Journal of Tropical Pediatrics最新文献

{"title":"Assessing the impact of standardized-patient scenario-based simulation teaching combined with serialized micro-course instruction in pediatric nursing teaching.","authors":"Meili Hao, Xiaolin Kang, Xiaojing Li, Liting Wang, Lu Chen","doi":"10.1093/tropej/fmaf031","DOIUrl":"10.1093/tropej/fmaf031","url":null,"abstract":"<p><p>Access to advanced clinical training and experienced instructors is often limited in many low- and middle-income countries (LMICs), highlighting the need for practical, scalable, and resource-efficient teaching approaches. This study aimed to ascertain the application value of student-standardized patient (SSP) scenario-based simulation teaching mode in combination with serialized micro-course instruction in pediatric clinical nursing teaching. A quasi-experimental design was employed. Third-year nursing students from the 2017 and 2018 cohorts were selected via convenience sampling, with 45 students in both the control and experimental groups. The control group received traditional teaching methods, while the experimental group was instructed using a teaching model combining SSP scenario-based simulation with serialized micro-course instruction. Outcomes assessed included theoretical and practical examination scores, self-directed learning, communication, empathy, humanistic care, self-efficacy, professional identity, and teaching satisfaction. Nursing students in the experimental group possessed higher scores in both theoretical and practical assessment, better self-learning ability, communication ability, empathy ability, humanistic caring ability, self-efficacy and professional identity, and more satisfaction with teaching versus nursing students in the control group (P-value <.05). The application of SSP scenario-based simulation teaching mode combined with serialized micro-course instruction in pediatric clinical nursing teaching can effectively enhance nursing students' theoretical and practical assessment skills, self-learning, communication, empathy, humanistic caring, self-efficacy, professional identity, and satisfaction with teaching. Due to its flexibility and low demand for resources, this model presents a feasible and scalable option for enhancing nursing education, particularly in settings with limited educational infrastructure, such as LMICs.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 4","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731999","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 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":"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":"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":"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":"Seroprotection against hepatitis B, measles, mumps, and rubella in children with diabetes.","authors":"Maruti Haranalli, Sangeeta Yadav, Aashima Dabas, Vikas Manchanda","doi":"10.1093/tropej/fmaf026","DOIUrl":"https://doi.org/10.1093/tropej/fmaf026","url":null,"abstract":"<p><p>Vaccine-preventable diseases (VPD) account for a major proportion of childhood morbidity and mortality in developing countries. This study aimed to evaluate the seroprotection status of common VPD in children with type 1 diabetes mellitus (T1DM). The study enrolled 38 children aged 3-18 years with T1DM and 40 age-and sex-matched healthy controls. Demographic and clinical parameters were recorded. Venous blood samples were collected to estimate glycated hemoglobin (HbA1c) and antibody titers against hepatitis B and measles, mumps, and rubella (MMR). Both groups had completed immunization for these diseases by 2 years of age. The median age was 9.5 years with mean (SD) HbA1c 11.41 (2.57) %. Adequate seroprotection against hepatitis B, MMR were 42.5%, 32.5%, 50%, and 65% in T1DM, respectively and 55%, 50%, 40%, 65% in controls, respectively (P > .05). The median (first and third quartile) antibody levels for hepatitis B and measles in T1DM were 4.32 (0, 113.67) mIU/l and 127.4 (44.78, 347.68) mIU/l, respectively, both below the seroprotection cut-offs and lower than in controls (P > 0.05). The correlation (r) of age with anti-measles, antimumps, and antirubella antibody titers was 0.326 (P = 0.040), 0.096 (P = 0.554), and 0.334 (P = 0.035), respectively, in the cases. Anti-Hepatitis B titers correlated negatively with age (r = -0.287, P = .072). Lower seroprotection (statistically insignificant) to hepatitis B and measles were observed in children with T1DM than in controls. Physicians should consider surveillance of hepatitis B and measles, mumps, and rubella seroprotection in T1DM to evaluate the need for further boosters. Larger and more robust studies are needed on seroprotection in patients with T1DM.</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":"144553811","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":"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":"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":"Study to assess the need for paediatric trauma training in India.","authors":"Neha Thakur Rai, Prashant Mahajan, Jabeen Fayyaz, Narendra Rai, Samir Misra","doi":"10.1093/tropej/fmaf025","DOIUrl":"10.1093/tropej/fmaf025","url":null,"abstract":"<p><strong>Introduction: </strong>Paediatric trauma is an ever-rising problem in low- and middle-income (LMIC) countries. Recent studies have demonstrated that children with lower injury scores are more likely to die in LMIC countries as compared to developed countries. We conducted this study to assess the need for a dedicated trauma training curriculum relevant to the epidemiology of paediatric injuries in LMIC countries.</p><p><strong>Methods: </strong>We conducted the study in the apex trauma training site in India, wherein a predesigned questionnaire was circulated to understand the need for additional trauma training for children.</p><p><strong>Results: </strong>A total of 642 trauma care providers out of 800 (response rate is 80.25%) completed the study. Eighty-six per cent (552/642) of trauma care providers felt the need for paediatric trauma training. Only 40% (255/642) of trauma providers were confident in handling children.</p><p><strong>Conclusion: </strong>In an anonymous survey, trauma care providers in India admit that they need more specific paediatric trauma training because the majority of them are not confident in handling child victims of trauma. Furthermore, they felt the best solution would be to create paediatric trauma centres, instead of caring for children in adult centres for traumas. Further studies are needed to discover if the development of a standardized Paediatric Trauma Resuscitation Module for trauma care providers can increase their confidence in caring for children who are victims of road injury or other traumas in low- and middle-income countries, and if specialized paediatric trauma centres would indeed decrease morbidity and mortality of children who experience trauma in LMIC countries.</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":"144506132","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 utility of cord blood lactate as a low-resource tool in perinatal asphyxia diagnosis and prognosis; lessons from a tertiary hospital in Southern Nigeria.","authors":"Chidiebere K Ani, Ikechukwu R Okonkwo, Augustine I Omoigberale","doi":"10.1093/tropej/fmaf032","DOIUrl":"10.1093/tropej/fmaf032","url":null,"abstract":"<p><p>Perinatal asphyxia (PA) is a global health concern associated with long-term morbidity and significant mortality. Limited finance and inadequate facilities are the bane of the low- and middle-income countries (LMICs) making the diagnosis of PA challenging. The identification of cheap, simple, specific, and sensitive, biochemical parameter as an alternative to blood gas analysis would improve the assessment of PA in LMICs. This study is designed to assess the utility of umbilical cord arterial blood (UCAB) lactate in diagnosis and prognosis of PA among term babies. This was a prospective, cross-sectional analytical study done at UBTH over a 7-month period. The inclusion criteria for PA were documented risk factors, Apearance, Pulse, Grimace, Activity, Respiration (APGAR) score of <7 in 5 minutes, and umbilical cord pH ≤7.25. Samples were collected from the umbilical cord segments of 132 study participants and analysed using Abbott i-STAT. Sixty-six asphyxiated babies were the subjects for this study. The median (interquartile range) UCAB lactate value of the asphyxiated newborns was 7.23 (5.90-9.41) mmol/l which is significantly higher than the apparently healthy newborns of 2.97 (2.27-3.82) mmol/l (U = 4175.50; P < .001). The optimal diagnostic cut-off value of UCAB lactate in the diagnosis of PA was >5.1 mmol/l, with a sensitivity of 89.4% and specificity of 90.9%. The optimal cut-off value of UCAB lactate in predicting short-term adverse neonatal outcome (moderate to severe encephalopathy) was >8.32 mmol/l, having a sensitivity of 100% and specificity of 94.7%. UCAB lactate shows a good performance in the diagnosis of PA and prediction of short-term outcome among term neonates.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 4","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732000","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}