Journal of Perinatal Medicine最新文献

{"title":"Enhancing patient understanding in obstetrics: The role of generative AI in simplifying informed consent for labor induction with oxytocin.","authors":"Amos Grünebaum, Joachim Dudenhausen, Frank A Chervenak","doi":"10.1515/jpm-2024-0428","DOIUrl":"10.1515/jpm-2024-0428","url":null,"abstract":"<p><p>Informed consent is a cornerstone of ethical medical practice, particularly in obstetrics where procedures like labor induction carry significant risks and require clear patient understanding. Despite legal mandates for patient materials to be accessible, many consent forms remain too complex, resulting in patient confusion and dissatisfaction. This study explores the use of Generative Artificial Intelligence (GAI) to simplify informed consent for labor induction with oxytocin, ensuring content is both medically accurate and comprehensible at an 8th-grade readability level. GAI-generated consent forms streamline the process, automatically tailoring content to meet readability standards while retaining essential details such as the procedure's nature, risks, benefits, and alternatives. Through iterative prompts and expert refinement, the AI produces clear, patient-friendly language that bridges the gap between medical jargon and patient comprehension. Flesch Reading Ease scores show improved readability, meeting recommended levels for health literacy. GAI has the potential to revolutionize healthcare communication by enhancing patient understanding, promoting shared decision-making, and improving satisfaction with the consent process. However, human oversight remains critical to ensure that AI-generated content adheres to legal and ethical standards. This case study demonstrates that GAI can be an effective tool in creating accessible, standardized, yet personalized consent documents, contributing to better-informed patients and potentially reducing malpractice claims.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522200","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":"The first 2-year prospective audit of prenatal cell-free deoxyribonucleic screening using single nucleotide polymorphisms approach in a single academic laboratory.","authors":"Tachjaree Panchalee, Naravat Poungvarin, Warisa Amornrit, Chutima Yaiyiam, Tuangsit Wataganara","doi":"10.1515/jpm-2024-0339","DOIUrl":"10.1515/jpm-2024-0339","url":null,"abstract":"<p><strong>Objectives: </strong>We reported a performance during an implementation of prenatal cell-free (cf) DNA screening using single nucleotide polymorphism (SNP) approach in our accredited laboratory.</p><p><strong>Methods: </strong>Prospective audit with prompt intervention was set for the processing of 2,502 samples from singleton pregnancy from August 2017 to July 2019. Risks of trisomy 21 (T21), T18, T13, monosomy X (XO), and other sex chromosome aneuploidies (SCAs) were clarified by a proprietary bioinformatics algorithm.</p><p><strong>Results: </strong>Laboratory failure occurred in 192 samples (7.7 %) as a result of inadequate sequencing (n=144), fundamental limitation of the testing (n=19), and obvious human error (n=29). Faulty setting of the calibration curve was the most common human error (n=22/29). After a redraw (n=110), 79 (71.8 %) were settled. Overall, 2,389/2,502 samples (95.5 %) were reportable. Thirty-five samples were high-risk for T21 (n=19), T18 (n=5), T13 (n=1), XO (n=3), and other SCAs (n=7), respectively. Positive predictive values calculated from either prenatal confirmatory tests or postnatal findings were 93.8 % (n=16), 100 % (n=4), 50 % (n=2), and 83.3 % (n=6) for T21, T18, XO, and other SCAs, respectively, with high sensitivity and specificity (>99.9 %). Vanishing twin was detected from 1 out of 4 samples with detected additional haplotypes.</p><p><strong>Conclusions: </strong>An overall performance of SNP-based prenatal cf-DNA screening during our initial implementation can be optimized with proactive approach. The technical know-how was a significant limiting factor for adopting the technology. The lessons learnt may be of interest to the academic laboratory considering adopting their own test instead of sending blood to a testing service of a supplier.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"73-79"},"PeriodicalIF":1.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522201","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":"Contemporary prenatal diagnosis of congenital heart disease in a regional perinatal center lacking onsite pediatric cardiac surgery: obstetrical and neonatal outcomes.","authors":"Deena Elkafrawi, Danielle Passafiume, Michelle Blomgren, Pamela Parker, Steven Gross, Frank Smith, Robert Silverman, Dimitrios Mastrogiannis","doi":"10.1515/jpm-2024-0153","DOIUrl":"10.1515/jpm-2024-0153","url":null,"abstract":"<p><strong>Objectives: </strong>Determine obstetrical and neonatal outcomes in neonates with major congenital heart disease (CHD) delivered at a level IV neonatal intensive care units (NICU) center lacking onsite pediatric cardiac surgery.</p><p><strong>Methods: </strong>A 10-year retrospective review of all neonates admitted to our level IV NICU, with CHD between January 1st, 2011 and December 31st, 2021. Births and NICU charts were cross queried with those from our perinatal center which include pediatric cardiology records. Terminations and stillbirths were excluded.</p><p><strong>Results: </strong>A total of 285 neonates with major CHD and 78 with minor defects were included. In the major CHD group, 82.8 % had an isolated cardiac anomaly and 17.2 % had an extracardiac anomaly. Type of extracardiac anomaly had no impact on neonatal survival. Prenatal diagnosis of aneuploidy did not impact survival in major CHD. Truncus arteriosus had the highest NICU mortality at 34.0 % followed by hypoplastic left heart syndrome (HLHS) at 31.6 %. Double outlet right ventricle with transposition of the great vessels and interrupted aortic arch (both types) had a 25 % mortality. Neonates with truncus arteriosus and total anomalous pulmonary venous returns were likely to have 5-min Apgar score<7. Transfer rate of neonates with major CHD for cardiac surgery was 58.6 %. Of those 81.5 % were discharged home, 14.3 % expired before discharge, and 1 % were transferred elsewhere post-operatively for higher level of care.</p><p><strong>Conclusions: </strong>Neonates with major CHD can deliver safely at a level IV NICU lacking onsite pediatric cardiac surgery. Our neonatal mortality was high for HLHS and truncus arteriosus, however comparable to other centers with proximate pediatric cardiac surgery.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"58-66"},"PeriodicalIF":1.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522199","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":"Comparison of cord blood alarin levels of full-term infants according to birth weight.","authors":"Melek Buyukeren, Beyza Ozcan, Ummugulsum Can, Aytac Kenar, Ramazan Kececi, Melike Geyik Bayman, Oguzhan Gunenc","doi":"10.1515/jpm-2024-0236","DOIUrl":"10.1515/jpm-2024-0236","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the cord blood alarin levels of infants in different birth weight groups with those of infants born to mothers diagnosed with gestational diabetes mellitus (GDM) who were not subgrouped according to birth weight.</p><p><strong>Methods: </strong>This prospective study was conducted between September 2023 and January 2024. Healthy term babies whose families agreed to participate in the study were divided into four groups according to their birth weight (small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA)) and whether their mothers had GDM.</p><p><strong>Results: </strong>There was a significant difference between the cord blood alarin levels of the AGA and SGA groups (p=0.014). There was also a significant difference between the cord blood alarin levels of the AGA and GDM groups (p=0.012). However, the cord blood alarin levels of the LGA group (whose mothers did not have GDM) were similar to those of the AGA group (p=0.394).</p><p><strong>Conclusions: </strong>We found evidence that alarin levels in umbilical cord blood are associated with low birth weight and GDM.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"110-116"},"PeriodicalIF":1.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502504","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":"Effect of combination of uterine artery doppler and vitamin D level on perinatal outcomes in second trimester pregnant women.","authors":"Gokhan Tosun, Ayca Nazli Akar, Derya Burkankulu, Venhar Ceyhan, Emine Aydin","doi":"10.1515/jpm-2024-0274","DOIUrl":"10.1515/jpm-2024-0274","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effect of the combination of uterine artery (UtA) Doppler and vitamin D levels on perinatal outcomes in second trimester pregnants was aimed.</p><p><strong>Methods: </strong>UtA Dopplers and vitamin D levels of 226 pregnant women in the second trimester were measured. Patients were followed for adverse pregnancy outcomes. The relationship of this combination with these pregnancy outcomes was evaluated.</p><p><strong>Results: </strong>Sensitivity and specificity values ​​are respectively; Left UtA-S/D ratio for preeclampsia was 85.29 and 81.77 %, left UtA-RI was 90.62 and 43.30 % for preterm birth, and 76.19 and 66.34 % for the development of fetal distress had the best predictive effect. Vitamin D values ​​had no predictive value for any parameter (p>0.005).</p><p><strong>Conclusions: </strong>UtA Doppler has a good predictive value for many adverse pregnancy outcomes. However, in order to correlate these results with second trimester vitamin D levels, more homogeneous and specific groups are needed.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"48-57"},"PeriodicalIF":1.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502505","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":"A systematic catalog of studies on fetal heart rate pattern and neonatal outcome variables.","authors":"Chantal Eenkhoorn, Sarah van den Wildenberg, Tom G Goos, Jenny Dankelman, Arie Franx, Alex J Eggink","doi":"10.1515/jpm-2024-0364","DOIUrl":"10.1515/jpm-2024-0364","url":null,"abstract":"<p><strong>Objectives: </strong>To study the methodology and results of studies assessing the relationship between fetal heart rate and specified neonatal outcomes including, heart rate, infection, necrotizing enterocolitis, intraventricular hemorrhage, hypoxic-ischemic encephalopathy, and seizure.</p><p><strong>Methods: </strong>Embase, Medline ALL, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and CINAHL were searched from inception to October 5, 2023.</p><p><strong>Results: </strong>Forty-two studies were included, encompassing 57,232 cases that underwent fetal monitoring and were evaluated for neonatal outcome. Heterogeneity was observed in the timing and duration of fetal heart rate assessment, classification guidelines used, number of assessors, and definition and timing of neonatal outcome assessment. Nonreassuring fetal heart rate was linked to lower neonatal heart rate variability. A significant increase in abnormal fetal heart rate patterns were reported in neonates with hypoxic-ischemic encephalopathy, but the predictive ability was found to be limited. Conflicting results were reported regarding sepsis, seizure and intraventricular hemorrhage. No association was found between necrotizing enterocolitis rate and fetal heart rate.</p><p><strong>Conclusions: </strong>There is great heterogeneity in the methodology used in studies evaluating the association between fetal heart rate and aforementioned neonatal outcomes. Hypoxic-ischemic encephalopathy was associated with increased abnormal fetal heart rate patterns, although the predictive ability was low. Further research on developing and evaluating an automated early warning system that integrates computerized cardiotocography with a perinatal health parameter database to provide objective alerts for patients at-risk is recommended.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"94-109"},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502503","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":"Evaluation of fetal growth and birth weight in pregnancies with placenta previa with and without placenta accreta spectrum.","authors":"Neha Agarwal, Ramesha Papanna, Baha M Sibai, Alexandra Garcia, Dejian Lai, Eleazar E Soto Torres, Farah H Amro, Sean C Blackwell, Edgar Hernandez-Andrade","doi":"10.1515/jpm-2024-0290","DOIUrl":"10.1515/jpm-2024-0290","url":null,"abstract":"<p><strong>Objectives: </strong>We evaluated fetal growth and birthweight in pregnancies with placenta previa with and without placenta accreta spectrum (PAS).</p><p><strong>Methods: </strong>We retrospectively studied pregnant patients with placenta previa with or without PAS diagnosed at 20-37 weeks' gestation. Estimated fetal weight (EFW) percentile and fetal growth rate were calculated based on ultrasound at two timepoints: 20-24 and 30-34-weeks' gestation. Fetuses were small (SGA) or large for gestational age (LGA) when EFW or abdominal circumference was <10th or >90th percentile for gestational age, respectively. Fetal growth rate was estimated by subtracting EFW percentiles from the two ultrasounds. Birthweight in grams and percentiles were estimated via Anderson and INTERGROWTH-21 standards adjusted for neonatal sex. EFW percentiles, fetal growth rate, birth weight and birthweight percentiles were compared between patients with placenta previa with and without PAS.</p><p><strong>Results: </strong>We studied 171 patients with and 146 patients without PAS. SGA rates did not differ between groups on first (PAS n=3, no-PAS n=3, p=0.8) or second ultrasound (PAS n=10, no-PAS n=8, p=0.8). LGA rates were similar between groups on first (PAS n=11, no-PAS n=9, p=0.8) and second ultrasound (PAS n=20, no-PAS n=12, p=0.6). The growth rate was higher in fetuses with PAS than placenta previa (1.22 ± 22.3 vs. -4.1 ± 18.1, p=0.07), but not significantly. The birthweight percentile was higher in the PAS than the placenta previa group (74 vs. 67, p=0.01). On multi-linear regression, birthweight percentile remained higher in the PAS group, but not significantly.</p><p><strong>Conclusions: </strong>Placenta previa with or without PAS is not associated with SGA, LGA or lower birthweight.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"9-14"},"PeriodicalIF":1.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468250","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":"Nutritional guidance through digital media for glycemic control of women with gestational diabetes mellitus: a randomized clinical trial.","authors":"Marlene Carvalho Teixeira Valença, Marcelo Santucci França, Rosiane Mattar, Patricia Medici Dualib, Victor Hugo Saucedo Sanchez, Bianca de Almeida-Pititto, Edward Araujo Júnior, Evelyn Traina","doi":"10.1515/jpm-2024-0294","DOIUrl":"10.1515/jpm-2024-0294","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the effectiveness of outpatient nutritional guidance supplemented by digital media with exclusively standard outpatient nutritional guidance in pregnant women with gestational diabetes mellitus (GDM).</p><p><strong>Methods: </strong>This was a randomized, patient-blinded clinical trial conducted at the Diabetes and Pregnancy outpatient clinic from February 2021 to January 2023. Pregnant women with GDM were randomly allocated into two groups: the control group received exclusively outpatient nutritional guidance, and the Intervention Group received outpatient nutritional guidance along with reminders via WhatsApp. Dietary intake (calories, carbohydrates, lipids, proteins, and fibers) was evaluated using 24 h dietary recalls. Glycemic control and the need for pharmacological treatment were also assessed.</p><p><strong>Results: </strong>A total of 81 women were included, 34 allocated to the control group, and 47 to the intervention group. Patients were followed for a period of 4-8 weeks. Significant differences were observed in some points of glycemic control between the two groups over the follow-up period. There were no statistical differences in pharmacological therapy (p=0.498); 188 24 h dietary recall were conducted in the control group and 290 in the intervention group. A statistically significant increase in lipid intake was observed in the intervention group over the follow-up period compared to the control group (p<0.001). No changes in calorie intake, other macronutrients, or fiber consumption were noted.</p><p><strong>Conclusions: </strong>Glycemic control was significantly improved with the addition of frequent text reminders about dietary choices, and a significant increase in lipid intake was seen in all women, more so in the reminder group.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"15-24"},"PeriodicalIF":1.7,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468253","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 education - Impressive results of Ian Donald school.","authors":"Asim Kurjak, Frank A Chervenak, Milan Stanojević","doi":"10.1515/jpm-2024-0420","DOIUrl":"10.1515/jpm-2024-0420","url":null,"abstract":"<p><p>The Ian Donald International School of Ultrasound bears testament to globalization in its most successful and worthwhile form. The school was founded in Dubrovnik in 1981. Since then, the growth has been meteoric and now consists of 126 branches throughout the world. The reason for this success has been the tireless and selfless efforts of the world's leading authorities in ultrasound who are willing to dedicate their valuable time without reimbursement to teach sonologists and sonographers throughout the world. The teachers put national, religious, political, and other parochial considerations aside as they strive to improve the care of all women and fetal patients. Our politicians in all of the myriad countries represented in the school have much to learn from the purity of spirit that exists throughout the international family of Ian Donald schools. We believe that Ian Donald is smiling down from heaven at the School that bears his name. It is not overstating the fact to say that Donald's innovation has changed the thinking of our age. The magnitude of this step alone is incalculable. Indeed, diagnostic ultrasound, more than any other modern technique, has made manifest that the fetus is an individual virtually from conception.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468251","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":"Molecular evidence that GBS early neonatal sepsis results from ascending infection: comparative hybrid genomics analyses show that microorganisms in the vaginal ecosystem, amniotic fluid, chorioamniotic membranes, and neonatal blood are the same.","authors":"Pisut Pongchaikul, Roberto Romero, Thidathip Wongsurawat, Piroon Jenjaroenpun, Worarat Kruasuwan, Paninee Mongkolsuk, Pornpun Vivithanaporn, Iyarit Thaipisuttikul, Arunee Singsaneh, Jakkrit Khamphakul, Pitak Santanirand, Kanyaphat Kotchompoo, Maolee Bhuwapathanapun, Puntabut Warintaksa, Piya Chaemsaithong","doi":"10.1515/jpm-2024-0310","DOIUrl":"10.1515/jpm-2024-0310","url":null,"abstract":"<p><strong>Objectives: </strong><i>Streptococcus agalactiae</i>, or Group B <i>Streptococcus</i> (GBS), is a leading cause of neonatal sepsis. Materno-fetal transmission of the microorganisms present in the lower genital tract/perineum is considered to be the most frequent mode for acquisition of infection. It has also been proposed that, in a subset of cases, GBS causes acute chorioamnionitis, intraamniotic infection, and fetal/neonatal sepsis. However, the evidence to support this ascending pathway is derived from microbiologic studies that rely on cultivation methods, which do not have the resolution to determine if the microorganisms causing neonatal sepsis are the same as those found in the amniotic fluid and the vaginal ecosystem.</p><p><strong>Methods: </strong>We used whole genome sequencing of the microorganisms isolated from the vagina, amniotic fluid, chorioamniotic membranes, and neonatal blood (four isolates) in a case of early neonatal sepsis. Using hybrid genome assembly, we characterized the genomic features including virulence factors and antimicrobial resistance in four isolates from the same mother, placenta, and newborn.</p><p><strong>Results: </strong>Whole genome sequencing revealed that the microorganisms in the four clinical isolates corresponded to <i>S. agalactiae</i> sequence type 1, clonal complexes 1, and serotype Ib. Comparative genomic analysis illustrated similar DNA sequences of the four genomes.</p><p><strong>Conclusions: </strong>This study presents the first evidence of the genomic similarity of microorganisms in the vaginal ecosystem, the space between the chorioamniotic membranes of the placenta, amniotic fluid, and neonatal blood.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"977-990"},"PeriodicalIF":1.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}