Paediatric and perinatal epidemiology最新文献

{"title":"Short-Term Effect of Air Pollutants on Sudden Unexpected Death in Infancy: A Case-Crossover Study Based on the French National Registry.","authors":"Emmanuel Bourdet, Noémie Letellier, Tarik Benmarhnia, Johanna Lepeule, Bénédicte Jacquemin, Karine Levieux, Guillaume Barbalat, Itai Kloog, Rémi Béranger, David Boels","doi":"10.1111/ppe.70196","DOIUrl":"https://doi.org/10.1111/ppe.70196","url":null,"abstract":"<p><strong>Background: </strong>Sudden unexpected death in infancy (SUDI) remains poorly understood, and the potential contribution of air pollution exposure is largely unexplored. Given its known impact on infant health, air pollution may influence the risk of SUDI, particularly through short-term effects.</p><p><strong>Objectives: </strong>We aimed to evaluate the short-term effect of exposure to ambient air pollutants on SUDI in France.</p><p><strong>Methods: </strong>Using data from the French national SUDI registry (2015-2022) and modelled air pollution data, we assigned daily concentrations of particulate matter (PM₁₀ and PM_2.5, μg/m³), nitrogen dioxide (NO₂, μg/m³) and ozone (O₃, μg/m³) at each infant's residence. We conducted a time-stratified case-crossover analysis comparing single- and multi-pollutant exposure on the day of death with matched control days, considering lagged effects up to 6 days. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression, adjusted for public holiday, influenza-like syndrome and daily mean temperature. We assessed the potential effect of several effect modifiers, such as biological sex, age at death, season, urban or rural residence, social deprivation and sleeping position at discovery.</p><p><strong>Results: </strong>A total of 1078 SUDI cases were included. Exposure to PM was consistently associated with higher odds of SUDI, with a lag effect of 3 to 5 days before death and during the last week of life. NO₂ exposure presented a trend of association. Higher effects were observed for PM and NO₂ with cumulative exposure, especially for PM and consistent with the multi-pollutant model. We observed seasonal heterogeneity, with higher ORs in the spring for PM and O₃.</p><p><strong>Conclusions: </strong>Our findings support a plausible short-term trigger effect of air pollution on SUDI. These results highlight the need to integrate environmental determinants, particularly for NO₂ and PM, into SUDI prevention strategies.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective Study of Preconception and Early Pregnancy Cannabis Use and Birth Outcomes.","authors":"Amelia K Wesselink, Ruth J Geller, Alyssa F Harlow, Collette N Ncube, Krystal E Kuan, David A Savitz, Kenneth J Rothman, Michael L Eisenberg, Lauren A Wise","doi":"10.1111/ppe.70201","DOIUrl":"10.1111/ppe.70201","url":null,"abstract":"<p><strong>Background: </strong>Cannabis use among reproductive-aged individuals is common, yet there are gaps in our understanding of the effect of cannabis use on adverse birth outcomes.</p><p><strong>Objective: </strong>To determine the extent to which female and male preconception cannabis use and female early pregnancy cannabis use are associated with the incidence of preterm birth (PTB), small-for-gestational-age birth (SGA), and large-for-gestational-age (LGA) birth.</p><p><strong>Methods: </strong>We analysed data from Pregnancy Study Online, an internet-based preconception cohort study of couples trying to conceive. Eligible participants were aged 21-45 years (female) and ≥ 21 years (male) and residents of the United States or Canada. We followed 6838 couples who conceived between June 2013 and September 2024. Both partners completed preconception baseline questionnaires; female participants completed preconception follow-up questionnaires every 8 weeks, at early (< 12 weeks) and late pregnancy (~32 weeks), and at 6 months postpartum. Participants self-reported cannabis use during preconception (female and male) and early pregnancy (female only). We ascertained birthweight and gestational age from birth certificates and questionnaires and defined PTB (delivery < 37 gestational weeks) and SGA and LGA (< 10th and > 90th percentiles of birthweight, respectively, for gestational age and sex). We fit Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI), adjusting for potential confounders.</p><p><strong>Results: </strong>Preconception cannabis use was not appreciably associated with PTB (≥ 1 per week vs. non-use: HR 1.06, 95% CI 0.71, 1.57 for females and HR 1.41, 95% CI 0.73, 2.75 for males). Higher frequency of female cannabis use in early pregnancy was associated with an increased incidence of PTB, although results were imprecise (≥ 1 per week vs. non-use: HR 1.87, 95% CI 1.06, 3.29; < 1/week vs. non-use: HR 0.85, 95% CI 0.36, 2.02). Cannabis use in either partner was not associated with the incidence of SGA or LGA.</p><p><strong>Conclusions: </strong>Our results support the existing evidence that cannabis use during early pregnancy is a risk factor for PTB.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Threshold-Based Stratification of Predicted Preterm Birth Risk in a National Natality Cohort: An Empirical Application of the Prevalence Threshold.","authors":"Jacques Balayla","doi":"10.1111/ppe.70194","DOIUrl":"https://doi.org/10.1111/ppe.70194","url":null,"abstract":"<p><strong>Background: </strong>Clinical prediction becomes actionable only when estimated risk is connected to a decision boundary. The prevalence threshold is a likelihood-ratio-derived landmark that may complement conventional risk stratification, but its empirical behaviour in obstetric populations is incompletely described.</p><p><strong>Objectives: </strong>To evaluate how fixed probability cutoffs and a formally derived prevalence threshold partition predicted preterm birth risk in a national cohort.</p><p><strong>Methods: </strong>We analysed singleton births to U.S. residents in the 2024 natality public-use file. Preterm birth was delivery before 37 completed weeks using the obstetric estimate. A logistic model generated predicted probabilities, and adjusted risk ratios were estimated by modified Poisson regression with robust variance. We assessed discrimination, calibration across risk tenths, fixed cutoffs of 5%, 10%, 15% and 20%, and a cervical-length prevalence threshold derived from a sensitivity of 23.3% and a specificity of 93.6%.</p><p><strong>Results: </strong>Among 3,004,719 complete-case pregnancies, 263,034 (8.8%) were preterm. The c-statistic was 0.634 (95% CI 0.633, 0.636), with close agreement between predicted and observed risk across tenths. Predicted risk had a mean of 8.75%, a median of 7.40%, and a range of 4.83%-84.22%. At the 10%, 15% and 20% cutoffs, 17.7%, 7.1% and 4.5% of pregnancies were above threshold, with observed preterm birth rates of 16.9%, 24.4% and 27.4%, respectively. The cervical-length likelihood ratio was 3.64, giving a prevalence threshold of 34.4%; 21,212 pregnancies (0.71%) were above this landmark, with an observed preterm birth rate of 38.1%.</p><p><strong>Conclusions: </strong>Higher fixed cutoffs selected smaller, more outcome-enriched groups while capturing fewer preterm births. The derived prevalence threshold supplied a transparent evidentiary landmark for a specified downstream test, but it was not a utility-derived treatment threshold or a screening recommendation.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Small Relative Risks, Large Uncertainty: What Confounding Leaves Unresolved for Clinical Actionability.","authors":"Bailey M Milne, Susan B Brogly, Maria P Velez","doi":"10.1111/ppe.70200","DOIUrl":"10.1111/ppe.70200","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"842-843"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assisted Reproductive Technologies and Offspring's School Grades by Maternal Education.","authors":"Alice Goisis, Øystein Kravdal","doi":"10.1111/ppe.70181","DOIUrl":"10.1111/ppe.70181","url":null,"abstract":"<p><strong>Background: </strong>Children conceived through assisted reproductive technologies (ART) often achieve higher school grades than spontaneously conceived peers in unadjusted analyses, a pattern largely attributed to the socio-economic advantage of parents who use ART. However, as ART is increasingly utilised by less advantaged groups, it is important to understand how ART-conceived children fare when their parents have lower levels of education.</p><p><strong>Objective: </strong>The objective of this study is to examine whether the association between conception through assisted reproductive technologies and school grades at age 16 differs by maternal education.</p><p><strong>Methods: </strong>We conducted a population-based cohort study of all live-born children in Norway from 1985 to 2002 who completed compulsory schooling (n = 929,017), using nationwide register data. The exposure was conception through ART (1.0%), and the outcome was the standardised grade point average (GPA) at age 16. Analyses were stratified by maternal education (primary/secondary vs. tertiary). Using linear regression models, we estimated differences in GPA between ART- and spontaneously conceived children. We progressively adjusted for child sex, birth cohort, plurality, birth order, maternal age, parental income and family structure.</p><p><strong>Results: </strong>Among children of lower-educated mothers, mean GPA was higher for ART-conceived than spontaneously conceived children in baseline models (0.17, 95% confidence interval [CI] 0.14, 0.19). Among children of tertiary-educated mothers, the corresponding difference was 0.06 (95% CI 0.03, 0.09). After adjustment, the differences were slightly negative but small in magnitude in both education groups (primary/secondary: -0.18, 95% CI -0.21, -0.16; tertiary: -0.08, 95% CI -0.11, -0.05).</p><p><strong>Conclusions: </strong>Both ART-conceived children of less- and more-educated mothers appear advantaged in unadjusted analyses. After accounting for parental characteristics, differences were small in both education groups, reflecting socio-demographic selection into treatment within each group. These findings suggest that as ART use expands across more socio-economically diverse populations, it is unlikely to independently improve or worsen children's school performance across educational strata.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"805-810"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Effects of Chronic Hypertension Be Studied Independently of Superimposed Preeclampsia?","authors":"Samantha L Martin, Alan T N Tita","doi":"10.1111/ppe.70197","DOIUrl":"10.1111/ppe.70197","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"834-835"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choice of Growth Standard and Interpretation of Large for Gestational Age Outcomes: Evidence From the CDC4G Trial.","authors":"Sara Grass, Maryam de Brun, Anders Magnuson, Martina Persson, Anna-Karin Wikström, David Simmons, Snehal Patil, Verena Sengpiel, Scott Montgomery, Kerstin Berntorp, Ulla-Britt Wennerholm, Helena Strevens, Karin Hildén, Elisabeth Storck-Lindholm, Helena Backman, Fredrik Ahlsson","doi":"10.1111/ppe.70180","DOIUrl":"10.1111/ppe.70180","url":null,"abstract":"<p><strong>Background: </strong>The lack of a standardised definition of large for gestational age (LGA) complicates clinical assessments and the interpretation of research.</p><p><strong>Objective: </strong>The objective of this study is to assess how different definitions of LGA affect the interpretation of outcomes in a stepped wedge cluster randomised controlled trial (SW-CRT).</p><p><strong>Methods: </strong>Secondary analysis of the Changing Diagnostic Criteria for Gestational Diabetes (CDC4G, ISRCTN41918550) study population (n = 47,080 pregnancies), including eight delivery units in Sweden during 2018. The outcome measures were the prevalence of LGA and severe LGA before and after switching from the previous Swedish diagnostic criteria for gestational diabetes (SWE-GDM) to the World Health Organisation (WHO-2013) criteria. LGA and severe LGA were defined as birthweight > 90th and > 97th percentile, respectively, using the following reference growth charts: The new Swedish reference ranges for fetal weight (SWE-REF), the Gestation Related Optimal Weight (GROW) and the International Fetal and Newborn Growth Consortium for the 21st Century (Intergrowth-21st). Analyses were performed on a modified intention-to-treat (mITT) population and on the subgroup discordant for GDM diagnosis between new and former criteria, i.e., glucose levels between the WHO-2013 and SWE-GDM diagnostic thresholds.</p><p><strong>Results: </strong>In the mITT population, the prevalence of LGA decreased from 19.4% to 13.1% after the switch to the WHO-2013 GDM criteria, as defined by SWE-REF (adjusted relative risk [RR], 0.92; 95% confidence interval [CI] 0.86, 0.98). There was no change in severe LGA using any of the reference charts. In the subgroup, LGA defined by SWE-REF (RR 0.68, 95% CI 0.50, 0.91) and GROW (RR 0.78, 95% CI 0.63, 0.95) was reduced, but not when defined by Intergrowth-21st (RR 0.88, 95% CI 0.74, 1.06). Severe LGA was reduced only when defined by Intergrowth-21st (RR 0.73, 95% CI 0.62, 0.85).</p><p><strong>Conclusions: </strong>The choice of LGA definition affected the interpretation of the results in the CDC4G trial.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"785-793"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conditioning on Live Birth May Explain the Paradoxical Association Between Larger Mid-Gestation Head Size and Neurodevelopmental Disorders.","authors":"Cai Zhang, Yu Lin","doi":"10.1111/ppe.70186","DOIUrl":"10.1111/ppe.70186","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"836-837"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Gastrointestinal Outcomes in Children Exposed in Utero to Maternal Chronic Hypertension.","authors":"Nir Roguin, Gil Gutvirtz, Gali Pariente, Tamar Wainstock, Eyal Sheiner","doi":"10.1111/ppe.70148","DOIUrl":"10.1111/ppe.70148","url":null,"abstract":"<p><strong>Background: </strong>Maternal hypertension has been linked to adverse pregnancy and neonatal outcomes, but long-term effects on offspring, particularly gastrointestinal (GI) health, are less well studied. Chronic hypertension may impair uteroplacental perfusion and promote a pro-inflammatory intrauterine environment, potentially disrupting foetal gut development; however, its independent effect on offspring GI health has not been examined.</p><p><strong>Objectives: </strong>To evaluate whether in utero exposure to maternal chronic hypertension, independent of preeclampsia, is associated with long-term GI morbidity in offspring.</p><p><strong>Methods: </strong>This population-based retrospective cohort study included all singleton deliveries at a tertiary medical centre over a 30-year period (1991-2021). Offspring were followed until age 18 for GI diagnoses based on ICD-9 codes from hospital and outpatient records. The primary exposure was maternal chronic hypertension, and the primary outcome was the incidence of GI morbidity in offspring. Piecewise Poisson log-linear models estimated adjusted incidence rate ratios (IRR), controlling for maternal age, parity, ethnic origin, smoking, obesity, and pre-gestational diabetes.</p><p><strong>Results: </strong>Among 342,635 singleton deliveries, 3097 (0.9%) were to mothers with chronic hypertension. The median follow-up was 12.6 years (interquartile range 5.6, 18.0). GI incidence rates were 1903.0 and 1901.9 per 100,000 person-years among chronic hypertension and normotensive groups. Offspring of mothers with chronic hypertension showed lower GI risk in early childhood (adjusted IRR < 1 year: 0.34, 95% confidence interval [CI] 0.11, 1.05; 1-3 years: 0.46, 95% CI 0.29, 0.73), with estimates consistent with no difference in late adolescence (15-18 years: adjusted IRR 1.09, 95% CI 0.98, 1.21). All-cause mortality was low and similar between groups.</p><p><strong>Conclusions: </strong>The association between maternal chronic hypertension and offspring GI morbidity is time-varying and non-proportional, with lower risk in early childhood and no evidence of excess risk at later ages.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"824-833"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical Windows of Air Pollution Exposure During Spermatogenesis and Intrauterine Insemination Outcomes.","authors":"Lindsey M Russo, J Richard Pilsner, Timothy P Canty, Neil J Perkins, Pauline Mendola, Karen C Schliep, May Shaaban, Rachael B Hemmert, Akanksha Singh, Allison M Ring, James A Vanderslice, C Matthew Peterson, Erica B Johnstone, Kaniz Rabeya, Carrie Nobles","doi":"10.1111/ppe.70185","DOIUrl":"10.1111/ppe.70185","url":null,"abstract":"<p><strong>Background: </strong>Male preconception health remains a critically under-addressed area of family planning. While research suggests air pollution may harm semen quality, downstream impacts on pregnancy, particularly for more vulnerable infertility treatment populations, are understudied.</p><p><strong>Objectives: </strong>Among couples seeking infertility treatment, we examined the relationship between men's exposure to ambient air pollution and intrauterine insemination (IUI) cycle treatment outcomes.</p><p><strong>Methods: </strong>In the Folic Acid and Zinc Supplementation Trial (2013-2018), 592 male partners resided in the Salt Lake City area with at least one IUI cycle in 9 months of follow-up (n = 1223 cycles). Residential air pollution exposure was estimated using Community Multiscale Air Quality models and averaged across the 74-day window of spermatogenesis prior to the insemination date, as well as across developmental windows of mitosis, meiosis I-II, spermiogenesis, and spermiation. Treatment-cycle probabilities of hCG+ pregnancy, pregnancy loss, and livebirth were evaluated using generalised linear mixed models adjusted for age, season, income, and co-pollutants (fine particulate matter [PM_2.5], nitrogen dioxide [NO₂], ozone [O₃], and sulfur dioxide [SO₂]).</p><p><strong>Results: </strong>In multivariable models, we observed a lower probability of pregnancy per 5 ppb increase in O₃ and NO₂ across the 74-day spermatogenesis window (relative risk [RR] 0.71, 95% confidence interval [CI] 0.55, 0.93; RR 0.73, 95% CI 0.50, 1.05, respectively), with associations noted during mitosis and meiosis. PM_2.5 and SO₂ were less consistently associated with IUI outcomes. Findings from mixture models were similar, as were findings for air pollutants and a lower probability of live birth. No clear patterns emerged between air pollutants and pregnancy loss.</p><p><strong>Conclusions: </strong>Ambient air pollution during spermatogenesis, especially during mitosis and meiosis, was associated with a lower chance of pregnancy and live birth in an IUI treatment population. Further understanding pathways between men's air pollution exposure and pregnancy and live birth is an important future research need.</p><p><strong>Trial registration: </strong>clinicaltrials.gov identifier: NCT01857310.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"774-784"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}