Journal of pediatric surgery最新文献

{"title":"Announcements of Future Meetings","authors":"","doi":"10.1016/S0022-3468(24)00990-4","DOIUrl":"10.1016/S0022-3468(24)00990-4","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"59 12","pages":"Article 162035"},"PeriodicalIF":2.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intercostal Nerve Cryoablation in Minimally Invasive Repair of Pectus Excavatum: National Trends, Outcomes, and Predictors of Utilization","authors":"Alyssa Green,&nbsp;Gabriel Ramos-Gonzalez,&nbsp;JoAnn DeRosa,&nbsp;Nicole M. Chandler,&nbsp;Christopher W. Snyder","doi":"10.1016/j.jpedsurg.2024.162060","DOIUrl":"10.1016/j.jpedsurg.2024.162060","url":null,"abstract":"<div><h3>Purpose</h3><div>Intercostal nerve cryoablation during minimally invasive repair of pectus excavatum (MIRPE) is an effective pain control technique. Some insurers may not reimburse for cryoablation in this context, contending that it’s an experimental procedure. This study aimed to describe national trends in cryoablation use and evaluate outcomes and predictors of its use.</div></div><div><h3>Methods</h3><div>The Pediatric Health Information System database was queried for pectus excavatum patients aged 9–21 who underwent MIRPE between 2016 and 2023. Concurrent cryoablation use was identified using billing/supply codes. Temporal trends in cryoablation utilization were described and quantified using linear regression. Demographics, resource utilization, and outcomes were compared for patients based on cryoablation utilization using chi-square and Kruskal–Wallis tests. Predictors of cryoablation use were evaluated with logistic regression.</div></div><div><h3>Results</h3><div>This analysis included 2068 patients (mean age 15 ± 1.8 years; 86 % male). Cryoablation utilization increased from 33 % to 61 % from 2016 to 2023, with a strong positive trend (R² = 0.73). Cryoablation patients had fewer surgical complications (8 % vs 12 %, p = 0.004), shorter LOS (2.0 ± 1.3 vs. 2.8 ± 1.6 days, p &lt; 0.001), fewer total mean opiate days billed (1.4 ± 1.1 vs. 1.6 ± 1.4 days, p &lt; 0.0001) and higher total costs ($24,045 ± $9696 vs. $20,751 ± $9,237, p &lt; 0.001). High-volume centers (odds ratio (OR) 1.9, 95 % confidence interval (CI) 1.2–3.0) and commercial HMO insurance (OR 2.7, 95 % CI 1.9–3.8) were predictors of cryoablation use.</div></div><div><h3>Conclusion</h3><div>Cryoablation during MIRPE has increased nationally since 2016; now being performed in nearly two-thirds of all cases. Cryoablation should be considered a standard adjunct to MIRPE rather than an experimental technique.</div></div><div><h3>Level of evidence</h3><div>2.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 3","pages":"Article 162060"},"PeriodicalIF":2.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevent Injury by Providing Evidence.","authors":"Minna M Wieck","doi":"10.1016/j.jpedsurg.2024.162059","DOIUrl":"10.1016/j.jpedsurg.2024.162059","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162059"},"PeriodicalIF":2.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Nationwide Comparison of Laparoscopic vs Open Inguinal Hernia Repair in Children","authors":"Michela Carter ,&nbsp;Steven T. Papastefan ,&nbsp;Yao Tian ,&nbsp;Stephen J. Hartman ,&nbsp;Meredith S. Elman ,&nbsp;Sara G. Ungerleider ,&nbsp;Aaron P. Garrison ,&nbsp;Tolulope A. Oyetunji ,&nbsp;Matthew P. Landman ,&nbsp;Mehul V. Raval ,&nbsp;Seth D. Goldstein ,&nbsp;Timothy B. Lautz","doi":"10.1016/j.jpedsurg.2024.162056","DOIUrl":"10.1016/j.jpedsurg.2024.162056","url":null,"abstract":"<div><h3>Background</h3><div>Utilization of the laparoscopic approach for inguinal hernia repair has increased significantly over the past decade. The purpose of this study is to compare rates of second hernia operation and same side recurrence following open and laparoscopic inguinal hernia repair in a large national cohort.</div></div><div><h3>Methods</h3><div>This retrospective analysis utilized the Pediatric Health Information System database to identify children &lt;18 years-old who underwent laparoscopic or open primary inguinal hernia repair from 2017 to 2021. Data were collected through 2022 to allow minimum one year follow-up. Second hernia operation rates, inclusive of same side recurrence and metachronous contralateral hernia, and same side recurrence rates were compared by multivariable mixed effects model controlling for confounders and institutional clustering. Misclassification rates were determined through data validation at four constituent institutions. Sensitivity analyses determined true outcome rates.</div></div><div><h3>Results</h3><div>We identified 53,287 operations (15.6% laparoscopic). Rate of second hernia operation was greater following laparoscopic repair (2.9% vs 2.6%, p = 0.04) with no difference on multivariable analysis (OR 1.14, 95% CI 0.98–1.32). Same side recurrence rate was greater following laparoscopic repair (1.5% vs 0.4%, p &lt; 0.001) which persisted on multivariable analysis (OR 3.72, 95% CI 2.90–4.78). Sensitivity analysis demonstrated true laparoscopic and open repair rates of 14.2% and 85.8%, respectively. True rates of second hernia operation and same side recurrence were identical to those determined by PHIS.</div></div><div><h3>Conclusion</h3><div>Laparoscopic inguinal hernia repair in children has more than three times the odds of same side hernia recurrence than open repair which is balanced by a reduced rate of second operation for metachronous hernia.</div></div><div><h3>Level of evidence</h3><div>Treatment Study – Level III.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 2","pages":"Article 162056"},"PeriodicalIF":2.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic Prophylaxis for Elective Pediatric Laparoscopic Cholecystectomies","authors":"Christine Rodhouse ,&nbsp;Rachel Raymond ,&nbsp;Dan Neal ,&nbsp;Tyler J. Loftus ,&nbsp;Faraz A. Khan ,&nbsp;Ana R. Do ,&nbsp;Janice A. Taylor ,&nbsp;Philip A. Efron ,&nbsp;Shawn D. Larson ,&nbsp;Steven L. Raymond","doi":"10.1016/j.jpedsurg.2024.162055","DOIUrl":"10.1016/j.jpedsurg.2024.162055","url":null,"abstract":"<div><h3>Background</h3><div>The Surgical Infection Society (SIS) guidelines recommend against the use of surgical antibiotic prophylaxis (SAP) for low-risk patients undergoing elective laparoscopic cholecystectomies.</div></div><div><h3>Methods</h3><div>Using National Surgical Quality Improvement Program (NSQIP) data, 5440 pediatric patients were identified who underwent laparoscopic cholecystectomy from 2021 to 2022. Patients who had immunodeficiency, active malignancy, American Society of Anesthesiologists (ASA) physical status classification 3–5, procedure indicated for infection, emergent procedure, received intravenous antibiotics before the prophylaxis window, or missing SAP data were excluded.</div></div><div><h3>Results</h3><div>3959 patients were included in the analysis. Among these patients, 3570 (90.2 %) received SAP. Overall incidence of 30-day superficial incisional surgical site infection (SSI), deep incisional SSI, and organ space SSI were 0.9 %, 0.0 %, and 0.1 %, respectively. The incidence of superficial incisional SSI was significantly higher in the patients who did not receive SAP (SAP 0.8 %, no SAP 2.1 %; p = 0.024). The incidence of organ space SSI was also significantly higher in the patients who did not receive SAP (SAP 0.1 %, no SAP 0.8 %; p = 0.008). There was no difference in the incidence of <em>C. diff</em> colitis (SAP 0.1 %, no SAP 0.0 %; p = 1.000). Multivariable modeling, controlling for Hispanic ethnicity, age, and gender, demonstrated patients that received SAP were significantly less likely to have any postoperative SSI compared to patients who did not receive SAP (OR = 0.35).</div></div><div><h3>Conclusion</h3><div>Hospitals are not currently compliant with SIS guidelines regarding omission of antibiotic prophylaxis for low-risk patients undergoing elective laparoscopic cholecystectomies. The authors advocate for additional studies and reassessment of current guidelines for pediatric patients given the above findings.</div></div><div><h3>Type of Study</h3><div>Retrospective comparative study.</div></div><div><h3>Level of Evidence</h3><div>III.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 3","pages":"Article 162055"},"PeriodicalIF":2.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic Management After Neonatal Enteric Operations in US Children's Hospitals","authors":"Priyanka Jadhav ,&nbsp;Pamela M. Choi ,&nbsp;Romeo Ignacio ,&nbsp;Benjamin Keller ,&nbsp;Gerald Gollin","doi":"10.1016/j.jpedsurg.2024.162052","DOIUrl":"10.1016/j.jpedsurg.2024.162052","url":null,"abstract":"<div><h3>Background</h3><div>There are few evidence-based guidelines for perioperative antibiotic management in neonates who undergo enteric operations. We sought to assess antibiotic administration practices in a large population of patients who underwent operations involving enteric anastomoses and evaluate the incidence of postoperative infection and other outcomes based on antibiotic approach.</div></div><div><h3>Methods</h3><div>The Pediatric Health Information Systems database was queried for patients who underwent repair of esophageal, duodenal or jejuno-ileal atresia in 2021. The type and number of consecutive days of perioperative antibiotics was determined and ICD-10 codes corresponding to infection were noted. The incidences of post operative infections (bacterial and fungal), antibiotic-resistant infections and anti-fungal medication administration were determined.</div></div><div><h3>Results</h3><div>516 infants were identified. A wide variety of antibiotics were administered and 39 % of patients received more than one day of treatment. There were no differences in the incidence of postoperative infection between those who received more or less than one day of perioperative antibiotics for any of the operations assessed. The incidence of bacterial infection in patients treated with cefazolin or cefoxitin monotherapy was no different than that for all other regimens. There were no significant differences in the incidence of post-operative fungal infection based on antibiotic type or duration.</div></div><div><h3>Conclusion</h3><div>There was substantial variation in the duration and type of antibiotics administered after neonatal enteric operations. We identified a low incidence of infection with only one day of perioperative antibiotics and there was no evidence that longer treatment reduced infection risk. Cefazolin monotherapy was likewise associated with a low risk for perioperative infections.</div></div><div><h3>Study type</h3><div>Non-interventional observational database study.</div></div><div><h3>Level of evidence</h3><div>3.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 3","pages":"Article 162052"},"PeriodicalIF":2.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheal Allotransplantation to Deliver Growing Airway Implants for Infants and Children.","authors":"Adam Lorio, Herra Javed, Eli Contorno, Lawrence Greiten, Brian Reemtsen, Taufiek Konrad Rajab","doi":"10.1016/j.jpedsurg.2024.162048","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2024.162048","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162048"},"PeriodicalIF":2.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partial Splenectomy Versus Total Splenectomy in Sickle Cell Disease: A Systematic Review and Meta-Analysis","authors":"Merna Raafat Roshdy ,&nbsp;Mina Botros ,&nbsp;Abanoub Mokhles ,&nbsp;Mohamed A. Aldemerdash ,&nbsp;Haneen Sabet ,&nbsp;Bishoy Fahim ,&nbsp;Mahmoud Diaa Hindawi","doi":"10.1016/j.jpedsurg.2024.162058","DOIUrl":"10.1016/j.jpedsurg.2024.162058","url":null,"abstract":"<div><h3>Background</h3><div>Sickle cell disease (SCD) patients encounter various complications, such as acute splenic sequestration crisis and hypersplenism that may require splenectomy. This systematic review and meta-analysis aims to clarify differences between total splenectomy (TS) or partial splenectomy (PS) in terms of hematological and postoperative outcomes.</div></div><div><h3>Methods</h3><div>We identified studies involving SCD patients who underwent PS or TS, whether open or laparoscopic, and whose hematological and operative outcomes were evaluated, through searching PubMed, Web of Science, Scopus, Embase and Cochrane databases from inception until June 2024. Primary outcomes: hemoglobin concentration and reticulocytes %. Secondary outcomes: operative blood transfusion need, length of hospital stay (LoS), postoperative infections, overwhelming postsplenectomy sepsis (OPSS), acute chest syndrome (ACS), thromboembolic events and mortality.</div></div><div><h3>Results</h3><div>Eighteen studies were included; 17 cohort and one case series. Seven studies collected data from the same SICHA institutions, so a total of 756 SCD patients is included. According to the most recent study, no significant changes in hemoglobin (preoperative 10.5 ± 0.3 vs 9.6 ± 0.4 one year postoperative in 24 PS cases, and 9.7 ± 0.1 vs 9.7 ± 0.2 in 73 TS cases), however, both TS and PS significantly decreased reticulocyte by 2 % (0.8–3.2 %). Proportional analysis of short-term infection revealed a lower incidence in TS 2.71 % vs 8.64 % in PS, and similarly for ACS, it is 6.97 % in TS vs 14.90 % in PS.</div></div><div><h3>Conclusion</h3><div>This first systematic review and meta-analysis shows that TS and PS have no or minimal effect on hemoglobin but a strong lowering effect on reticulocyte %. Proportional analysis reveals lower short-term infections and ACS following TS than PS. However, further clinical trials are necessary to draw definite conclusions and improve surgical decision making.</div></div><div><h3>Type of study</h3><div>Systematic review and meta-analysis of cohort studies.</div></div><div><h3>Level of evidence</h3><div>II.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 2","pages":"Article 162058"},"PeriodicalIF":2.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Cecostomy Placement for Antegrade Enema Access in the Pediatric Population.","authors":"Wendy Jo Svetanoff, Shruthi Srinivas, Kristine Griffin, Karen A Diefenbach, Ihab Halaweish, Richard Wood, Alessandra Gasior","doi":"10.1016/j.jpedsurg.2024.162053","DOIUrl":"https://doi.org/10.1016/j.jpedsurg.2024.162053","url":null,"abstract":"<p><strong>Aim: </strong>Use of the appendix for an antegrade continence enema (ACE) is not always possible. Various methods exist for creating cecostomy tubes, including percutaneous, endoscopic, or surgical placement. We describe our laparoscopic cecostomy technique and review short- and long-term outcomes.</p><p><strong>Methods: </strong>Single institution retrospective review of children who underwent laparoscopic cecostomy placement from June 2016-June 2023. The cecum is secured to the abdominal wall with trans-fascial sutures and placement of an enterostomy button under direct vision. Half-volume flushes begin after 48 h; after two weeks, patients transition to full flushes. Demographic, intraoperative, and postoperative variables were analyzed.</p><p><strong>Results: </strong>Forty patients were included [24 (60 %) female; 31 (77.5 %) Caucasian]. Twenty-one (52.5 %) had myelomeningocele, 15 (37.5 %) had an anorectal malformation and 4 (10 %) had functional constipation. Twenty-five (62.5 %) underwent laparoscopic cecostomy placement alone, while 15 (37.5 %) had it performed with another procedure. Median operative time was 1.12 (IQR 0:93-1.45) hours for isolated cecostomy placement, with median post-operative stay of 2.0 days (2.2-3.1) days. Post-operatively, one patient had severe withholding, ultimately requiring a diverting ileostomy. No other 30-day complications (surgical site infection, tube removal) were identified. One patient required revision four months post-op due to inadvertent placement in the sigmoid. At one-year follow-up, 11/36 (30.6 %) children noted granulation tissue, and 11 (30.6 %) noted superficial leakage. Two (6 %) patients had transitioned to oral laxatives.</p><p><strong>Conclusion: </strong>Laparoscopic cecostomy tube placement is a safe and alternative method of developing ACE access that can be done concurrently with other procedures.</p>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":" ","pages":"162053"},"PeriodicalIF":2.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Recovery After Surgery for Pediatric Abdominal Tumor Resections: A Prospective Multi-institution Study","authors":"Sara A. Mansfield ,&nbsp;Meera Kotagal ,&nbsp;Stephen J. Hartman ,&nbsp;Andrew J. Murphy ,&nbsp;Andrew M. Davidoff ,&nbsp;Brady Hogan ,&nbsp;Darren Ha ,&nbsp;Doralina L. Anghelescu ,&nbsp;Marc Mecoli ,&nbsp;Nicholas G. Cost ,&nbsp;Kyle O. Rove","doi":"10.1016/j.jpedsurg.2024.162046","DOIUrl":"10.1016/j.jpedsurg.2024.162046","url":null,"abstract":"<div><h3>Background</h3><div>Enhanced recovery after surgery (ERAS) protocols are multi-disciplinary approaches to standardize perioperative care. This is the first prospective, multi-institutional study to evaluate ERAS in pediatric patients undergoing abdominal tumor resections.</div></div><div><h3>Methods</h3><div>All patients &gt;1-month-old undergoing abdominal tumor resection at one of three children’s hospitals between 2020 and 2022 were eligible. ERAS counseling was performed, and informed consent obtained. The ERAS protocol was standardized across institutions. We compared the prospective cohort to a propensity-matched historical cohort (2014–2020) from each institution utilizing 16 variables. Categorical variables were compared using McNemar’s and/or Stuart–Maxwell testing. Continuous data was compared using logistic regression.</div></div><div><h3>Results</h3><div>Ninety-five patients enrolled in the prospective cohort and were compared to 95 well-matched historic patients. Median LOS was 5.3 (4.1–7.2) days in the historic cohort, and 4.3 (3.3–6.2) days in the ERAS cohort (<em>p</em> = 0.053). Post-operative opioid consumption was lower in ERAS patients at 0.08 (0.03–0.16) MME mg/kg/day versus 0.23 (0.12–0.52) in historic patients (<em>p</em> = 0.013). ERAS patients received clear (POD#0, 0-0) and regular (POD#1, 1.0–1.0) diets two days sooner (both <em>p</em> &lt; 0.001). ERAS patients ambulated two days sooner (1.0, 1.0–2.0 versus 3.0, 2.0–5.0). The number of patients who experienced any complication was significantly lower in the ERAS cohort (44, 44.2 %) compared to historic (82, 86.3 %, <em>p</em> &lt; 0.001). This reduction was seen across each Clavien-Dindo grade 1–3 category (all <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>ERAS protocols are feasible in pediatric patients undergoing abdominal tumor resections. Use of an ERAS protocol significantly reduced complications, opioid consumption, time to mobility, and time to diets.</div></div><div><h3>Level of Evidence</h3><div>II.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 2","pages":"Article 162046"},"PeriodicalIF":2.4,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}