Pediatric Blood & Cancer最新文献

{"title":"PET Response and Outcome in Low-Risk Nodular Lymphocyte-Predominant Hodgkin Lymphoma: Children's Oncology Group Study AHOD03P1.","authors":"Lianna J Marks, Yue Wu, Kathleen M McCarten, Lindsay A Renfro, Qinglin Pei, Kara M Kelly, Cindy L Schwartz, Sharon M Castellino, Burton E Appel","doi":"10.1002/pbc.31606","DOIUrl":"10.1002/pbc.31606","url":null,"abstract":"<p><p>A better understanding of positron emission tomography (PET) response in nodular lymphocyte-predominant Hodgkin lymphoma (nLPHL) is critical for incorporating PET into prospective trials. PET scans from Children's Oncology Group study AHOD03P1 for patients less than 22 years with low-risk nLPHL, treated with three cycles of doxorubicin, vincristine, prednisone, and cyclophosphamide chemotherapy, were retrospectively reviewed and assigned Deauville 5-point scale (5PS) scores. Five-year post-PET event-free survival was 90.1% (80% CI: 85.2%-93.4%) for PET-negative (5PS 1-3) and 66.7% (80% CI: 36.4%-85.0%) for PET-positive (5PS 4-5) patients. PET response after three cycles of low-dose chemotherapy is predictive of relapse risk for low-risk nLPHL.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31606"},"PeriodicalIF":2.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425963","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":"Centralization of Pediatric Surgical Oncological Care. Why and How.","authors":"Marc H W A Wijnen, Alida F W van der Steeg","doi":"10.1002/pbc.31607","DOIUrl":"https://doi.org/10.1002/pbc.31607","url":null,"abstract":"","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31607"},"PeriodicalIF":2.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414225","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":"Barriers and Facilitators to Comprehensive Pediatric Sickle Cell Care: A Qualitative Study.","authors":"Alyssa M Schlenz, Elisabeth Vestal, Christina M Abrams, Julie Kanter, Shannon Phillips","doi":"10.1002/pbc.31603","DOIUrl":"https://doi.org/10.1002/pbc.31603","url":null,"abstract":"<p><strong>Background: </strong>Children with sickle cell disease (SCD) require comprehensive care to prevent and treat serious and life-threatening complications and to access disease-specific treatment approaches that can improve outcomes. This study characterized barriers and facilitators to care for SCD in the context of the Conceptual Framework of Access to Care Model.</p><p><strong>Methods: </strong>This qualitative descriptive study was conducted using semi-structured interviews with 27 patient/caregivers focused on sickle cell anemia (SCA; a subtype of SCD). Data were analyzed using directed content analysis with the model above as the initial coding framework.</p><p><strong>Results: </strong>Themes were identified among healthcare system and patient/community-level factors. Healthcare system facilitators predominated themes, with a focus on the extent to which the healthcare services provided were a good match for the family and available and accommodating to patient and family needs. Additional facilitators at the patient/community level focused on whether patients and families could perceive and seek out, reach and pay for, and engage with healthcare. Barriers reflected the opposite experiences, with negative or challenging healthcare experiences and adverse social determinants of health interfering with access to care.</p><p><strong>Conclusions: </strong>Barriers and facilitators were mapped to the Conceptual Framework of Access to Care Model, with facilitators playing a more substantial role than barriers in access to comprehensive care among children with SCA and their caregivers. A focus on optimizing facilitators at both the healthcare system and patient/family level may have a considerable impact on improving access to and engagement in care.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31603"},"PeriodicalIF":2.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414141","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 Outcomes Following Radiotherapy for Pediatric Salivary Gland Tumors.","authors":"Etzer M Augustin, Daniel J Indelicato, Julie A Bradley, E Charles Fortune, Roi Dagan, Christopher G Morris, Scott M Bradfield, Raymond B Mailhot Vega","doi":"10.1002/pbc.31571","DOIUrl":"https://doi.org/10.1002/pbc.31571","url":null,"abstract":"<p><strong>Background: </strong>In contrast to adult salivary gland tumors, our institutional guidelines utilize lower radiation doses, smaller target margins, and proton therapy (PT) to minimize radiation to children's developing skull base anatomy. Herein, we report outcomes of our pediatric management approach.</p><p><strong>Procedures: </strong>We identified 31 pediatric patients with salivary gland tumors treated with PT at our institution between 2006 and 2023. Most common histologies were mucoepidermoid carcinoma (n = 14), acinic cell carcinoma (n = 5), and adenoid cystic carcinoma (n = 5). Eight patients with radiographic lymphadenopathy underwent neck dissection prior to presentation, with selective dissections involving <4 nodal levels in 7/8 cases. The gross tumor volume (GTV) encompassed the residual tumor and tumor bed. Clinical target volume (CTV1), defined as GTV + 1 cm margin, received 50.4 Gy. Prophylactic nodal irradiation was administered to three patients. CTV2 equaled the GTV and was treated to a median total dose of 64.8 Gy (range, 61.2-70.8). Toxicity was assessed with CTCAE Version 5.0.</p><p><strong>Results: </strong>Median follow-up was 7.5 years (range, 1.2-15). Overall survival (OS) was 96%, and local control was 94%. There were no nodal recurrences. Acute toxicities were limited to mucositis requiring opioids and transient Grade 3 dermatitis. The most serious late toxicity involved the auditory system, including three patients requiring hearing aids, one with chronic otitis media, one with osteonecrosis of the mastoid, and one with external canal stenosis. There was neither Grade 4 toxicity nor second malignancy.</p><p><strong>Conclusions: </strong>Conservative neck management and moderate-dose PT delivered to smaller volumes resulted in excellent long-term disease control and limited toxicity in children with common salivary gland tumors.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31571"},"PeriodicalIF":2.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414321","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":"Localized Lymphoblastic Lymphoma in Children and Adolescents: Results of the LLB-NHL03 Trial-A Report From the Japan Children's Cancer Group.","authors":"Masahiro Sekimizu, Tomoyuki Watanabe, Hiroko Fukushima, Katsuyoshi Koh, Yuki Yuza, Yasuhiro Takeshima, Hiroyoshi Watanabe, Tadashi Anan, Takeshi Mori, Tetsuya Mori, Ryoji Kobayashi, Atsuko Nakazawa, Koichi Ohshima, Akiko M Saito, Tetsuya Takimoto, Masahito Tsurusawa, Keizo Horibe, Shosuke Sunami","doi":"10.1002/pbc.31590","DOIUrl":"https://doi.org/10.1002/pbc.31590","url":null,"abstract":"<p><strong>Background: </strong>Localized lymphoblastic lymphoma (LL) is rare in pediatric patients. The best treatment for patients with localized LL remains to be determined because of the rarity of the disease.</p><p><strong>Methods: </strong>Between November 2004 and October 2019, 41 newly diagnosed patients up to 18 years of age with localized LL (Murphy stages I and II) were enrolled in the LLB-NHL03 trial. The treatment consisted of five phases: induction, consolidation, central nervous system prophylaxis, delayed intensification, and maintenance. The total duration of therapy was 24 months from the time of diagnosis.</p><p><strong>Results: </strong>Of the 41 patients, six patients were excluded with a different diagnosis; therefore, 35 were included in the primary efficacy and safety analysis. The mean age at diagnosis was 9.2 years (range 2.1-16.1 years). Sixty-five percent of patients were male. Twenty-nine patients had a pre-B immunophenotype, and six had a pre-T immunophenotype. The head and neck area accounted for 66% of the primary sites. At a median follow-up of more than 10 years, the 3-year event-free survival rate [95% confidence interval] was 97.1% [81.4-99.6%], and the 3-year overall survival rate was 100%. Overall, patients tolerated the therapy well, and no treatment-related deaths were observed.</p><p><strong>Conclusion: </strong>This is the largest clinical trial conducted exclusively in children with newly diagnosed localized stage LL. The outcomes of pediatric patients with localized LL treated with 2 years of acute lymphoblastic leukemia-type therapy, which is characterized by a relatively low anthracycline dose, exclusive use of prednisolone steroids, and fewer intrathecal therapies compared with previous studies, were excellent.</p><p><strong>Clinical trial registration number: </strong>This trial was registered in the Japan Registry of Clinical Trials (jRCT): jRCTs041180131.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31590"},"PeriodicalIF":2.4,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414304","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":"Neonatal Portal Vein Thrombosis: A Retrospective Study of Management and Follow-Up at One Institution.","authors":"Suhani Jain, Lisa Maurer, James Cooper, Debra Correa, Meghan McCormick, Kaitlin Devine, Allison Close, Erica Braverman, Judy Squires, Arthur Kim Ritchey, Deirdre Nolfi-Donegan","doi":"10.1002/pbc.31589","DOIUrl":"https://doi.org/10.1002/pbc.31589","url":null,"abstract":"<p><strong>Background: </strong>Management of neonatal portal vein thrombosis (PVT), a relatively common type of pediatric deep vein thrombosis, is not completely standardized. Questions remain about the benefit of anticoagulation (ATC) therapy and about the optimal frequency and duration of doppler ultrasound (US) surveillance for liver complications such as portal hypertension and gastrointestinal bleeding. Current guidelines suggest reserving ATC only for occlusive PVT, highlighting a need for explicit grading of PVT in radiologic reports and a consensus approach to imaging and management.</p><p><strong>Methods: </strong>To address these issues, we implemented an institutional Neonatal PVT Management Algorithm using plan-do-study-act (PDSA) methodology. We aimed to standardize screening tests, reduce unnecessary ATC, and optimize imaging checkpoints. A five-year retrospective review established baseline data, which we compared to outcomes five years post-implementation of the algorithm.</p><p><strong>Results: </strong>The algorithm recommended ATC only for occlusive PVT and advised US imaging at Week 1, Month 1, Month 3, and Month 6 from diagnosis, with annual surveillance for unresolved or abnormal cases. Post-implementation analysis revealed improvements in radiologic documentation of PVT grading, a reduction in the use of ATC for subocclusive PVT, and a decrease in the median duration of ATC for all patients. Follow-up imaging adherence did not improve between the pre- and post-implementation periods.</p><p><strong>Conclusions: </strong>The algorithm successfully enhanced documentation of PVT grading and reduced unnecessary ATC but highlighted persistent challenges in follow-up adherence, suggesting a need for further refinement in future PDSA cycles.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31589"},"PeriodicalIF":2.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399676","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":"Cognitive Outcomes in Children Treated for Ependymoma Diagnosed Under 36 Months: A Systematic Review.","authors":"Sophie Thomas, Emily Morley, Timothy Ritzmann, Christopher Clayton, Kathyrn Powers, Jac Airdrie, Louise Robinson, Kate Fifield, Anna Packham, Maria Chiara Oprandi, Jo-Fen Lui, Gillian Whitfield, Nicola Thorp, Jennifer Limond, Richard Grundy","doi":"10.1002/pbc.31588","DOIUrl":"https://doi.org/10.1002/pbc.31588","url":null,"abstract":"<p><p>It is crucial to understand the morbidity associated with treatments for young children with ependymoma given this is a high incidence age group also known to be at risk of poorer cognitive outcomes. This review aimed to identify the quality of existing evidence describing cognitive outcomes in children treated for ependymoma under 36 months of age with a particular focus on the impact of radiotherapy. Eight studies were identified. Given the quality and heterogeneity of methodology, studies were only suitable for qualitative synthesis, as the majority included small numbers of participants with multiple confounding factors. Whilst some studies reported poor cognitive outcomes, the only large study reporting planned irradiation reported outcomes below the population mean but still broadly in the average range. This was consistent with a further study of interest that did not meet inclusion criteria but reported outcomes for children treated under five years old, many of whom were likely in the target population age for this review. Overall, the length of follow-up was often limited, and further research to monitor long-term impact, including photon and proton irradiation protocols on cognitive development, is required. Importantly, there is an urgent need to agree homogeneous methodology and achieve international consensus for cognitive assessment protocols to interrogate cognitive outcomes in this vulnerable population.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31588"},"PeriodicalIF":2.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399675","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":"The Lived Experience of Childhood Cancer Survivors and Their Parents: A Multi-National Study of Access to Survivorship Care and Information and Support Needs.","authors":"Jordana K McLoone, Claire E Wakefield, N Glasson, Lori Wiener, R Ortiz, Andre Ilbawi, Clarissa E Schilstra, Ruth Hoffman, Julie Cayrol","doi":"10.1002/pbc.31593","DOIUrl":"https://doi.org/10.1002/pbc.31593","url":null,"abstract":"<p><strong>Introduction: </strong>Lifelong follow-up care for childhood cancer survivors (CCS) is recommended and ideally involves both medical and psychosocial care. It is important for CCS and their families to be adequately informed about what to expect after cancer treatment completion to ensure they receive appropriate care. This study aimed to describe patterns of access to survivorship care among a multi-national sample, as well as examine unmet information and support needs, for CCS and their parents.</p><p><strong>Method: </strong>An online survey, developed by pediatric psycho-oncology experts and people with lived experience of pediatric cancer, was distributed by the World Health Organization. This study presents a subanalysis from these data.</p><p><strong>Results: </strong>Participants included 102 parents of CCS (94 females, mean age 45 years, mean time since child's diagnosis 9 years), and 43 CCS (28 females, mean age 31 years, mean time since diagnosis 21 years) from 17 countries. Thirty-five percent of CCS (13/37) were not accessing survivorship care. Most parents (95%; 97/102) and CCS (76%; 31/41) reported a desire for discussion of emotional impacts following cancer treatment completion; however, this did not occur for 69% (70/102) of parents and 46% (19/41) of CCS. Additionally, 92% (93/102) of parents and 83% (33/41) of CCS reported an unmet need for more information about what to expect after cancer treatment. Most CCS (54%; 22/41) reported feeling \"somewhat-not at all\" supported by healthcare professionals in the period after cancer treatment.</p><p><strong>Conclusion: </strong>Discussions regarding emotional well-being and ongoing needs post treatment are lacking in cancer survivorship care worldwide.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31593"},"PeriodicalIF":2.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399677","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":"Vincristine Sulfate Liposome Injection with Combination Chemotherapy for Children, Adolescents, and Young Adults with Relapsed Acute Lymphoblastic Leukemia: A Therapeutic Advances in Childhood Leukemia and Lymphoma Consortium Trial.","authors":"Nirali N Shah, Eric S Schafer, Yueh-Yun Chi, Jemily Malvar, Kenneth M Heym, Andrew E Place, Melissa Burns, Bill H Chang, Tamra Slone, Anupam Verma, Nathan Gossai, Peter H Shaw, Michael J Burke, Michelle Hermiston, Reuven J Schore, Todd Cooper, Melinda Pauly, Teresa Rushing, Paul Jarosinski, Ellynore Florendo, Bonnie Yates, Brigitte C Widemann, Cody J Peer, William D Figg, Lewis B Silverman, Deepa Bhojwani, Alan S Wayne","doi":"10.1002/pbc.31584","DOIUrl":"https://doi.org/10.1002/pbc.31584","url":null,"abstract":"<p><strong>Introduction: </strong>Vincristine sulfate liposome injection (VSLI), a liposomal formulation of vincristine, may be better tolerated than standard aqueous vincristine and enable dose intensification.</p><p><strong>Procedures: </strong>Based on single-agent tolerability, activity, and FDA approval in adults with acute lymphoblastic leukemia (ALL), we tested the safety and feasibility of VSLI as replacement for standard vincristine in the UK ALL R3 mitoxantrone-based four-drug induction (Cohort A), a three-drug anthracycline-free induction (Cohort B), and maintenance chemotherapy (Cohort C) in children and young adults with relapsed/refractory B-cell ALL.</p><p><strong>Results: </strong>Among 29 participants with a median age of 12.4 years (range: 1.8-19.6 years), 16 received Cohort A, eight received Cohort B, and five received Cohort C therapy. Dose level 1 (DL1): 1.5 mg/m² and dose level 2 (DL2): 2 mg/m² of VSLI, each without a dose cap, were tested. Collectively, the median VSLI dose administered was 1.9 mg (range: 0.71-4.06 mg), and 13 (44.8%) received a dose above the standard 2 mg vincristine dose cap. Dose-limiting toxicities (DLTs) at DL2 were seen in three patients, two in Cohort A and one in Cohort B, prompting further evaluation at DL1 for both cohorts. No DLTs were experienced at DL1. Only DL2 was tested in Cohort C-without DLT. Complete remissions were seen in 14 of 16 (87.5%) participants in Cohort A; three of eight (37.5%) in Cohort B; and one (20%) in Cohort C. VSLI with combination chemotherapy at DL1 was generally well tolerated.</p><p><strong>Conclusion: </strong>Based on the promising response signal in this heavily pretreated population, further study of VSLI is warranted. (ClinicalTrials.gov NCT02879643).</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31584"},"PeriodicalIF":2.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399678","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":"African Hospital-Based Paediatric Palliative Oncology Care Independent of Economic Indicators: An International Society of Paediatric Oncology (SIOP) Global Mapping Programme Survey.","authors":"Angidi Mauree, Khumo Myezo, Neil Ranasinghe, Julia Challinor, Rossella Bandini, Kathryn Burns, Katherine Eyal, Julia Downing, Kathy Pritchard-Jones, Eric Bouffet, Jennifer Geel","doi":"10.1002/pbc.31598","DOIUrl":"https://doi.org/10.1002/pbc.31598","url":null,"abstract":"<p><strong>Background: </strong>Paediatric palliative care (PPC) is considered an essential component of the management of children and adolescents with cancer. The International Society of Paediatric Oncology Global Mapping Programme (SIOP GMP) surveyed hospital-based paediatric oncology facilities across Africa from 2018 to 2020 to document PPC and provision of PPC services. We aimed to assess possible correlations between existing PPC services across Africa with economic indicators.</p><p><strong>Procedure: </strong>An electronic and paper survey was widely distributed to elicit the presence of components of PPC: PPC teams, bereavement counselling services, patient support groups, and spiritual and religious support. Results were correlated with the countries' Gini coefficient, World Bank income status indicators and Human Development Index.</p><p><strong>Results: </strong>Hospital-based paediatric oncology facilities in 16/54 African countries reported having all four PPC services, while those in 12 countries reported having none of the four PPC services. No clear correlations were found between provision of such services and selected economic factors.</p><p><strong>Conclusions: </strong>This study assesses components of PPC through four binary questions and demonstrates that hospital-based paediatric oncology facilities with limited resources caring for children and adolescents can provide PPC. Adoption of the World Health Organization's conceptual framework for palliative care and knowledge transfer between African facilities on the integration of PPC into paediatric oncology care, would benefit the increasing numbers of children and adolescents with cancer across the continent.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31598"},"PeriodicalIF":2.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399711","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}