Journal of Pediatric Gastroenterology and Nutrition最新文献

{"title":"Vitamin and trace element status and growth in children with short bowel syndrome being weaned off parenteral nutrition.","authors":"Jetta Tuokkola, Elina Olkkonen, Riikka Gunnar, Mikko Pakarinen, Laura Merras-Salmio","doi":"10.1002/jpn3.12427","DOIUrl":"10.1002/jpn3.12427","url":null,"abstract":"<p><strong>Objectives: </strong>Children with short bowel syndrome (SBS) are at increased risk of micronutrient deficiencies. We aimed to study weaning off parenteral nutrition (PN) as a risk factor for vitamin and trace element deficiencies and growth deficit.</p><p><strong>Methods: </strong>Children born between 2010 and 2019, treated for SBS in Helsinki University Hospital, were followed for their nutrition, growth, and vitamin and trace element biochemical status. Information on these as well as patient characteristics and intestinal anatomy were collected from electronic patient records.</p><p><strong>Results: </strong>A total of 59 patients with SBS were identified. The weaning period was found to be a risk factor for micronutrient deficiencies and growth. Most frequent deficiencies were detected for vitamin K as suggested by prothrombin time (PT) (91% of patients), vitamin D (70%), and vitamin A (67%). Other deficiencies were less common with 44% for vitamin B12, 25% for selenium, 19% for copper, 24% for zinc, and 11% for vitamin E. For all the studied micronutrients, 3 months before to 1 month postweaning had the highest rate of micronutrient deficiencies, except for vitamin B12, for which the highest proportion of deficiencies presented at 1-6 months postweaning.</p><p><strong>Conclusions: </strong>The weaning period from PN is a risk for micronutrient deficiencies. Regular monitoring and sufficient supplementation are essential for preventing malnutrition.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"318-325"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794862","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":"Influence of pediatric ERCP positioning on procedural outcomes: A single-center study.","authors":"Michael Joseph, Rebecca Schiff, Jacob Mark, Robert Kramer","doi":"10.1002/jpn3.12438","DOIUrl":"10.1002/jpn3.12438","url":null,"abstract":"<p><strong>Objectives: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is traditionally done in the prone position. In pediatrics, patient anatomy and anesthesia practices are considerations that affect procedural success and anesthesia time. The aim of our study was to evaluate the safety, procedural success, and efficiency of pediatric ERCP in the prone versus supine positions.</p><p><strong>Methods: </strong>ERCPs from September 2016 to August 2023 were reviewed at our center. Demographic and procedure variables were collected. Multivariate linear regression was performed to determine the effect of patient position on total anesthesia time.</p><p><strong>Results: </strong>Two hundred and eighty-three patients (378 ERCPs) were included. There were significant differences in fellow involvement, proportion of native papillae, procedural indication, and total anesthesia time by ERCP position. Multivariate linear regression found that supine position was associated with 9.3-min decrease in anesthesia time and American Society of Anesthesiologists Class 1 or 2 was associated with 10.6-min decrease in anesthesia time. Factors that were associated with increased anesthesia time were additional procedure, increased procedure time, and native papilla. Finally, we found a learning curve for transitioning from prone to supine position was between 10 and 40 cases. After the learning curve, we found 11-min decrease in mean procedure time and 16-min decrease in total anesthesia time in the supine position.</p><p><strong>Conclusions: </strong>This is the first pediatric study to evaluate the role of patient positioning on ERCP outcomes and total anesthesia time. Given similar procedural outcomes, the impact of increased anesthesia time on neurodevelopment in children, and the cost to the patient, the supine position may be preferred to a prone position.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"345-352"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837201","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":"Health-related quality of life determinants in Spanish children with eosinophilic esophagitis.","authors":"Ruth García-Martínez de Bartolomé, Josefa Barrio-Torres, Tomás Sebastián-Viana, Víctor Vila-Miravet, Enrique La Orden-Izquierdo, Sonia Fernández-Fernández, Myriam Herrero-Álvarez, Marta Soria-López, Gonzalo Botija-Arcos, Alejandro Rodríguez-Martínez, Gonzalo Galicia-Poblet, Alejandro García-Díaz, Marta Herreros-Sáenz, Javier Blasco-Alonso, Gloria Rodrigo-García, Natalia Alonso-Pérez, Ana Fernández de Valderrama-Rodríguez, Noel Oppenau-López, Begoña Pérez-Moneo, Sara Feo-Ortega, Raquel Vecino-López, Paloma Donado-Palencia, José Ramón Alberto-Alonso, Margarita Revenga-Parra, Helena Lorenzo-Garrido, Miguel Ángel Carro-Rodríguez, Luis Grande-Herrero, Saioa Vicente-Santamaría, Elena Balmaseda-Serrano, María Carmen Miranda-Cid, Jessica Martín-González, Ruth García-Romero, Diana García-Tirado, Jana Rizo-Pascual, Pedro Alonso-López, Miriam Blanco-Rodríguez, Alicia Rendo-Vázquez, Antonio Millán-Jiménez, Ana Castro-Millán, Eduard Bastida-Ratera, M Luz Cilleruelo-Pascual","doi":"10.1002/jpn3.12426","DOIUrl":"10.1002/jpn3.12426","url":null,"abstract":"<p><strong>Objectives: </strong>To study the health-related quality of life (HRQoL) and its possible determinant factors in Spanish children with eosinophilic esophagitis (EoE) and their parents.</p><p><strong>Methods: </strong>Multicenter observational cross-sectional study. The Spanish version of the Pediatric Quality of Life Eosinophilic Esophagitis Module was filled out by EoE patients aged 8-18 and their parents. Demographic, psychosocial, and clinical variables were studied. Multiple linear regression was performed to identify related factors of HRQoL.</p><p><strong>Results: </strong>A total of 279 children and their parents participated (72.7% males). 39.1% received swallowed corticosteroids, 35.5% proton pump inhibitors and 16.8% diet. 1.1% received other treatments and 7.5% received no treatment. Poor compliance to treatment was observed in 11.5% and 6.5% of patients were referred to mental health. The Total Scale Scores were 72.71 ± 17.50 and 75.62 ± 16.73 for children and parents, respectively. \"Communication\" was the dimension with the highest scores (82.14 ± 21.65 and 81.59 ± 24.13) while \"Food and Eating\" (48.92 ± 32.94 and 62.85 ± 28.78), and \"Food Feelings\" (53.55 ± 29.96 and 53.95 ± 27.78) had the lower scores. Patients and parents under dietary treatment showed lower scores than those under pharmacological treatment, 65.77 ± 16.96 versus 74.28 ± 16.96, p = 0.001 and 68.33 ± 17.32 versus 77.24 ± 15.97, p = 0.001, respectively. Factors associated with worse HRQoL scores were symptom frequency, diet, food allergies, and the need for mental health assistance.</p><p><strong>Conclusions: </strong>The HRQoL of children and their parents was \"good.\" However, diet, frequency of symptoms, food allergies, and the need for mental health care were the factors that had a negative impact on HRQoL of children with EoE.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"308-317"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813627","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":"Current practice in the management of paediatric autoimmune liver disease in Europe.","authors":"Mara Cananzi, Marianne Hørby Jørgensen, Gustav Buescher, Ruth De Bruyne, Marianne Samyn","doi":"10.1002/jpn3.12424","DOIUrl":"10.1002/jpn3.12424","url":null,"abstract":"<p><strong>Objective: </strong>Paediatric autoimmune liver disease (pAILD) is a rare condition with serious health implications. Notwithstanding treatment advancements, areas of uncertainty and knowledge gaps still exist. We here investigated the real-life approach to pAILD management in Europe.</p><p><strong>Methods: </strong>A survey was distributed to members of the European Rare Liver Disease Reference Network (ERN RARE-LIVER) and the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Hepatology Interest Group. Information was gathered regarding clinical activity, medications used, and access to paediatric drug formulations at each site.</p><p><strong>Results: </strong>Thirty-six centres from 22 European countries responded to the survey. The majority are exclusively paediatric units (86%). Among participants, 80% follow <50 children with pAILD, of which 25%-50% are <10 years old in 44% of centres. All centres use predniso(lo)ne as first-line therapy, alone (15/36) or with azathioprine (21/36). Azathioprine and mycophenolate are the preferred second-line options in centres using first-line steroid monotherapy (11/15) or combined steroid-azathioprine (19/21), respectively. Tacrolimus is used as third-line agent in 15/36 centres. Proactive measurement of drug metabolites and target levels vary widely among centres. Paediatric predniso(lo)ne formulations are commercially available in 7/22 European countries, azathioprine in 3, mycophenolate in 14, tacrolimus in 15 and ursodeoxycholic acid in 14. When paediatric formulations are unavailable, children are treated with magisterial preparations or 'solid' formulations (crushed or intact).</p><p><strong>Conclusions: </strong>Treatment of pAILD in Europe varies widely in terms of medications used and treatment monitoring. Availability of paediatric drug formulations across Europe is limited. Collaborative initiatives are needed to define evidence-based strategies for management of pAILD and to promote an equal, age-appropriate treatment for affected children.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"260-270"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770030","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":"Primary sclerosing cholangitis in children with inflammatory bowel disease: An ESPGHAN position paper from the Hepatology Committee and the IBD Porto group.","authors":"Patrick F van Rheenen, Kaija-Leena Kolho, Richard K Russell, Marina Aloi, Annamaria Deganello, Séamus Hussey, Norman Junge, Jan De Laffolie, Mark R Deneau, Emer Fitzpatrick, Anne M Griffiths, Iva Hojsak, Emanuele Nicastro, Andreia Nita, Mikko Pakarinen, Amanda Ricciuto, Lissy de Ridder, Aurelio Sonzogni, Andrea Tenca, Marianne Samyn, Giuseppe Indolfi","doi":"10.1002/jpn3.12378","DOIUrl":"10.1002/jpn3.12378","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to provide an evidence-supported approach to diagnose, monitor, and treat children with inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC).</p><p><strong>Methods: </strong>The core group formulated seven PICO-structured clinical questions. A systematic literature search from inception to December 2022 was conducted by a medical librarian using MEDLINE and EMBASE. Core messages from the literature were phrased as position statements and then circulated to a sounding board composed of international experts in pediatric gastroenterology and hepatology, histopathology, adult gastroenterology and hepatology, radiology, and surgery. Statements reaching at least 80% agreement were considered as final. The other statements were refined and then subjected to a second online vote or rejection.</p><p><strong>Results: </strong>Regular screening for gamma-glutamyltransferase (GGT) is essential for detecting possible biliary disease in children with IBD. MR cholangiopancreatography is the radiological modality of choice for establishing the diagnosis of PSC. Liver biopsy is relevant in the evaluation of small duct PSC or autoimmune hepatitis. Children who do not have known IBD at the time of PSC diagnosis should undergo initial screening with fecal calprotectin for asymptomatic colitis, and then at least once yearly thereafter. Children with a cholestatic liver enzyme profile can be considered for treatment with ursodeoxycholic acid and can continue if there is a meaningful reduction or normalization in GGT. Oral vancomycin may have a beneficial effect on GGT and intestinal inflammation, but judicious use is recommended due to the lack of long-term studies. Children with PSC-IBD combined with convincing features of autoimmune hepatitis may benefit from corticosteroids and antimetabolites.</p><p><strong>Conclusions: </strong>We present state-of-the-art guidance on the diagnostic criteria, follow-up strategies, and therapeutic strategies and point out research gaps in children and adolescents with PSC-IBD.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"374-393"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915248","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 decade of real-world clinical experience with 8-week azithromycin-metronidazole combined therapy in paediatric Crohn's disease.","authors":"Maria Teresa Fioretti, Laura Gianolio, Katherine Armstrong, Rosalind M Rabone, Paul Henderson, David C Wilson, Richard K Russell","doi":"10.1002/jpn3.12430","DOIUrl":"10.1002/jpn3.12430","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of our study was to assess the effectiveness and side-effect profile of a combination of azithromycin and metronidazole (CD AZCRO) as alternative induction therapy for 8 weeks in mild to moderately active paediatric Crohn's disease (CD).</p><p><strong>Methods: </strong>We performed a retrospective cohort study (November 2012 to July 2023) of a regional paediatric inflammatory bowel disease service. Disease activity, faecal calprotectin (FC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), haematological parameters and albumin were collected at baseline, 8 and 16 weeks. At Week 8, patients were divided based on (paediatric Crohn's disease activity index) score and inflammatory markers (blood and stool) into: Group 1 clinical remission and Group 2 non-remission.</p><p><strong>Results: </strong>A total of 48 patients were initially identified of whom 44 were included in the intention-to-treat analysis. After 8 weeks, the overall remission rate was 64%. Of the 38 patients who completed the CD AZCRO course, 28 patients (74%) entered remission (Group 1) and 10 (26%) did not (Group 2). At baseline a shorter disease duration, low weight z score and higher inflammatory burden (ESR, platelets and FC levels) were observed in Group 2. After 8 weeks, Group 1 showed improved CRP levels and higher albumin and haemoglobin levels than Group 2. Median FC declined significantly from 650 mcg/g at baseline to 190 mcg/g at Week 8 in Group 1 (p < 0.001). At 16 weeks, 23/28 patients (82%) continued in clinical remission. Nausea and vomiting were reported in 4/44 patients.</p><p><strong>Conclusions: </strong>Our real-world data demonstrate that CD AZCRO represents an alternative induction therapy for mild to moderate paediatric CD.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"300-307"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794850","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":"Unveiling distinctive patterns in pediatric PSC-IBD: Time for a tailored histopathologic index?","authors":"Oscar F Lopez-Nunez, Sarangarajan Ranganathan","doi":"10.1002/jpn3.12435","DOIUrl":"10.1002/jpn3.12435","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"257-259"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818459","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":"Evaluation and management of pediatric refractory constipation: Recommendations from the NASPGHAN neurogastroenterology and motility committee.","authors":"Alexandra L Kilgore, Mary K Rogers Boruta, Lusine Ambartsumyan, Roberto Gomez Suarez, Dhiren Patel, Richard J Wood, Anil Darbari, Leonel Rodriguez","doi":"10.1002/jpn3.12390","DOIUrl":"10.1002/jpn3.12390","url":null,"abstract":"<p><p>Refractory constipation (RC) in pediatric patients should be recognized as a distinct condition with long-term impacts on patient and family quality of life. RC requires a more targeted diagnostic evaluation and complex management strategy that may involve management by pediatric neurogastroenterology and motility specialists and multidisciplinary teams including surgeons. Currently, there is a lack of a clear definition, evaluation, and management strategies for RC. This is the first North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition position paper to address pediatric RC regarding its definition, evaluation, and management.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"353-373"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915245","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":"Early management of acute caustic ingestion in pediatrics.","authors":"Elliott S Gordon, Elaine Barfield, Benjamin D Gold","doi":"10.1002/jpn3.12440","DOIUrl":"https://doi.org/10.1002/jpn3.12440","url":null,"abstract":"<p><p>This review is intended to provide an overview of currently available literature related to caustic ingestion in pediatric patients, including initial management considerations in symptomatic versus asymptomatic children, timing and necessity of endoscopic evaluations, and the use of various therapeutic interventions. Further, this review provides management considerations for children presenting for evaluation following caustic ingestion based on the best available evidence. Additional research is needed to develop conclusive pediatric guidelines that meet GRADE criteria for management of caustic ingestion in children.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066325","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":"Ustekinumab is safe and effective in pediatric patients with Crohn's disease.","authors":"Elana B Mitchel, Michael T Dolinger, Brad Constant, Zi Wang, Daniela Guisado, Michael Gao, Steven Fusillo, Robert N Baldassano, Judith Kelsen, Marla Dubinsky, Jing Huang, Lindsey Albenberg","doi":"10.1002/jpn3.12452","DOIUrl":"https://doi.org/10.1002/jpn3.12452","url":null,"abstract":"<p><strong>Objectives: </strong>Real-world data on ustekinumab for the treatment of pediatric Crohn's disease (CD) are limited. This study sought to evaluate the effectiveness, long-term durability, and safety of ustekinumab in the treatment of children with CD.</p><p><strong>Methods: </strong>A retrospective longitudinal cohort study of children with CD treated with ustekinumab from two large centers between 2015 and 2020 was performed. The primary outcome was frequency of steroid-free clinical remission at 1 year. Secondary outcomes included time to steroid-free clinical remission, frequency of clinical and biochemical remission, drug escalation and discontinuation, serum level data, and adverse events. Standard descriptive and comparative statistics were performed. Logistic regression was used to identify factors associated with steroid-free remission at 1 year. Kaplan-Meier curves were used to visualize time-to-event relationships for outcomes.</p><p><strong>Results: </strong>A total of 101 patients were included. Median follow-up time on ustekinumab was 16.6 months (interquartile range [IQR]: 8.71-31.2) with drug failure in 28% at 1 year. Fifty-nine patients were in steroid-free clinical remission at 1 year. Higher baseline disease activity (odds ratio [OR]: 0.91 (95% confidence interval [CI]: 0.84-0.97), p = 0.01) and stricturing/penetrating disease phenotype (OR: 0.14 (95% CI: 0.03-0.65), p = 0.02) were associated with decreased likelihood of steroid-free clinical remission at 1-year. Ustekinumab drug escalation occurred in 70% of patients, and after escalation, 50 (70%) achieved clinical remission, and 49 (69%) achieved steroid-free remission at the last follow-up. Adverse events were rare and did not require therapy discontinuation.</p><p><strong>Conclusions: </strong>Ustekinumab is effective and safe in the treatment of children with CD. Escalation of therapy occurs frequently but results in sustained durability.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066328","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}