Journal of Tropical Pediatrics最新文献

{"title":"Evaluation of pregnant women's knowledge about RSV and immunization attitudes before infant immunization with monoclonal antibodies in Turkey.","authors":"Büşra Demirci, Aslınur Özkaya-Parlakay, Mehmet Yılmaz, Hasan Ekici, Mahmut Mert Erçel, Gonca Türker Ergün, Sevinç Püren Yücel","doi":"10.1093/tropej/fmaf024","DOIUrl":"https://doi.org/10.1093/tropej/fmaf024","url":null,"abstract":"<p><p>RSV is a major health concern for infants. A new long-acting anti-RSV monoclonal antibody has been introduced in some countries. This study aims to assess pregnant women's awareness of RSV and their attitudes toward infant immunization with the anti-RSV monoclonal antibody. A survey on the RSV mAb was conducted with 217 pregnant women, consisting of 28 questions on sociodemographic characteristics, knowledge of RSV infection and the RSV mAb, and attitudes toward giving the mAb to their infant. Pregnant women were specifically surveyed about the use of nirsevimab. Among the participants, 18.5% reported that their child had previously experienced an RSV infection, with 47.6% requiring hospitalization. Willingness expressed by 50.7% to get the RSV mAb, 27.8% were undecided, and 21.6% would not get immunized. The main reason for refusal was lack of information (67.3%). Notably, 58.4% of undecided mothers would consider the RSV mAb if included in the routine immunization schedule. Multiple logistic regression analysis revealed that \"having previously heard of the RSV mAb\" and \"receipt of other nonroutine vaccines\" were independent factors influencing the consideration of the RSV mAb. A thorough literature review revealed no other studies assessing pregnant women's attitudes toward RSV mAb; it showed they would be more willing to accept it if included in Turkey's national vaccine programs. Further studies are needed globally to find if RSV vaccination rates increase if the benefits of infection protection and detailed information about the RSV vaccine are provided to mothers or families.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258369","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":"Burden and determinants of diarrhoea, and health seeking behaviour amongst under-five children in India: evidence from National Family Health Survey-5.","authors":"Premkumar Ramasubramani, Manikandan Srinivasan, Karthiga Vijayakumar, Vadivelan Kanniappan, Deivasigamani Kuberan, Yuvaraj Krishnamoorthy","doi":"10.1093/tropej/fmaf021","DOIUrl":"https://doi.org/10.1093/tropej/fmaf021","url":null,"abstract":"<p><p>Diarrhoeal diseases remain a significant public health concern globally, particularly among under-five children. Understanding the factors influencing diarrhoea prevalence and treatment practices is crucial for improving child health outcomes. Hence, this study aimed to assess the burden, determinants, and management practices of diarrhoeal diseases among under-five children in India. We conducted a secondary data analysis of NFHS-5, covering 707 districts across India. The survey employed a stratified two-stage sampling method, and analysis included 186 920 under-five children. Poisson regression was utilized for identifying determinants of diarrhoeal burden and health-seeking behaviour and reported as adjusted prevalence ratio with 95% confidence interval. Prevalence of diarrhoea in under-five children has decreased from 9.5% in 2015-16 to the current estimate of 7.5% in 2019-21. Health seeking behaviour for diarrhoea has changed from 76.2% in 2015-16 to 76.8% in 2019-21. Age, gender, birth weight, malnutrition, maternal age, and education level were significantly associated with diarrhoea prevalence. Geographical region and wealth index influenced health-seeking behaviour towards diarrhoeal illness. The study shows a marginal decline in the diarrhoeal prevalence among children under-five years in India. Key determinants identified highlight the critical areas where targeted interventions are urgently needed.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258368","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":"Distinguishing the overlapping features of severe multi-inflammatory syndrome in children from severe dengue, scrub typhus and other endemic tropical infections-a comparative study from a tertiary care pediatric intensive care unit.","authors":"Arpita Chattopadhyay, Sakshi Singla, Karnika Saigal, Shariqa Qureshi, Diganta Saikia","doi":"10.1093/tropej/fmaf022","DOIUrl":"https://doi.org/10.1093/tropej/fmaf022","url":null,"abstract":"<p><p>Early differentiation between severe multi-inflammatory syndrome in children (MIS-C) and severe presentations of dengue, scrub typhus, and other endemic tropical infections could help clinicians devise appropriate treatment strategies. This study aims to identify the diagnostic markers that may be used to discriminate between MIS-C versus endemic tropical infections, namely dengue and scrub typhus, which frequently occur in endemic areas. A retrospective study was conducted in a pediatric intensive care unit (PICU) of a tertiary care center in New Delhi, India between 2020 and 2023. Comparative analysis of 33 children diagnosed with MIS-C was done versus 77 children with five endemic tropical infections-dengue, scrub typhus, typhoid fever, malaria, and leptospirosis. Rash [63.63% vs. 31.64% (P = 0.005)], conjunctival redness [63.63% vs. 8.86% (P < 0.001)], and altered sensorium [45.45% vs. 22.78% (P = 0.031)] were seen in a greater proportion of MIS-C cases than those with tropical infections. C-reactive protein (CRP) (mg/dl) was significantly higher in children with MIS-C versus those with tropical infections [176.1 (112.61, 198.32) vs. 9.25 (24.05, 69.38), P ≤ 0.001]. Ferritin and lactate dehydrogenase (LDH) were observed to be significantly higher in children with tropical infections compared to those with MIS-C. Using multivariable logistic regression analysis, the odds of having a rash were higher among children with MIS-C than those with dengue [OR = 8.07 (95% CI: 1.22-53.48, P = 0.03)]; followed by altered sensorium [OR = 16.04 (95% CI: 2.06-124.62, P = 0.008)]; myocardial involvement [OR = 7.18 (95% CI: 1.12-45.93, P = 0.037)]; and CRP (>50 mg/dl) [OR = 17.59 (95% CI: 2.69-114.92, P = 0.003)]. The findings of our study suggest that several clinical and laboratory measures could potentially distinguish between patients with severe MIS-C and endemic tropical infections. Clinical markers such as rash, altered sensorium, myocardial involvement, and shock were seen in a greater proportion of cases with MIS-C. Inflammatory markers such as CRP were higher in children with MIS-C, whereas ferritin and LDH were higher in dengue, scrub typhus, typhoid fever, malaria, and leptospirosis.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293883","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":"Characteristics of patients with disseminated Bacillus Calmette-Guérin infection: a retrospective study at Namazi Hospital, Southern Iran, from 1991 to 2022.","authors":"Anahita Sanaei Dashti, Siavash Soflaee Shahrbabak, Younes Malekzadeh, Alireza Davarpanah, Ehsan Taherifard, Alireza Ahmadkhani, Gholamreza Pouladfar, Seyedeh Sedigheh Hamzavi, Mohammad Rahim Kadivar, Bita Geramizadeh, Mohammad Hossein Anbardar, Kowsar Shoja, Erfan Taherifard","doi":"10.1093/tropej/fmaf023","DOIUrl":"https://doi.org/10.1093/tropej/fmaf023","url":null,"abstract":"<p><p>Bacillus Calmette-Guérin (BCG) vaccine has an acceptable safety record; however, the vaccination can be accompanied by a variety of complications including local and systemic ones. Disseminated BCG infection is one of these complications, i.e. associated with a higher rate of mortality. In the present study, we aimed to identify the demographic and clinical characteristics of these patients. In this retrospective study, patients with a diagnosis of disseminated BCG infection admitted to Namazi Hospital between January 1991 and January 2022 were included. Demographic, clinical, and paraclinical data of these patients were collected. Statistical Package for Social Sciences was used for data management and analysis. One hundred and eighteen patients with a documented diagnosis of disseminated BCG infection were included in the study. The age range was between 1 and 85 months; however, the majority of them were infants. Immunodeficiency was detected in more than half the patients (51.7%) with severe combined immunodeficiency on the top. Forty-three patients, 36.4%, did not survive the disease. The age of the patients and the status of their immune systems were significantly associated with their outcomes in the hospital course. Disseminated BCG infection may be the first manifestation of an underlying immunodeficiency. The study showed that the common presentations of this condition, such as fever, lymphadenopathy, and failure to thrive, can mimic those of many other pediatric diseases. Given its high mortality rate, affecting over a third of our study population, thorough history-taking and careful examination are essential to avoid missing the diagnosis.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275225","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":"Neural tube defects: stigma, costs, global health implications, and a call for increased education and research about a preventable birth defect.","authors":"Samrawit Abebaw, Helina Heluf, Mastewal Derara, Elizabeth Montgomery Collins, Lola Madrid","doi":"10.1093/tropej/fmaf019","DOIUrl":"https://doi.org/10.1093/tropej/fmaf019","url":null,"abstract":"","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248484","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":"High prevalence of antimicrobial resistance to initial empirical antibiotic therapy in neonatal sepsis in Bengaluru, India-a multicentre study.","authors":"Abhishek Somasekhara Aradhya, Prathik Bandiya, Shivashankar Diggikar, Vimal Kumar U, M V Krithika, Bharathi Balachander, Venugopal Reddy I, Chandrakala Bs, J Bhavana, Srikanth Kulkarni, Praveen Venkatagiri, Pradeep G C M, Kanekal S Gautham","doi":"10.1093/tropej/fmaf020","DOIUrl":"10.1093/tropej/fmaf020","url":null,"abstract":"<p><p>Data about epidemiologic and microbiologic patterns of neonatal sepsis in specific regions of low- and middle-income countries can help improve management and stimulate prevention efforts. We conducted a multicentre study within a large metropolitan region in South India to describe the burden of neonatal sepsis; and identify the antimicrobial sensitivity patterns of causative organisms. In a collaborative network of six neonatal intensive care units, standardized data were collected on every admitted neonate with a positive blood culture from June 2020 to May 2022. The frequency of sepsis, the organisms, antimicrobial resistance patterns, and mortality were analysed. Factors associated with lack of 'on-target' initial empirical antibiotic therapy were identified through univariate and multivariate analysis. Among 6229 admissions, the incidence of sepsis was 3.5%. Klebsiella (30%), Coagulase-negative staphylococcus (13%), and Escherichia coli (10%) were the commonest organisms. The overall incidence of multidrug resistance among Gram-negative organisms was 26%, with organism-specific incidence as follows: Klebsiella (48%), Acinetobacter (81%), and E. coli (45%). The organisms were sensitive to one or more of the initial empirical antibiotics used ('on-target') in 48% [95% confidence interval (CI) 45-58%] of cases. Mortality was higher in those neonates where initial antibiotic therapy was not 'on-target' (Relative risk (RR): 2.2, 95% CI 1.06-4.9). To conclude gram-negative septicaemia constituted 60% of the burden of neonatal sepsis. Klebsiella pneumonia was the predominant organism. Multidrug resistant organisms were highly prevalent. Initial empirical antibiotic therapy was not 'on-target' more than 50% of the time and was associated with higher mortality.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333425","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":"Urinary screening and nutritional health assessment in a community of indigenous school children from Totoró (Colombia).","authors":"Jaime M Restrepo, Alejandro Padilla-Guzmán, Roberth Alirio Ortiz Martinez, Yolanda Mueses Guerrero, John Jamer Paz Montañez, Laura Alejandra Torres-Canchala, María Amparo Acosta Aragón","doi":"10.1093/tropej/fmaf001","DOIUrl":"10.1093/tropej/fmaf001","url":null,"abstract":"<p><p>A higher risk for kidney disease in aboriginal populations has been proposed but it has not been established in their children. Likewise, there is a lack of studies focused on early markers of kidney disease in South American indigenous children. A descriptive prevalence study with an exploratory analysis was conducted between November 2015 and April 2018 on 249 indigenous children aged 5-18 years from the \"Institución Educativa Agropecuaria Pueblo Totoroés\" in the Totoró indigenous reserve. Eighty-five percent of subjects received exclusive breastfeeding. Spontaneous proteinuria was found in nine subjects, and in one case the proteinuria persisted in a second sample. Isolated hematuria was seen in 1.6% of subjects and blood pressure measurement over the 95th percentile in 7.2%. Overweight and obesity was related to hematuria (P = .009) but weakly related to transient proteinuria (P = .06). Some urinalyses (3.6%) were suggestive of urinary infection, but urine culture was negative in all cases. Hematuria and proteinuria in indigenous children from Totoró are transient and related to overweight and obesity. Early markers of kidney disease can be applied to other indigenous communities. A lower prevalence of chronic underweight than the general Colombian indigenous population was found, which is proposed to be related to prolonged breastfeeding.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 3","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033249","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":"Mortality and clinical outcomes in paediatric septic shock: a propensity-matched analysis before and after the implementation of an institutional guideline in single centre in Thailand.","authors":"Natar Wajanathawornchai, Kantara Saelim, Ponlagrit Kumwichar, Kanokpan Ruangnapa, Pharsai Prasertsan, Wanaporn Anuntaseree","doi":"10.1093/tropej/fmaf015","DOIUrl":"10.1093/tropej/fmaf015","url":null,"abstract":"<p><p>Paediatric septic shock is a life-threatening condition with high global morbidity and mortality rates. Prior guidelines for paediatric septic shock demonstrated varying levels of effectiveness. In 2017, the institutional paediatric septic shock guidelines were established, emphasizing three pivotal components: prompt recognition, early and appropriate resuscitation, and organ support with intensive stabilization. Herein, we aimed to assess the effect of paediatric septic shock guidelines on mortality and clinical outcomes. This single-centre retrospective cohort study investigating the pre- and postimplementation of paediatric septic shock guidelines was conducted in patients aged 1 month to 15 years diagnosed with septic shock from January 2014 to December 2022. The effectiveness of the guideline implementation was evaluated through propensity matching analysis to compare 30-day in-hospital mortality rates. Adherence to key components of the guidelines was also assessed. In total, 71 and 106 paediatric patients with septic shock were admitted to the paediatric intensive care unit during the pre- and postguideline periods, respectively. The postguideline group exhibited a significant reduction in mortality [adjusted odds ratio (aOR): 0.29, 95% confidence interval (CI): 0.12-0.71, P = .007] and a decrease in respiratory dysfunction (aOR: 0.40, 95% CI: 0.18-0.91, P = .03). Guideline adherence revealed a substantial increase in the use of peripheral inotropes and noninvasive cardiac monitoring. The number needed to treat for the protocol to prevent death was six. The implementation of the paediatric septic shock guidelines, emphasizing early shock recognition, prompt resuscitation, infection control, and appropriate organ management in intensive care, significantly improved outcomes.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649586","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":"Risk factors for failure to thrive among infants at a hospital in North India: a case-control study.","authors":"Durgesh Kumar, Shambhavi Mishra, Dinesh Kumar, Atul Singh, Ganesh Kumar Verma","doi":"10.1093/tropej/fmaf017","DOIUrl":"10.1093/tropej/fmaf017","url":null,"abstract":"<p><p>Failure to thrive (FTT) is a commonly used term in pediatric clinical practice, referring to a significant deviation from normal growth patterns. It can have multiple adverse effects on a child, including developmental delays, intellectual deficits, and insecure attachment. Inadequate nutritional intake is the most frequent underlying cause. This study aims to identify the risk factors contributing to FTT in infants in a rural North Indian setting. A case-control study was conducted on infants aged 2-12 months admitted to the pediatric ward of Uttar Pradesh University of Medical Sciences, Saifai, Etawah, India. Detailed histories, clinical examinations, and relevant laboratory investigations were performed for all enrolled patients. Among the 456 study participants, 152 infants (33.33%) were diagnosed with FTT. The majority of cases (92.1%) were from rural areas. Multivariate regression analysis identified key independent risk factors for FTT, including rural residence, incomplete or lack of immunization, absence of exclusive breastfeeding, and lack of timely complementary feeding. This study underscores the significant role of rural residency, inadequate immunization, absence of exclusive breastfeeding, and delayed complementary feeding in increasing the risk of FTT among infants aged 2-12 months in rural North India. Early identification of these risk factors, timely diagnosis, and appropriate interventions are crucial for improving child health outcomes. It will also help in the efficient allocation of healthcare resources.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730594","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":"Low levels of pertussis- and measles-specific IgG antibodies in 6-week-old HIV-exposed and -unexposed Malawian infants: implications for vaccination strategies and role of long term HIV therapy.","authors":"Silvia Baroncelli, Clementina Maria Galluzzo, Stefano Orlando, Richard Luhanga, Robert Mphwere, Thom Kavalo, Roberta Amici, Marco Floridia, Mauro Andreotti, Fausto Ciccacci, Maria Cristina Marazzi, Marina Giuliano","doi":"10.1093/tropej/fmaf013","DOIUrl":"10.1093/tropej/fmaf013","url":null,"abstract":"<p><p>Serological studies in infants can provide valuable information on the degree of protection conferred by IgG maternal passive transfer during early life. If infant levels are inadequate, protection may be incomplete, increasing the risk of life-threatening diseases such as pertussis and measles, before immunization completion. In addition, HIV infection, -highly prevalent in African countries like Malawi-may impair transplacental antibody transfer. We determined anti-Pertussis Toxin (PT) and anti-measles IgG in 86 6-week-old infants, born to mothers living with HIV (HIV-exposed uninfected, HEU, n = 58) and to HIV-negative mothers (HIV-unexposed uninfected, HUU, n = 28). The HEU group was divided into two subgroups: Infants born to mothers who initiated antiretroviral therapy (ART) during pregnancy (Short-ART, SA-HEU group, n = 29) or already in stable ART (Long-term ART, LA-HEU group, n = 29). The mean anti-PT and anti-measles IgG levels (1.97 IU/ml and 32.9 mIU/ml, respectively) were comparable between the HUU and HEU infants. Overall, only 12.8% and 18.6% of all infants had IgG levels above the protective thresholds for pertussis and measles, respectively. The duration of ART significantly influenced the infant's serological profile, with SA-HEU infants showing significantly lower IgG levels compared to both HUU and LA-HEU infants. Protecting infants during early life remains a significant health challenge in many middle and low-income countries. Achieving better early serological protection requires the implementation of diverse vaccination strategies. This study emphasizes the crucial importance for women living with HIV to be on stable ART before pregnancy.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597308","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}