Pediatric Cardiology最新文献

{"title":"Patient Characteristics Associated with 30-Day Readmission to a Pediatric Cardiac Center.","authors":"Michael He, Maria-Theresa Balbin, Janet Kreutzer, Jenhao J Cheng, Janika Peyasena, Lisa A Hom, Mary Morgan, Tracy Baust, Yuliya Domnina, Ashraf S Harahsheh","doi":"10.1007/s00246-025-04015-z","DOIUrl":"https://doi.org/10.1007/s00246-025-04015-z","url":null,"abstract":"<p><p>Patients with acquired and congenital heart disease (CHD) are at higher risk of hospitalization. Despite quality improvement (QI) initiatives, many patients experience readmission soon after discharge. We aimed to identify risk factors for 30-day readmission and hypothesized that direct discharge from the cardiac intensive care unit (CICU) is associated with an increased readmission rate. A single-center retrospective cohort study was performed of patients discharged from the acute care cardiac unit (ACCU) or CICU from January 1, 2022 to June 30, 2024. Pediatric patients with cardiac disease and adults with CHD were included. Patients with a scheduled readmission were excluded. A total of 1,848 hospitalizations were included, and 223 resulted in readmission within 30 days of discharge. In multivariable analysis, no difference was seen in readmission rates between direct CICU discharge or ACCU discharge (36 [11%] vs. 187 [12%], p = 0.7, odds ratio [OR] 1.2 [0.8-1.8]). Readmission risk factors included single ventricle anatomy (odds ratio [OR] 1.7, 95% confidence interval [1.1-2.4]), chromosomal anomaly (1.8 [1.3-2.6]), cardiomyopathy (3.3 [2.1-5.2])), tube feeding (1.6 [1.1-2.5]), and increased length of stay (1.5 [1.2-1.7]). Tracheostomy (1.7 [0.8-3.1]), and prematurity (1.3 [0.8-1.9]) were not associated with increased risk. Weekend discharge (0.6 [0.4-0.9]) and surgical hospitalizations (OR 0.6 [0.4-0.8]) were associated with fewer readmissions. Risk factors for 30-day readmission included underlying medical complexity, single ventricle physiology, and increased length of admission. Discharging patients from the CICU was not associated with an increased readmission rate. The risk factors identified were largely non-modifiable, and future QI initiatives should examine the resources allocated to discharge teaching, care coordination, and follow up in these high-risk populations.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033848","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":"Asymptomatic ALCAPA with Preserved Myocardial Function in a 3-Year-Old Child.","authors":"C Leclercq, F Kaladji, J P Vallée, T Nalecz, T Sologashvili, M Beghetti, J Wacker","doi":"10.1007/s00246-025-04012-2","DOIUrl":"https://doi.org/10.1007/s00246-025-04012-2","url":null,"abstract":"<p><p>Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. Its clinical course is typically severe in infancy, leading to left ventricular ischemia, cardiogenic shock, and high mortality without surgical intervention.We describe a rare case of a 3-year-old girl diagnosed with ALCAPA, showing extensive right-to-left collaterals, preserved left ventricular function, and minimal myocardial injury.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016035","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 Heart Under Pressure: Traumatic Gerbode Defect and Aortic Dissection After a Tire Explosion: A Case Report and Literature Review.","authors":"Bilgehan Betül Biçer, Hayrettin Hakan Aykan, Elif Tuzdelen, Timuçin Sabuncu, Murat Güvener","doi":"10.1007/s00246-025-03998-z","DOIUrl":"10.1007/s00246-025-03998-z","url":null,"abstract":"<p><p>We report an unusual case of a 13-year-old boy who sustained multiple traumatic cardiac injuries-including ventricular septal and Gerbode defects, aortic dissection, and severe tricuspid regurgitation (TR)-following a high-pressure truck tire explosion. The patient underwent successful endovascular and surgical repair, with full recovery observed at the 1-year follow-up. This case highlights the importance of thorough evaluation and individualized management in pediatric patients with complex cardiac trauma resulting from uncommon high-energy mechanisms.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964204","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":"Application of the New 2023 World Heart Federation Criteria to Rheumatic Heart Disease in the Setting of First Episode of Acute Rheumatic Fever: Predictors for Resolution.","authors":"Jacqueline M Williamson, Gillian A Whalley, James Marangou, Peter S Morris, Zhiqiang Wang, Joshua R Francis, Bo Remenyi","doi":"10.1007/s00246-025-03966-7","DOIUrl":"10.1007/s00246-025-03966-7","url":null,"abstract":"<p><p>Rheumatic heart disease (RHD) is a chronic complication of acute rhematic fever (ARF). Echocardiography is used to assess valve disease in ARF. Acute valvulitis in ARF may normalise once inflammation has subsided. In the Top End of the Northern Territory (NT), a diagnosis of RHD is regularly made in conjunction with ARF diagnosis. We aimed to determine if baseline echocardiogram features could predict resolution of RHD when diagnosed during ARF. This retrospective cohort study includes children and young Australians diagnosed concurrently with first ARF and RHD between January 2012 and December 2021. Echocardiograms were reclassified based on the 2023 World Heart Federation guidelines for diagnosis of RHD. Primary outcome was echocardiographic resolution of RHD. The NT register recorded 311 individuals with concurrent diagnoses of ARF and RHD with 165 eligible for inclusion. Median age was 10 years (IQR 8-13 years), and 51.5% were female. Early RHD was diagnosed in 64% (106/165) of cases. Median follow-up time was 34 months. Resolution of RHD occurred in 19% (32/165) and 97% (31/32) of those had Early RHD at diagnosis. Absence of mitral valve leaflet thickening, restriction, and excessive leaflet motion were all associated with RHD resolution with univariate analysis. Multivariate Cox proportional modelling found that Early RHD at baseline independently predicted RHD resolution with HR of 16.6 (95% CI 2.25-122.74, p = 0.006). No difference was found between Stage A or Stage B RHD, (p = 0.461). The morphological features of valve disease were not as important as the severity in predicting resolution of RHD.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964335","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":"Current Status of Fetal Echocardiography Imaging and Fetal Counseling Fellow Training in 29 European Countries.","authors":"Taisto Sarkola, Anna N Seale, Andreas Tulzer, Sophie M Duignan, Agnieszka Grzyb, Giulia Tuo, Ellen Vanhie, Colin J McMahon","doi":"10.1007/s00246-025-04006-0","DOIUrl":"https://doi.org/10.1007/s00246-025-04006-0","url":null,"abstract":"<p><p>Limited data exist on the implementation of current fetal cardiology training and practice guidelines, how trainees are assessed, and how trained fetal cardiologists maintain their skills among countries affiliated with the Association of European Paediatric and Congenital Cardiology (AEPC). A structured questionnaire was sent to fetal cardiologists or national delegates from 44 centers in 33 European countries. Responses were obtained from 37 centers in 29 European countries with 31 responses from fetal cardiologists. Fetal echocardiography was equally performed in maternal (18) and pediatric (16) hospitals with median 3 (range 0-6) fetal cardiologists per center and > 4 fetal cardiologists in 13 centers. Core and advanced fetal cardiology training was offered in 17 (46%) and 21 (57%) centers. Advanced training was provided in higher volume centers (19/21). Assessment methods included direct trainee observation, case-based discussions, and participation in multidisciplinary team meetings, with mostly verbal feedback provided. Criteria for independent fetal echocardiography and counseling were based on training duration (range 2-24 months), number of assessments (range 100-1500), and number of counseling abnormal cases (range 40-200) performed under expert supervision, as well as on expert evaluations of trainees based on direct observation and fetal cardiac diagnostic accuracy. Formal certification in fetal cardiology was reported in three centers. Research activity among trained experts was reported among 25 (68%) respondents overall with 19 respondents involved with collaborative research. Trainee research was encouraged but not mandatory in clinical training. Maintenance of expert skills included sufficient clinical activity volume, teaching, and different forms of national and international networking. Fetal cardiology service quality assessments included missed cases discussion in 20 (54%) centers. There is substantial variation in advanced fetal cardiology training practice in Europe suggesting a need for further clarification of training criteria and structure. Trainee assessment is mainly verbal and based on direct observation. There seems to be a need to strengthen the fetal cardiology module in core pediatric cardiology training and to improve quality assessment of the clinical service provided.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Index to Predict Time to School Attendance After Pediatric Heart Transplant: SAAT Score.","authors":"Brooke Cohen, Zhi Mei He, Roman Gorchs, Nhu Thao Nguyen Galván, John Goss, Abbas Rana","doi":"10.1007/s00246-025-04007-z","DOIUrl":"10.1007/s00246-025-04007-z","url":null,"abstract":"<p><p>School attendance is associated with increased quality of life in chronically ill pediatric patients and has a profound impact on child development[ 1, 2, 3, 4, 5, 6, 7, 8 ]. Despite the importance of school attendance, little research has been done to identify which pediatric transplant recipients are at risk for delayed school attendance due to morbidity. We conducted univariate and multivariate analysis on 5355 pediatric heart transplant recipients using the UNOS database. Recipients were split into two age groups, ≤ 4 year and 5-16 years. The outcome of interest was returning to school at age 6 for ≤ 4 years, and within 2 years post-transplant for 5-16 years. School attendance after transplant (SAAT scores) were generated via weighting significant variables (p < 0.05) based on odds ratio. We found 20 significant factors combined across both cohorts. The most significant protective factors included having a VAD/TAH, age, and transplantation with an ABO incompatible organ. The most significant risk factors included low-medium functional status, age, and elevated total bilirubin. The indices for each age group had Area Under the Receiver Operating Curve (AUROC) indicating high predictive value, at 0.81 (≤ 4 years) and 0.72 (5-16 years). In this study, we created SAAT scores to predict time to school attendance in both infants and children with the intention of identifying patients at risk for delayed school attendance who may benefit from targeted interventions including Enhanced Recovery Programs.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964260","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 Effect of Secondary Prophylaxis Adherence on Rheumatic Heart Disease and Determinants of Poor Adherence in Children: A 10-Year Retrospective Cohort Study.","authors":"Ipek Ulkersoy, Fatih Karagozlu, Yusuf Iskender Coskun, Nujin Ulug Murt, Mehmet Yildiz, Fatih Haslak, Reyhan Dedeoglu, Ozgur Kasapcopur, Funda Oztunc","doi":"10.1007/s00246-025-04005-1","DOIUrl":"https://doi.org/10.1007/s00246-025-04005-1","url":null,"abstract":"<p><p>Rheumatic heart disease (RHD) remains the leading cause of acquired cardiovascular morbidity and mortality in children. Since secondary prophylaxis is the cornerstone of the management of acute rheumatic fever (ARF) and RHD, this study aimed to assess the impact of prophylaxis adherence on disease recurrence and cardiac outcomes and to identify causes of non-adherence with prophylaxis. We retrospectively reviewed 137 ARF cases diagnosed before the age of 18 years, with a minimum follow-up duration of ≥ 6 months. Diagnosis was based on the Revised Jones criteria. Clinical and echocardiographic evaluations were conducted to assess RHD, and prophylaxis adherence was evaluated through qualitative interviews. The cohort (49% female, mean age 13.97 ± 3.69 years) had a 43.8% rate of cardiac involvement at diagnosis, decreasing to 40.9% at last follow-up, with 38% developing RHD. RHD development was significantly associated with initial carditis presence and worse severity (p = 0.001; p = 0.046). Adherence to secondary prophylaxis was observed in 88.3% (n = 121). Low socioeconomic status, milder valvulitis at diagnosis, and longer follow-up duration were associated with non-adherence (p = 0.008; 0.041; 0.001). Adherent patients showed significant reductions in both the number of affected valves (p = 0.001) and severity of valvular regurgitation (p = 0.003). Recurrence was more frequent among non-adherent patients (p = 0.005). Non-adherence to secondary prophylaxis remains a major barrier in ARF/RHD control, as it correlates with more severe valvular involvement and recurrence. Identifying factors influencing adherence may guide future strategies to improve both prophylaxis adherence and long-term outcomes.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964200","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":"Practice Patterns in Pediatric Cardiothoracic Presurgical Conferences: A Multicenter Survey Study.","authors":"Britney Reed, Poonam Puranik, Andrew Rodenbarger, Mira Trivedi, Dilachew A Adebo, Gary Beasley, Louis Bezold, M Jay Campbell, Michael R Carr, Joshua Daily, Mark DeBrunner, Erica Del Grippo, Carlen G Fifer, Timothy M Hoffman, Susan R Hupp, Joshua D Kurtz, Gira Morchi, Carl Owada, Renuka Peterson, Michael D Puchalski, Ryan A Romans, Arwa Saidi, Rajesh U Shenoy, Anoop K Singh, Robert D Tunks, Thomas M Yohannan, Carolyn M Wilhelm, Jyoti K Patel","doi":"10.1007/s00246-025-04008-y","DOIUrl":"https://doi.org/10.1007/s00246-025-04008-y","url":null,"abstract":"<p><p>Pediatric cardiothoracic surgeries are high-stakes, complex procedures, typically undergoing prior review at multidisciplinary conferences. This study evaluates practice patterns of conferences throughout the United States (US). Surveys were distributed to fellowship program directors or division directors in 124 US pediatric cardiology centers seeking information on conference logistics, fellow roles, quality improvement (QI), and satisfaction. All 47 responding centers (response rate 38%) conduct presurgical conferences, mostly on a weekly basis (92%) lasting 60-120 min (79%). The conferences are solely virtual (19%) or hybrid (81%). High-volume centers (> 300 surgical cases/year) are more likely to hold multiple conferences (13/20 vs 7/27, p < 0.01) and less likely to designate a moderator (11/20 vs 22/26, p = 0.027). Categorical pediatric cardiology fellows at 33 centers present clinical data (97%), echocardiograms (85%), catheterizations (82%), and cross-sectional imaging (39%), typically beginning in their first year. Most centers report that minor (98%) or major changes (51%) are made to patient management at least \"sometimes.\" Responders rate conferences as very important (median 10/10 on a 10-point Likert scale, IQR 9-10), but satisfaction is more modest (median 7/10, IQR 7-9). Only 17% of centers have a formal QI process. Comments from 42 centers reveal positive themes of collaboration (68%) but also concerns about lengthy (30%) or inefficient (36%) discussion. Conclusions: This survey highlights common practices for pediatric cardiothoracic presurgical conferences. Conferences are collaborative and seen as highly impactful. However, satisfaction varies, and QI efforts are infrequent. These findings highlight opportunities for process improvement and standardization.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Burden of Pediatric Pulmonary Arterial Hypertension, 1990-2021: A Systematic Analysis from the Global Burden of Disease Study 2021.","authors":"Taixiang Liu, Xiaoliang Liu, Chenhong Wang, Jinxin Zheng, Liping Shi, Zheng Chen","doi":"10.1007/s00246-025-04009-x","DOIUrl":"https://doi.org/10.1007/s00246-025-04009-x","url":null,"abstract":"<p><p>Pediatric pulmonary arterial hypertension (PAH) remains a critical global health threat characterized by disparities in burden driven by sociodemographic factors, with persistent gaps in early screening and equitable healthcare access despite therapeutic advances. Leveraging Global Burden of Disease 2021 data including 204 countries and territories from 1990 to 2021, this study analyzed trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs) using joinpoint regression to discern temporal patterns, inequality metrics to quantify disparities, and decomposition and frontier analyses to investigate DALY change drivers and health system inefficiencies. Globally, pediatric PAH incidence increased by 20.1% from 1990 to 2021, while deaths and DALYs decreased significantly by 57.7 and 57.9%, respectively. Low-middle socio-demographic index (SDI) regions reported the highest incidence and deaths, whereas high-SDI regions achieved the most substantial mortality reductions. Neonates faced the highest mortality risk (4.86 per 100,000 population). Females demonstrated higher incidence and prevalence, while males under 10 years had elevated mortality and DALYs-a trend reversing in adolescence. Low-SDI regions experienced increasing burdens due to demographic shifts, and frontier analysis revealed inefficiencies even in resource-rich high-SDI countries. Addressing persistent inequities necessitates tailored regional strategies: optimizing resource allocation in high-SDI settings and expanding low-cost screening and treatment in low-SDI regions, alongside prioritizing neonatal care and risk mitigation to achieve global health equity in pediatric PAH.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964384","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":"Association between Mitral Valve Pathology and Ventricular Ectopy in the Pediatric Marfan Population.","authors":"Saneeha Shahid, Peter F Aziz, Iqbal El Assaad, Brendan J Burke, Kenneth Zahka, Tara Karamlou, Justin T Tretter, Maryann Patterson, Akash Patel","doi":"10.1007/s00246-025-03963-w","DOIUrl":"https://doi.org/10.1007/s00246-025-03963-w","url":null,"abstract":"<p><p>Adult studies establish an association between mitral valve pathology, namely mitral annular disjunction (MAD) and mitral valve prolapse (MVP), and ventricular arrhythmias. Data in the pediatric Marfan population is limited. To assess the association between (1) MAD and ventricular ectopy (VE), non-sustained ventricular tachycardia (NSVT) and ventricular tachycardia (VT); (2) MVP and VE, NSVT and VT and (3) MAD and MVP in the pediatric Marfan population. We carried out a retrospective single center study from January 2001 to January 2022 including all patients with Marfan syndrome who were ≤ 21 years of age and had a cardiac rhythm monitor. Of the 32 patients included, 12 (38%) were female and 21 (66%) had a positive Fibrillin 1 variant. The mean age at echocardiogram was 13.5 ± 4.5 years and median duration of cardiac monitoring was 58 (32.5-190.5) hours. Sixteen (50%) had complex VE (couplets, triplets, and/or NSVT). Fourteen (44%) had couplets with median episodes per monitor of 2 (1-4), 1 (3%) being polymorphic and 6 (19%) with fast RR (R-R interval < 350 ms). Six (19%) had triplets with median episodes per monitor of 1 (1-1) and fast RR in 4 (13%). Four (13%) had NSVT. There is a high prevalence of complex VE in the pediatric Marfan population. MAD and MVP were not associated with complex VE however, all patients with triplets and NSVT had MVP, mostly bileaflet. MAD is positively associated with bileaflet MVP and bileaflet MVP is associated with more ventricular ectopy.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964337","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}