Frontiers in Pediatrics最新文献

{"title":"Surgical delay in appendicitis among children: the role of social vulnerability.","authors":"Villa-Aguilar Estefany, Marín-Morales Karen, Ayala-Galvan Citlali, Gonzalez-Ortiz Ailema, Gonzalez-Zamora Jose Francisco","doi":"10.3389/fped.2025.1591200","DOIUrl":"10.3389/fped.2025.1591200","url":null,"abstract":"<p><strong>Background: </strong>Appendicitis is the most common abdominal emergency in pediatrics and is suggested as a quality indicator for timely access to care in time-sensitive conditions. Despite advances in diagnostics, the incidence of complicated appendicitis (CA) remains high due to delays in pediatric surgical care, which can increase disease severity. Social vulnerability has been associated with surgical access, particularly in low- and middle-income populations. This study examines the relationship between surgical delay and social determinants of complicated appendicitis in children without social security in the Metropolitan Zone of México.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted in a pediatric public hospital. Consecutive cases from 2018 to 2021 with confirmed appendicitis diagnoses were included. The primary outcome variable was the type of appendicitis (acute/complicated), while two independent variables were the time of evolution (patient and hospital timing) and socioeconomic factors associated with social vulnerability. A logistic regression analysis assessed the relationship between appendicitis type and covariates.</p><p><strong>Results: </strong>A total of 943 pediatric cases of appendicitis were included. Out of these, 62.67% presented CA, with a mean age 10 ± 4 years. 60.9% were well-nourished, and 16% had at least one comorbidity. Most subjects (76%) met at least two criteria for social vulnerability, and 74.7% of families held unskilled jobs. The median symptom-to-admission time was 2 days, with a median hospital-to-surgery time of 19.5 h (p25-p75). Prehospital delays affected 57.8% of cases (<i>n</i> = 545), and 39% (<i>n</i> = 365) experienced intrahospital delays. In the multivariable logistic regression, prehospital delay ≥48 h (OR 3.27, 95% CI 2.43-4.39) and children under 5 years (OR 1.76, 95% CI 1.09-2.84) were associated with higher odds of CA.</p><p><strong>Conclusion: </strong>The high frequency of CA in uninsured children at a public hospital is due to surgical delays of two or more days. Social vulnerabilities, as observed globally, hinder access to quality care. Thus, appendicitis should be recognized as both a medical and social issue, requiring a comprehensive approach that addresses social vulnerability.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1591200"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649273","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":"Adolescent late-onset riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency manifesting with severe multi-organ failure: a case report.","authors":"Yunhua Zhao, Zhichao Li, Lili Cui, Jun Chen, Wangtao Zhong","doi":"10.3389/fped.2025.1513288","DOIUrl":"10.3389/fped.2025.1513288","url":null,"abstract":"<p><strong>Background: </strong>Multiple acyl-CoA dehydrogenase deficiency (MADD) is a rare autosomal recessive disorder characterized by dysfunctional acyl-CoA dehydrogenases, leading to lipid accumulation in various tissues, including skeletal muscles, liver, and cardiac muscles, etc. Late-onset MADD presents with progressive muscular symptoms (muscle weakness, atrophy, and myalgia) and even multisystem disorders (metabolic encephalopathy, dilated cardiomyopathy, liver failure, acute kidney injury, respiratory failure, and cardiac arrest). Over the past decade, only one case of childhood late-onset MADD with severe multi-organ failure has been reported.</p><p><strong>Case presentation: </strong>We report a 15-year-old girl with worsening muscle weakness, atrophy, myalgia, hepatic insufficiency, respiratory failure and even cardiac arrest. Laboratory tests showed significantly elevated levels of creatine kinase MB isoenzyme (CK-MB) and lactate dehydrogenase (LDH). A weakly positive serum small ubiquitin-like modifier 1 activating enzyme (SAE1) antibody suggested antibody-negative polymyositis (PM), but serum acylcarnitine analysis indicated increased concentrations of various acylcarnitines, while urine organic acids was normal. Muscle biopsy revealed significant lipid deposition within muscle fibers pointing to the diagnosis of lipid storage myopathy (LSM). Genetic testing identified a homozygous c.250G>A (p.Ala84Thr) mutation in electron transfer flavoprotein dehydrogenase (ETFDH), inherited from her parents. Although this pathogenic mutation is known in MADD, it has not been associated with adolescent late-onset MADD with severe multi-organ failure. After riboflavin supplementation, the patient regained mobility without ventilator support, with no recurrence of myopathic symptoms upon follow-up.</p><p><strong>Conclusion: </strong>MADD is a rare but treatable disease and its diagnosis is challenging due to its high clinical heterogeneity. Therefore, based on clinical, biochemical and pathological findings, gene analysis is critical for accurate diagnosis and clinical intervention, as riboflavin supplementation has shown lifesaving therapeutic benefit even in adolescent late-onset MADD with severe multi-organ failure.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1513288"},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649289","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":"Parent and perinatal professional priorities and perspectives for the pre-birth periviable conversation: a thematic analysis of semi-structured interviews.","authors":"J Peterson, E J Johnstone, A Mahaveer, D M Smith","doi":"10.3389/fped.2025.1552911","DOIUrl":"10.3389/fped.2025.1552911","url":null,"abstract":"<p><strong>Background: </strong>Periviable birth (22 + 0-23 + 6 weeks) presents clinicians and parents with numerous ethical, psychological and practical difficulties. The study aimed to identify key features within pre-birth periviable conversations for both professionals and parents, including priorities and challenges.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with participants from the key stakeholder groups: neonatologists/paediatricians (<i>n</i> = 5), obstetricians (<i>n</i> = 5), midwives (<i>n</i> = 5) and parents (<i>n</i> = 7). Interviews explored their experience of periviable counselling including priorities, challenges and perceptions. Thematic analysis was used to develop across parents and professionals.</p><p><strong>Results: </strong>Three themes were identified summarising the parent and professional perspectives within the pre-birth periviable conversations: chronology and narrative within pre-birth conversations, different perspectives on uncertainty and the role of transparency within periviable trauma. The trauma experienced by parents through periviable birth can be compounded through poor communication practices of perinatal professionals. These themes demonstrate that the information provided to parents should consistently outline all available care options relevant to their baby, including compassionately delivered, but honest and descriptive accounts of emotive options, such as comfort care. Information should be individualised to the specific circumstances and risk factors of that individual family and incorporate discussion of topics key to the 'good parent belief' to empower parents within their role.</p><p><strong>Conclusion: </strong>Perinatal professionals need to be able to utilise transparent communication, individualisation of information and understand the necessary role that narrative plays within decision-making. Future research is required to better understand the educational methods best suited to train perinatal professionals to incorporate these, and other trauma-informed care principles, within their communication and interactions with future parents.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1552911"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649217","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":"Clinical characteristics and risk factors for perinatal arterial ischemic and hemorrhagic stroke: a comparative study.","authors":"Chongchong Liu, Yi Zhang, Run Yang, Shiwen Xia","doi":"10.3389/fped.2025.1540173","DOIUrl":"10.3389/fped.2025.1540173","url":null,"abstract":"<p><strong>Background: </strong>Perinatal cerebral infarction (PCI) is a common cause of neurological complications in neonates. This study aimed to compare the clinical characteristics and risk factors of perinatal arterial ischemic stroke (PAIS) and perinatal hemorrhagic stroke (PHS) to inform early recognition and intervention strategies.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 124 neonates diagnosed with PCI, admitted to the neonatal intensive care unit (NICU) between June 2015 and December 2023. The neonates were divided into two groups-PAIS and PHS-based on clinical symptoms and cranial imaging findings.</p><p><strong>Results: </strong>Of the 124 patients, 87 (70.2%) were diagnosed with PAIS, while 37 (29.8%) had PHS. Clonic seizures were observed in 78 cases (62.9%), with apnoea noted in 11 cases (12.6%) within the PAIS group and jaundice in 8 cases (21.6%) within the PHS group. Lesions were primarily located in the left cerebral hemisphere in 53 cases (41.4%), whereas PHS lesions frequently involved the thalamus and basal ganglia (12 cases, 32.4%). Statistical analysis revealed significant differences in risk factors between the PAIS and PHS groups. The PAIS group had a higher rate of conversion from failed trial of labor to cesarean section compared to the PHS group (<i>P</i> = 0.012). Additionally, postnatal thrombocytopenia was more commonly associated with the PHS group than the PAIS group (<i>P</i> = 0.034).</p><p><strong>Conclusions: </strong>Our findings indicate that PAIS is more prevalent within the studied population, with a notable correlation between failed labor trials resulting in cesarean sections and the incidence of PAIS. This suggests a potential link between complications during labor and the occurrence of ischemic strokes. In contrast, postnatal thrombocytopenia was found to be significantly more common in the PHS group, indicating a possible association between low platelet counts and hemorrhagic strokes.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1540173"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642442","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: Management of congenital heart disease: challenges, implications, innovations and pitfalls.","authors":"Stefano Carmelo Di Bernardo","doi":"10.3389/fped.2025.1599311","DOIUrl":"https://doi.org/10.3389/fped.2025.1599311","url":null,"abstract":"","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1599311"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642444","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":"A population-based study of neonatal air transport in the Arctic region of Norway from 1994 to 2023.","authors":"Lene Nymo Trulsen, Lisa Gullhav Hansen, Nils Thomas Songstad, Astri Lang, Claus Klingenberg","doi":"10.3389/fped.2025.1594729","DOIUrl":"10.3389/fped.2025.1594729","url":null,"abstract":"<p><strong>Background and aims: </strong>Regionalized centralization of moderate and high-risk pregnancies is essential, but a well-organized postnatal transport service is equally important. This study evaluates the overall activity and clinical outcomes of the neonatal air transport team (NATT) at the University Hospital of North Norway (UNN) in Tromsø, covering a large catchment area in the Arctic region of Norway.</p><p><strong>Methods: </strong>Medical data from all neonatal air transports between the years 1994-2023 were recorded prospectively. Body temperature, blood glucose and blood gas within 3-6 h after arrival at UNN were assessed from medical files retrospectively. To assess temporal changes, we compared data between 1994 and 2008 (Period 1) and 2009-2023 (Period 2).</p><p><strong>Results: </strong>A total of 882 acute transports were included. Of these, 655 (74.3%) were referrals to the tertiary neonatal unit at UNN and 227 (25.7%) transfers to national surgical centers. Most transports (61.5%) were by fixed wing aircrafts. The proportion of infants transported due to congenital heart defects (CHD), prematurity and asphyxia was lower in Period 2. When comparing Period 1 and 2, upon arrival we found similar rates of hypothermia (9.8% vs. 6.7%, <i>p</i> = 0.17) and hypercapnia (17.3% vs. 15.3%, <i>p</i> = 0.55), but decreasing rates of hypocapnia (6.7% vs. 2.5%, <i>p</i> = 0.014) and hypoglycemia (10.8% vs. 2.3%, <i>p</i> = 0.001). There were low rates of outborn very low birth weight (VLBW) infants (<1,500 g) in both periods; 4.3% and 3.1%. However, severe IVH was observed in 6/29 (20.7%) outborn VLBW-infants vs. only 21/356 (5.9%) inborn VLBW-infants in the last 15-year period.</p><p><strong>Conclusion: </strong>Decreasing rates of transport due to prematurity and CHDs is probably secondary to improved perinatal care. Rates of hypoglycemia and hypocapnia improved in the second 15-year period, but further focus on improvements in both temperature and CO₂ control is warranted. Acute transport of VLBW-infants is associated with a markedly increased risk of severe IVH. In-utero transfer of women with threatened preterm birth to a tertiary perinatal center is therefore paramount.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1594729"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642441","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: Disorders of sex development in children: advancing multidisciplinary approaches for complex diagnosis and management.","authors":"Saida Hidouri, Evangelia Kalaitzoglou, Christopher J Romero","doi":"10.3389/fped.2025.1646197","DOIUrl":"10.3389/fped.2025.1646197","url":null,"abstract":"","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1646197"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642443","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":"Therapeutic effect of adalimumab in the treatment of intestinal Behçet's disease in children.","authors":"Tianjiao Gao, Xiaoxia Ren, Yanan Han, Fengfan Wang, Bianhua Liu, Ying Fang","doi":"10.3389/fped.2025.1619065","DOIUrl":"10.3389/fped.2025.1619065","url":null,"abstract":"<p><strong>Objective: </strong>Intestinal Behçet's disease is a rare but severe manifestation of Behçet's disease, particularly in pediatric populations. Currently, there is no cure for intestinal Behçet's disease, and the goal of treatment is to control acute episodes and reduce inflammation. Adalimumab, a tumor necrosis factor-alpha (TNF-α) inhibitor, has shown promise in adult patients, but data on its efficacy and safety in children are limited. The aim of this study was to evaluate the efficacy and safety of adalimumab in the treatment of intestinal Behçet's disease in children.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 8 children with intestinal Behçet's disease treated with adalimumab at Xi'an Children's Hospital from January 2021 to December 2024. Clinical symptoms, endoscopic findings, and inflammatory markers were assessed before and after treatment. Efficacy was evaluated on the basis of symptom resolution, ulcer healing, and changes in inflammatory markers.</p><p><strong>Results: </strong>The cohort included 4 males and 4 females, with an average age of 11.9 ± 1.4 years and a disease course of 10.5 (6.75, 22.5) months. All patients presented with gastrointestinal symptoms, including abdominal pain (<i>n</i> = 7), vomiting (<i>n</i> = 1), and complications such as intestinal obstruction (<i>n</i> = 3) and perforation (<i>n</i> = 1). Colonoscopy revealed ileocecal ulcers in 7 patients and only terminal ileal ulcers in 1 patient. After treatment with adalimumab, complete resolution of clinical symptoms was observed in all patients. Gastrointestinal endoscopy revealed that 6 patients had completely healed ulcers, while the remaining 2 patients had ulcers that were reduced to 50% of their original size. The levels of inflammatory markers significantly decreased, with the erythrocyte sedimentation rate (ESR) decreasing from 44.63 ± 43.48 mm/h to 10.50 ± 7.65 mm/h (<i>p</i> = 0.046) and the high sensitivity C-reactive protein (hs-CRP) level decreasing from 43.87 ± 39.10 mg/L to 0.96 ± 0.67 mg/L (<i>p</i> = 0.017). On the basis of clinical symptoms and endoscopic findings, 6 patients (75%) achieved complete remission, and 2 patients (25%) showed improvement. Adalimumab was well tolerated, with only one case of mild eczema reported.</p><p><strong>Conclusion: </strong>Adalimumab is safe and effective in the treatment of intestinal Behçet's disease in children.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1619065"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636827","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":"Cytokine dysregulation in children with severe neurological impairment correlates with significant clinical outcomes.","authors":"John Allen, Johana Isaza-Correa, Lynne Kelly, Ashanty Melo, Conor Power, Aoife Mahony, Denise McDonald, Eleanor J Molloy","doi":"10.3389/fped.2025.1567221","DOIUrl":"10.3389/fped.2025.1567221","url":null,"abstract":"<p><strong>Background: </strong>Children with neurological disorders have altered inflammatory responses. We aimed to describe pro-inflammatory, anti-inflammatory and hypoxia-induced cytokines in serum, at baseline, and in response to stimulation of whole blood with lipopolysaccharide, in children with Severe Neurological Impairment (SNI) compared to controls.</p><p><strong>Methods: </strong>Whole blood samples from children with SNI and healthy controls were incubated in the presence or absence of lipopolysaccharide (LPS). Serum was isolated and 12 cytokines were analysed by ELISA. Select clinical data was collected from healthcare records and correlated with cytokine results.</p><p><strong>Results: </strong>Twenty-nine children with SNI (<i>n</i> = 14) and age-matched controls (<i>n</i> = 15) were recruited. Cytokine responses to lipopolysaccharide were similar between the groups for Interferon (INF)-γ, Interleukin(IL)-18, Tumour Necrosis Factor(TNF)-β, IL-10, IL-1ra, IL-1β, IL-8, TNF-α and Vascular Endothelial Growth Factor (VEGF). Granulocyte Monocyte Colony Stimulating Factor (GM-CSF) increased in response to LPS in the control group (<i>p</i> = 0.04) but not in those with SNI (<i>p</i> = 0.07). The SNI cohort had a significantly greater increase in EPO in response to LPS than controls (<i>p</i> = 0.006). IL-6 in the SNI cohort was relatively hyporesponsive to LPS (<i>p</i> = 0.01). Correlations were found in LPS responses as follows: number of antiseizure medications and IL-1ra (<i>p</i> = 0.01) and TNF-α (<i>p</i> = 0.04); number of infections within the last year and IL-18 (<i>p</i> = 0.02); requirement for enteral feeding and IL-10 (<i>p</i> = 0.03) and EPO (<i>p</i> = 0.001); use of prophylactic antibiotics and IL-10 (<i>p</i> = 0.001); requirement for respiratory support and VEGF (<i>p</i> = 0.007).</p><p><strong>Conclusion: </strong>Children with SNI have persistent altered inflammatory responses. These alterations may contribute to tertiary neurological injury and impaired ability to respond to infection and may provide a target for immunomodulation.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1567221"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636816","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":"Artificial intelligence in pediatrics: promise, peril, and the path ahead.","authors":"Stefan Kurath-Koller","doi":"10.3389/fped.2025.1631521","DOIUrl":"10.3389/fped.2025.1631521","url":null,"abstract":"","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1631521"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636813","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}