Journal of Perinatal Medicine最新文献

{"title":"Latency after preterm prelabour rupture of membranes vs. gestational age: a maturation-growth trade-off.","authors":"Garima Garg, Neetu Sangwan, Shikha Madan, Savita Rani Singhal","doi":"10.1515/jpm-2026-0404","DOIUrl":"https://doi.org/10.1515/jpm-2026-0404","url":null,"abstract":"<p><strong>Objectives: </strong>In preterm prelabour rupture of membranes (PPROM), prolonging pregnancy for fetal maturity is traded against infection risk, yet latency is entangled with gestational age. We examined its determinants and, disentangled from gestational age, its impact on fetomaternal outcome.</p><p><strong>Methods: </strong>In a prospective tertiary-centre cohort, 96 singleton pregnancies with PPROM at 28-34 weeks, undelivered at 48 h, were followed to delivery. Admission and pre-delivery haematological and ultrasound measures were recorded. Analyses included Kaplan-Meier, restricted mean survival time, competing-risks and gestational-age-adjusted models.</p><p><strong>Results: </strong>Median latency was 5 days (IQR 3-11); 61 % delivered within a week. Gestational age at admission was the only predictor (rho -0.21, p=0.037); earlier-gestation women remained undelivered longer (restricted mean 10.5 vs. 6.4 days, p=0.006); amniotic fluid volume did not predict latency (oligohydramnios p=0.700; 6.6 vs. 9.0 days, p=0.084). Longer latency was associated with neonatal complications (OR 10.9), NICU admission (OR 3.4) and caesarean (OR 5.5). The near-zero crude latency-birth-weight correlation reflected gestational-age suppression: at equal gestational age at admission, longer latency meant greater birth weight (+129 g per 10 days, p=0.004), yet at equal age at delivery a lower weight (p=0.033). The neonatal-morbidity association persisted after adjustment (OR 1.21 per day). The serial total-leucocyte-count rise tracked chorioamnionitis (AUC 0.77), the neutrophil-to-lymphocyte ratio did not.</p><p><strong>Conclusions: </strong>Gestational age at admission, not amniotic fluid volume, governs latency. Prolonged latency is a genuine, double-edged trade-off, not a confounded marker of prematurity: at equal gestational age it yields maturational weight yet restrains growth-for-age and carries a gestational-age-independent morbidity and infection risk.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biochemical and anthropometric assessment of nutritional status at discharge in very-low-birth-weight infants: a retrospective cohort study.","authors":"Deniz Yaprak, Belma Saygılı Karagöl","doi":"10.1515/jpm-2026-0439","DOIUrl":"https://doi.org/10.1515/jpm-2026-0439","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate nutritional status at discharge in VLBW infants using biochemical and composite nutritional indices, and to examine their relationship with extrauterine growth restriction (EUGR; also termed \"growth faltering\" in more recent literature).</p><p><strong>Methods: </strong>This retrospective cohort study included 124 very low birth weight infants (≤32 weeks, ≤1,500 g) admitted to a tertiary NICU (2021-2025). Anthropometric, nutritional, and biochemical parameters were recorded from birth to discharge. Four composite biochemical deficiency outcomes were constructed: protein (CPDO), nutritional (CNDO), mineral-protein (CMPDO), and protein-nitrogen (CPNDO). Multivariable Firth logistic regression and ROC analyses were performed. EUGR was defined cross-sectionally (discharge weight <10th percentile) and longitudinally (weight-for-age Z-score decline >1).</p><p><strong>Results: </strong>EUGR occurred in 43.5 % (cross-sectional) and 38.7 % (longitudinal) of infants. Hypouremia (18.0 %) and hypocreatininemia (12.0 %) were the most frequent abnormalities. Composite outcomes were associated with lower gestational age and small-for-gestational-age status. Cross-sectional EUGR was nominally associated with CNDO (aOR 3.72, p=0.023) and CMPDO (aOR 3.96, p=0.031) but not CPDO; given testing across four correlated composite outcomes without formal correction for multiple comparisons, these associations should be regarded as nominal. AUCs for the four composites ranged narrowly from 0.761 to 0.794 and were not formally compared. Anthropometric differences were not significant.</p><p><strong>Conclusions: </strong>Subclinical biochemical deficiency was common at discharge despite non-significant anthropometric differences. Composite biochemical indices showed similar, moderate discriminative performance across definitions; findings are hypothesis-generating and require external, prospective validation before any composite can be considered superior or used clinically.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eligibility and prescribing of low-dose aspirin for preeclampsia prevention under two international guidelines: a retrospective cohort study.","authors":"Nimet Alyörük Geçici, Fatma Nazlı Demir, Yeliz Acar Sabır, Harun Karaağaç, Sefa Öztürk, Umutcan Kayıkçı","doi":"10.1515/jpm-2026-0436","DOIUrl":"https://doi.org/10.1515/jpm-2026-0436","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objective was to compare eligibility for low-dose aspirin prophylaxis according to the American College of Obstetricians and Gynecologists (ACOG) and the National Institute for Health and Care Excellence (NICE) recommendations. Secondary objectives were to evaluate aspirin prescribing among eligible women and preeclampsia outcomes according to guideline eligibility.</p><p><strong>Methods: </strong>This retrospective cohort study included 1,064 pregnant women with complete clinical data from a tertiary referral hospital in Türkiye. Eligibility was determined according to ACOG and NICE criteria. Agreement was assessed using Cohen's kappa and McNemar's test. Aspirin prescribing and preeclampsia outcomes were also evaluated.</p><p><strong>Results: </strong>According to the ACOG criteria, 311 women (29.23 %, 95 % CI, 26.58-32.03 %) were eligible for aspirin prophylaxis, whereas 130 (12.22 %, 95 % CI, 10.39-14.32 %) met the NICE criteria. The overall agreement between the two guidelines was 82.9 %, with moderate concordance (Cohen's kappa=0.50). McNemar's test demonstrated a significant difference in patient classification (p<0.001). Aspirin was prescribed to only 25.4 % of ACOG-eligible women and 48.5 % of NICE-eligible women. Overall, preeclampsia occurred in 38 of 1,064 women (3.57 %; 95 % CI, 2.61-4.86 %). Among women eligible for aspirin prophylaxis, preeclampsia developed in 23 of 311 women (7.4 %; 95 % CI, 4.98-10.85 %) according to ACOG criteria and in 16 of 130 women (12.3 %; 95 % CI, 7.72-19.06 %) according to NICE criteria.</p><p><strong>Conclusions: </strong>Although the ACOG guideline identified substantially more women as eligible for aspirin prophylaxis than the NICE guideline, documented aspirin prescribing remained considerably lower than guideline-defined eligibility, highlighting an implementation gap in routine clinical practice.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social determinants of necrotizing enterocolitis-associated mortality in very low birth weight infants: a population based study.","authors":"Keliy Fordham, Leslie A Parker, Yingwei Yao, Lakeshia Cousin","doi":"10.1515/jpm-2026-0473","DOIUrl":"https://doi.org/10.1515/jpm-2026-0473","url":null,"abstract":"<p><strong>Objectives: </strong>Necrotizing enterocolitis (NEC) remains a leading cause of morbidity and mortality among very low birth weight (VLBW) infants. This study examined associations between maternal social determinants of health (SDoH) and NEC-related infant mortality among VLBW infants.</p><p><strong>Methods: </strong>This retrospective cross-sectional study used Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiological Research (CDC WONDER) linked birth and death records from 2017 to 2023. Associations between maternal SDoH and NEC-related mortality were assessed using logistic regression.</p><p><strong>Results: </strong>Among 271,411 VLBW births, 1,725 NEC-associated deaths occurred, yielding a mortality rate of 6.36 per 1,000 live VLBW births. Younger maternal age, unmarried status, Medicaid insurance, and residence in the southern United States were associated with increased mortality risk. Infants of American Indian or Alaska Native (AIAN) mothers also had higher odds of NEC-related death, whereas infants of mothers aged 30-34 years or with a bachelor's degree or higher had reduced risk.</p><p><strong>Conclusions: </strong>Maternal socioeconomic disparities are associated with NEC-associated mortality in VLBW infants, underscoring the need to address these disparities to improve outcomes.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clarifications on strain values, cardiac geometry, and fetal size.","authors":"Ilenia Mappa, Giuseppe Rizzo","doi":"10.1515/jpm-2026-0604","DOIUrl":"https://doi.org/10.1515/jpm-2026-0604","url":null,"abstract":"","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conventional statistical and machine learning-based prediction of neonatal outcomes in late-onset fetal growth restriction.","authors":"Bilge Kapudere, Rabia Aydın, Ömer Aydın, Ergül Demirçivi, Reyhan Ayaz, Hanne Bulat Çim, Canan Satır Özel, Abdulkadir Turgut","doi":"10.1515/jpm-2026-0344","DOIUrl":"https://doi.org/10.1515/jpm-2026-0344","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate associations between antenatal fetal biometric and Doppler parameters and neonatal outcomes in late-onset fetal growth restriction (FGR), and to evaluate machine learning models for neonatal outcome prediction.</p><p><strong>Methods: </strong>This retrospective cohort included 137 singleton pregnancies. Continuous missing values were completed using a single iterative chained-equations procedure. Maternal characteristics, fetal biometric measurements, and Doppler parameters, including umbilical artery pulsatility index (UA-PI), middle cerebral artery pulsatility index (MCA-PI), and cerebroplacental ratio (CPR), were analyzed. Associations with neonatal outcomes were assessed using conventional statistical methods, multivariable regression analyses, and machine learning models with repeated 5-fold cross-validation.</p><p><strong>Results: </strong>NICU admission was associated with higher maternal age and lower gestational age, fetal biometric measurements, estimated fetal weight (EFW), birth weight, Apgar scores, and umbilical cord pH after FDR correction. In the final logistic models, maternal age, previous abortions, and EFW predicted NICU admission; previous cesarean delivery predicted transient tachypnea of the newborn; and maternal age and EFW predicted neonatal sepsis. The birth-weight linear model had the highest explanatory power (adjusted R²=0.662). Among machine learning models, birth weight had the best regression performance (cross-validated R²=0.592), and neonatal sepsis had the highest classification AUC (0.850).</p><p><strong>Conclusions: </strong>In late-onset FGR, fetal biometry, Doppler findings, and maternal characteristics were significantly associated with neonatal outcomes. Machine learning models showed moderate predictive performance and confirmed findings from conventional statistical analyses. These findings should be interpreted in light of the retrospective study design and the lack of external validation.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing of intraventricular hemorrhage in preterm infants less than 32 weeks of gestational age.","authors":"Deepak Kishore, Manish Kumar, Santhanam Sridhar, Sirisha Andey, M Nandhini, Shaik Naseeruddin, Debdip Mandal","doi":"10.1515/jpm-2026-0165","DOIUrl":"https://doi.org/10.1515/jpm-2026-0165","url":null,"abstract":"<p><strong>Objectives: </strong>Intraventricular hemorrhage (IVH) remains a major challenge in preterm infants, with its exact timing and periods of greatest risk still debated. This study aims to describe the timing, incidence, severity, and risk factors for IVH in preterm infants born before 32 weeks' gestation.</p><p><strong>Methods: </strong>A prospective observational study of 182 preterm infants (<32 weeks) was conducted in a tertiary neonatal intensive care unit. Standardized cranial ultrasounds were performed at 0-6, 6-24, 24-48, and 48-96 h post-birth and graded via Papile criteria. Maternal and neonatal associations with IVH were analyzed.</p><p><strong>Results: </strong>IVH incidence was 17 % (31/182), predominantly mild (80.7 %), while severe cases comprised 19.4 %. Almost half of the events (45 %) occurred within the first 6 h, followed by a second peak between days 2 and 4. While univariate analysis linked several immaturity and illness markers to IVH, multivariate models identified invasive ventilation as the sole independent predictor (adjusted OR 3.99, p=0.004).</p><p><strong>Conclusions: </strong>IVH in very preterm infants occurs predominantly in the first hours after birth, with a subsequent risk window between 2 and 4 days. Invasive ventilation is the strongest independent risk factor, emphasizing the need for protective respiratory care. Early and ongoing ultrasound screening remains essential for timely diagnosis.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of cephalic index with corpus callosum and cavum septi pellucidi measurements during second-trimester neurosonography.","authors":"Zekiye Soykan Sert, Hasan Beyhekim, Fatma Beyhekim, Mete Bertizlioglu, Gökçen Örgül, Aybike Tazegül Pekin","doi":"10.1515/jpm-2026-0469","DOIUrl":"https://doi.org/10.1515/jpm-2026-0469","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate whether physiologic variation in cephalic index during routine second-trimester neurosonography influences corpus callosum (CC) and cavum septum pellucidum (CSP) measurements.</p><p><strong>Methods: </strong>In this retrospective cross-sectional study, prospectively collected ultrasound data from singleton fetuses at 19-24 weeks of gestation from 2023 to 2025 were analyzed. A total of 1,701 structurally normal fetuses were included and categorized into lower, intermediate, and higher CI groups reflecting physiologic variation in fetal head shape. CC length and CSP width were measured using standardized techniques. Associations between CI and measurements were evaluated using multivariable linear regression adjusted for gestational age.</p><p><strong>Results: </strong>CC length did not differ significantly across CI groups (p=0.075), whereas CSP width showed a statistically significant but small difference (p=0.031). Gestational age was strongly associated with both CC length (β=0.842, p<0.001) and CSP width (β=0.448, p<0.001). CI demonstrated a modest independent association with CC (β=0.029, p=0.025) and CSP (β=0.092, p<0.001), with limited clinical relevance.</p><p><strong>Conclusions: </strong>Although small associations between CI and midline measurements were identified, gestational age remained the predominant determinant of CC and CSP size. These findings suggest that fetal head-shape variation during the mid-trimester period is unlikely to substantially affect routine clinical interpretation.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global research trends in fetal venous Doppler and umbilical vein blood flow: a bibliometric and visualization analysis.","authors":"Sevil Cicek, Zehra Tavukcuoglu, Yasemin Beyza Kaya Parspanci, Reyhan Ayaz","doi":"10.1515/jpm-2026-0398","DOIUrl":"https://doi.org/10.1515/jpm-2026-0398","url":null,"abstract":"<p><strong>Objectives: </strong>Umbilical venous Doppler and umbilical vein blood flow assessment complement arterial Doppler indices by reflecting placental-fetal hemodynamics, venous return, and fetal cardiovascular adaptation. Despite decades of research on fetal venous Doppler, its scientific evolution and the position of umbilical vein blood flow within the field remain insufficiently mapped. This study evaluated global research trends in fetal venous Doppler, emphasizing umbilical venous Doppler and umbilical vein blood flow.</p><p><strong>Methods: </strong>A bibliometric and visualization analysis was conducted using the Web of Science Core Collection. English-language articles and reviews published between 1980 and 2025 were included. Data were analyzed using bibliometrix and Biblioshiny. Publication trends, citation patterns, leading contributors, collaboration networks, Bradford's Law, keyword co-occurrence, thematic structure, and temporal topic changes were examined.</p><p><strong>Results: </strong>The final dataset included 787 documents from 230 sources, involving 2,692 authors and 12,887 cited references. Scientific output increased steadily, with an annual growth rate of 7.93 %. Ultrasound in Obstetrics & Gynecology was the leading journal, while the United States was the most productive country. Keyword, thematic, and trend analyses identified ductus venosus, umbilical vein, Doppler ultrasound, fetal growth restriction, placental function, perinatal outcome, and fetal hemodynamic adaptation as central themes, with recent trends indicating growing interest in quantitative umbilical vein flow assessment.</p><p><strong>Conclusions: </strong>Fetal venous Doppler research has expanded steadily over four decades. The increasing focus on umbilical vein blood flow highlights the need for standardized measurement techniques, gestational age-specific reference ranges, reproducibility, and outcome-based validation to clarify its independent clinical value in high-risk pregnancies.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Hawai'i to the world: innovation, ultrasound, and leadership in perinatal medicine.","authors":"Ivica Zalud, Kelly Yamasato, Frank A Chervenak","doi":"10.1515/jpm-2026-0526","DOIUrl":"https://doi.org/10.1515/jpm-2026-0526","url":null,"abstract":"<p><p>The Global Summit on Perinatal Medicine and Women's Health: Innovation, Ultrasound, and Leadership, held in Honolulu, Hawai'i, July 31-August 1, 2026, brought together physicians, scientists, educators, trainees, and leaders from across the world to consider the future of perinatal medicine. This Special Issue of the <i>Journal of Perinatal Medicine</i> extends the Summit's central themes beyond the meeting itself, emphasizing the intersection of scientific innovation, advanced ultrasound, responsible artificial intelligence, education, mentorship, and leadership. Modern perinatal medicine increasingly requires rapidly evolving technologies to be integrated with clinical judgment, ethical responsibility, and compassionate patient-centered care. Ultrasound remains fundamental to fetal assessment while continuing to evolve through three-dimensional imaging, advanced neurosonography, digital technologies, and artificial intelligence. At the same time, the future of the field depends on developing the next generation of clinicians, scientists, educators, and leaders through mentorship, global collaboration, and shared scholarship. The spirit of Hawai'i provides a meaningful framework for this vision. <i>Aloha</i>, <i>kuleana</i>, and <i>mālama</i> reflect values of connection, responsibility, stewardship, and care that are deeply relevant to medicine. A complementary Japanese concept, <i>ichi-go ichi-e</i>, often rendered as \"one time, one meeting,\" emphasizes that each encounter is unique and cannot be recreated exactly. In medicine, education, and collaboration, this perspective calls for attention to the present encounter and responsibility for what may follow from it. The Summit therefore represents not an endpoint, but a point of departure for continued international collaboration. From Hawai'i to the world, the challenge is to ensure that innovation remains guided by humanity, that technology serves patients, and that today's leaders prepare the next generation to advance the health and well-being of women and children worldwide.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}