding cranial growth (head circumference, cranial volume) and shape.</div></div><div><h3>Results</h3><div>Head circumference and cranial volume showed a similar course in vPT and TB. Cranial shape differed significantly between vPT and TB. At TEA, vPT showed longer and narrower heads (dolichocephaly), a difference that disappeared around the 6th month of life. Presence of plagiocephaly was initially similar in vPT and TB, with an increasing difference between both groups with a peak at six months when 34.8 % of the vPT versus none of the TB showed a moderate to severe plagiocephaly (<em>p</em> = 0.004). In vPT, cranial volume significantly correlated with cranial shape, whereas dolichocephaly at TEA had no influence on the further course of plagiocephaly.</div></div><div><h3>Conclusion</h3><div>Cranial development of vPT follows a different course than of TB in terms of cranial shape anomalies, while cranial growth remains unaffected.</div><div>German Clinical Trials Register number: DRKS00022558.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"198 ","pages":"Article 106131"},"PeriodicalIF":2.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal depressed mood and serotonergic antidepressant treatment during pregnancy differentially shape the continuity between fetal–newborn neurobehaviour","authors":"Kayleigh S.J. Campbell ,&nbsp;Ursula Brain ,&nbsp;Gillian E. Hanley ,&nbsp;Tim F. Oberlander ,&nbsp;Ken I. Lim","doi":"10.1016/j.earlhumdev.2024.106129","DOIUrl":"10.1016/j.earlhumdev.2024.106129","url":null,"abstract":"<div><h3>Background</h3><div>Prenatal serotonin reuptake inhibitor (SRI) antidepressant exposure is associated with newborn neurobehavioural disturbances, but it remains unclear whether this reflects a transient pharmacologic condition or an altered neurodevelopmental trajectory emerging <em>in utero</em> from sustained gestational SRI exposure.</div></div><div><h3>Aim</h3><div>This study explored longitudinal relationships between third-trimester fetal physiology and newborn neurobehaviour, and determined whether early neurobehavioural continuity is shaped by prenatal SRI or depression exposure.</div></div><div><h3>Methods</h3><div>Participants were 127 pregnant mothers and their fetal-newborn offspring. Four groups were defined based on antenatal depressive symptoms and SRI treatment: Control (<em>n</em> = 51), Depressed (unmedicated; <em>n</em> = 35), SRI-Depressed (<em>n</em> = 26) and SRI-Non-Depressed (<em>n</em> = 15). Doppler measures of fetal heart rate (fHR), motor activity and vascular hemodynamics were obtained at 36-weeks' gestation, then newborn neurobehavioural maturity was evaluated at postnatal day-7. Partial least squares analysis was used to identify latent correlations between fetal-newborn measures; associations were further studied with hierarchical regression testing group moderation.</div></div><div><h3>Results</h3><div>Two dimensions described 74% of the covariance between fetal physiologic and newborn neurobehavioural measures (permuted <em>p</em> &lt; 0.05). Three latent fetal-newborn relationships were significantly moderated by group: (1) lower fHR variability, and (2) greater fHR decelerations, predicted lower alertness/orientation scores but only in SRI-Depressed-group newborns; and (3) lower fetal cerebrovascular resistance predicted lower motor scores in Depressed-group newborns. SRI treatment to euthymia was not associated with fetal-newborn neurobehavioural disturbances.</div></div><div><h3>Conclusions</h3><div>Maternal depression, both unmedicated and SRI-treated with persistent/poorly-managed mood symptoms, differentially shaped fetal-newborn neurobehavioural continuity. These findings suggest that neurobehavioural disturbances may predate birth, and underscore the importance of effective mental health management during pregnancy.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"198 ","pages":"Article 106129"},"PeriodicalIF":2.2,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health screening for parents following surgical neonatal intensive care unit (NICU) discharge","authors":"Nadine Griffiths ,&nbsp;Sharon Laing ,&nbsp;Kaye Spence ,&nbsp;Maralyn Foureur ,&nbsp;Himanshu Popat ,&nbsp;Holly Gittany ,&nbsp;Lynn Sinclair ,&nbsp;Nadine KASPARIAN","doi":"10.1016/j.earlhumdev.2024.106128","DOIUrl":"10.1016/j.earlhumdev.2024.106128","url":null,"abstract":"<div><div>Admission to the surgical neonatal intensive care unit (sNICU) is a stressful experience. Care is often complex, with inherent risks and potential complications. This study describes the implementation of an outpatient mental health screening process for parents of infants admitted to a sNICU. Parents of infants aged &gt;34 weeks gestation with a congenital anomaly requiring neonatal surgery participated in this prospective observational study. Standardised measures to screen for parenting stress (Parenting Stress Index™ Fourth Edition Short Form) and depressive symptoms (Center for Epidemiologic Studies Depression Scale) were administered at the first outpatient visit scheduled when the infant's corrected gestational age was 4 months. A triage algorithm was developed, to review the initial screening results prompting appropriate action and intervention. Positive screens were triaged as evaluate (assess within 48 h), targeted information (email contact), or escalate response (same day risk assessment). Demographic factors associated with parental stress and depressive symptoms were explored. Forty parents (response rate: 88 %) participated in screening. A high portion of parents (52.5 %) required secondary screening, for parenting stress (<em>n</em> = 10), depressive symptoms (<em>n</em> = 5) or both stress and depressive symptoms (<em>n</em> = 6). Socioeconomic disadvantage was positively associated with parenting stress (<em>p</em> = 0.02) and greater depressive symptoms with parent education levels (<em>p</em> = 0.01). Results indicate screening of parent mental health in the outpatient setting is feasible. Use of a triage algorithm helped prioritise parent follow-up and facilitate workflows. Parent mental health screening should be prioritised within and beyond the sNICU to support family and infant outcomes during this critical period of development.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"198 ","pages":"Article 106128"},"PeriodicalIF":2.2,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-nutritional use of human milk as a therapeutic agent in neonates: Brain, gut, and immunologic targets","authors":"Rebecca Hoban ,&nbsp;Krystle M. Perez ,&nbsp;D. Taylor Hendrixson ,&nbsp;Gregory C. Valentine ,&nbsp;Katie M. Strobel","doi":"10.1016/j.earlhumdev.2024.106126","DOIUrl":"10.1016/j.earlhumdev.2024.106126","url":null,"abstract":"<div><div>Human milk (HM) exposure improves short- and long-term outcomes for infants due to a complex milieu of bioactive, stem cell, anti-inflammatory, anti-microbial, and nutritive components. Given this remarkable biologic fluid, non-nutritional utilization of HM as a targeted therapeutic is being explored in pre-clinical and clinical studies. This article describes recent research pertinent to non-nutritional uses of HM for neurologic, gastrointestinal, and infectious pathologies in neonates, as well as future directions.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"198 ","pages":"Article 106126"},"PeriodicalIF":2.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Sink or swim”: mothers' experiences of extremely preterm infants after 15 years from birth","authors":"Camilla Pisoni ,&nbsp;Serena Grumi ,&nbsp;Maria Letizia Minniti ,&nbsp;Linda Gasparini ,&nbsp;Annalisa Saracino ,&nbsp;Cecilia Naboni ,&nbsp;Stefano Ghirardello ,&nbsp;Renato Borgatti ,&nbsp;Simona Orcesi","doi":"10.1016/j.earlhumdev.2024.106123","DOIUrl":"10.1016/j.earlhumdev.2024.106123","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the experience of parenting a preterm infant from birth to adolescence and to raise awareness of the complexity of premature birth and the child's subsequent developmental journey for the entire family.</div></div><div><h3>Study design</h3><div>A phenomenological, qualitative approach using semi-structured interviews with open-ended questions was adopted to obtain retrospective, in-depth narratives. Seven mothers of adolescents born preterm with extremely low birth weight (ELBW) and admitted to a neonatal intensive care unit (NICU) participated in the study. Interviews were conducted by a trained researcher in qualitative methods, and independent coders performed data analysis.</div></div><div><h3>Results</h3><div>Three phases and eight core themes, chronologically organized, emerged from the thematic analysis: starting from preterm birth (<em>panic, fear and uncertainty</em>; <em>hope and a positive attitude to the future</em>; <em>altered parental role</em>), transitioning to life after hospitalization (<em>fatigue and worry about an uncertain future</em>; <em>need of support</em>), and extending into adolescence (<em>adolescents' fragility</em>; <em>overprotection</em>; <em>post-traumatic personal growth</em>).</div></div><div><h3>Conclusions</h3><div>The birth of a preterm baby has significant repercussions for the entire family, not only in the period immediately following birth but also for many years afterwards, as the traumatic event is retraced with memories that remain both painful and vivid. These findings should be acknowledged by professionals working in the NICU to foster the development of targeted interventions that help parents build resilience, including from a personal growth perspective.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"198 ","pages":"Article 106123"},"PeriodicalIF":2.2,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral motor interventions used to support the development of oral feeding skills in preterm infants: An integrative review","authors":"Carolyn Ibrahim ,&nbsp;Patricia Chavez ,&nbsp;Delaney Smith ,&nbsp;Jenene Craig ,&nbsp;Roberta Pineda","doi":"10.1016/j.earlhumdev.2024.106125","DOIUrl":"10.1016/j.earlhumdev.2024.106125","url":null,"abstract":"<div><h3>Background</h3><div>One criterion for infant NICU discharge is the ability to meet all nutritional needs by mouth, therefore, it is important to understand interventions that can improve the trajectory to full oral feeding. While many oral motor and feeding interventions are used in clinical practice, it remains unclear which are supported by the literature.</div></div><div><h3>Aim</h3><div>The aim of this integrative review was to identify and understand what oral motor interventions are defined in the literature to support positive outcomes for preterm infants and their parents.</div></div><div><h3>Methods</h3><div>An integrative review of studies published from 2002 to 2022 focusing on applied oral motor interventions and their impact on feeding-related outcomes was completed. The systematic search used databases including PubMed, Cochrane, CINAHL, Scopus, and Google Scholar. Studies were included if they used a study population of preterm infants born &lt;/= 32 weeks estimated gestational age (EGA) and imposed an oral motor intervention/exposure that commenced prior to 36 weeks postmenstrual age (PMA) while the infant was in the NICU, with outcomes of time to full oral feeding, length of stay (LOS), feeding performance measures, feeding efficiency, weight gain, infant physiology, and/or parental outcomes. Studies were excluded if they were observational, pilot, or feasibility designs; if they enrolled a purposefully healthy sample of infants; had non-relevant outcomes including apnea and incidence of retinopathy of prematurity; had a sample size &lt;30 without a priori calculation of power or had a calculated sample size that was not attained.</div></div><div><h3>Results</h3><div>Forty articles met inclusion criteria with four different interventions (or a combination of them) identified: nonnutritive sucking, oral motor stimulation [Fucile's protocol, Premature Infant Oral Motor Intervention (PIOMI)], NTrainer, and swallowing exercises.</div></div><div><h3>Discussion</h3><div>All interventions were associated with positive outcomes and began between 29- and 30-weeks PMA. Detailed information on adverse events (both physiologic and behavioral) in future research could allow for better risk-benefit analysis. The methodology and quality of the studies differed too much to allow for quantitative analysis; however, there does not appear to be compelling evidence that more stimulatory interventions are superior to less stimulatory interventions – a key consideration when working with preterm infants.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"198 ","pages":"Article 106125"},"PeriodicalIF":2.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of a Dutch post-discharge parenting intervention (TOP program) for moderate preterm born infants","authors":"Monique Flierman ,&nbsp;Eline L. Möller ,&nbsp;Raoul H.H. Engelbert ,&nbsp;Anton H. van Kaam ,&nbsp;Daniël Bossen ,&nbsp;Martine Jeukens-Visser","doi":"10.1016/j.earlhumdev.2024.106124","DOIUrl":"10.1016/j.earlhumdev.2024.106124","url":null,"abstract":"<div><h3>Background and aim</h3><p>Moderate preterm (MP) birth is associated with an increased risk of developmental problems. However, post-discharge support for this group is scarce. The aim of this study was to evaluate the feasibility of a post-discharge parenting program (TOP program) for MP infants. Three feasibility dimensions were evaluated (1) recruitment capability and compliance, (2) intervention acceptability, and (3) limited efficacy testing.</p></div><div><h3>Methods</h3><p>A group of MP infants with a gestational age (GA) between 32^0/7‐34^6/7 weeks and their parents received six home visits by a TOP interventionist until 6 months corrected age (CA). A pre-posttest intervention design with quantitative and qualitative measures was used.</p><p>Recruitment capability and compliance, acceptability, and satisfaction with the intervention were evaluated using a questionnaire, checklists, interviews, and a focus group. Infant socio-emotional development, parental distress, self-efficacy, and reflective functioning were measured with questionnaires. Observation measurements were used for infant motor development and parental sensitivity.</p></div><div><h3>Results</h3><p>Thirty-two families completed the six home visits. The satisfaction rate (scale 0–10) was remarkably high (Mean 9.4, range: 8–10). Parents reported that the program was suitable, enhanced their understanding of their infants' developmental needs, and increased their self-efficacy. The infants showed age-appropriate motor and socio-emotional development post-intervention. Parental self-efficacy, reflective functioning, and sensitivity improved from pre to post intervention, with small to large effect sizes.</p></div><div><h3>Conclusion</h3><p>The study demonstrated high compliance, acceptability, and satisfaction with the TOP program for MP infants with promising infant and parent outcomes. This study contributes to the preparatory work prior to a larger scale evaluation and dissemination.</p></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"198 ","pages":"Article 106124"},"PeriodicalIF":2.2,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}