Pediatric Blood & Cancer最新文献

{"title":"A Rare Intersection: Wilms Tumor in a Patient with PIGO Syndrome.","authors":"Şefika Akyol, Özge Vural, Gülsüm Kayhan, Zafer Türkyılmaz, Alper Özcan, Deniz Koçak Göl, Güçlü Pınarlı, Ekrem Ünal","doi":"10.1002/pbc.31762","DOIUrl":"https://doi.org/10.1002/pbc.31762","url":null,"abstract":"","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31762"},"PeriodicalIF":2.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006943","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":"Associations Between Pain Scores and Opioid Doses With Emergency Department Disposition and Return Visit Rates in Children With Sickle Cell Disease.","authors":"Keli D Coleman, Kenneth McKinley, Angela M Ellison, Elizabeth R Alpern, Selena Hariharan, Irina Topoz, Morgan Wurtz, Blake Nielsen, Lawrence J Cook, Claudia R Morris, Amanda M Brandow, Andrew D Campbell, Robert I Liem, Rachelle Nuss, Charles T Quinn, Alexis A Thompson, Anthony Villella, Allison A King, Ana Baumann, Warren Frankenberger, David C Brousseau","doi":"10.1002/pbc.31750","DOIUrl":"https://doi.org/10.1002/pbc.31750","url":null,"abstract":"<p><p>Rapid treatment and frequent reassessment of pain are key components of treatment guidelines for acute sickle cell disease (SCD) pain. Few studies, however, report the associations between emergency department (ED) pain scores, number of ED opioid doses, receipt of an opioid prescription, ED visit disposition, or ED return visits. This seven-site retrospective cohort study analyzed 4983 ED visits by children with SCD pain using electronic health record data from the Pediatric Emergency Care Applied Research Network Registry. ED pain scores included initial, last, and change in scores (initial minus last), measured on a 0-10 scale. Dispositions of discharge and hospital admission were included. Modified Poisson regression and the Cochran-Armitage test of trend were used for analysis. The median (IQR) initial pain score was 8.0 (6-10); last pain score was 5.0 (2-8); and median decrease was 2.0 (0-5). In multivariable analysis, last pain score was the best predictor of disposition. For the return visit analyses, of the 2377 visits discharged at index ED visit, 29% returned within 14 days. Higher initial and last ED pain scores were associated with increased return visits. Children with no opioid discharge prescription and ≥3 ED opioid doses had a return visit rate of 36% compared to 22% if the child received an opioid prescription and only one ED opioid. Increasing discharge opioid prescriptions and targeting interventions for those who receive multiple ED opioid doses could decrease return visits.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31750"},"PeriodicalIF":2.4,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006945","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 Phase 1/2 Study of Lenvatinib in Combination With Everolimus in Recurrent and Refractory Pediatric and Young Adult Solid Tumors.","authors":"Filemon S Dela Cruz, Elizabeth Fox, Steven G DuBois, Gregory K Friedman, James M Croop, AeRang Kim, Daniel A Morgenstern, Frank M Balis, Margaret E Macy, Joseph G Pressey, Tanya Watt, Julie I Krystal, Kieuhoa T Vo, Rajen Mody, Theodore W Laetsch, Brenda J Weigel, Karen O'Hara, Cixin S He, Jagadeesh Aluri, Chinyere E Okpara, Julia L Glade Bender","doi":"10.1002/pbc.31692","DOIUrl":"https://doi.org/10.1002/pbc.31692","url":null,"abstract":"<p><strong>Introduction: </strong>Developing targeted therapies with manageable toxicities remains a high priority for pediatric cancer. We sought to determine the recommended Phase 2 dose (RP2D) and evaluate the antitumor activity of lenvatinib+everolimus in children/young adults with select recurrent/refractory solid tumors.</p><p><strong>Methods: </strong>Patients 2-21 years old were eligible. Phase 1 used a rolling-six design. Phase 2 was limited to patients with Ewing sarcoma (EWS), rhabdomyosarcoma (RMS), or high-grade glioma (HGG), and ≤2 prior VEGF/VEGFR-targeted therapies. Primary endpoints included the determination of maximum tolerated dose (MTD), RP2D, safety/toxicity (Phase 1), and objective response rate (ORR) per RECIST version 1.1 (RANO for HGG) at Week 16 (Phase 2).</p><p><strong>Results: </strong>In Phase 1, 23 patients received lenvatinib 11 mg/m² (dose level [DL] 1, n = 18) or 8 mg/m² (DL -1, n = 5) combined with everolimus 3 mg/m² orally once daily. DL1 was declared the MTD/RP2D given dose-limiting toxicities (proteinuria [n = 1]; hypertriglyceridemia and hypercholesterolemia [n = 1]) observed in two of 12 patients treated at DL1. In Phase 2, 41 patients (EWS, n = 10; RMS, n = 20; HGG, n = 11) were treated with the RP2D. Two patients with RMS experienced partial response by Week 16. No other objective responses were observed. Two patients with EWS experienced prolonged disease control (≥23 weeks). No new safety signals were identified. The safety profile was similar to those of treated adults with renal cell carcinoma.</p><p><strong>Conclusion: </strong>Lenvatinib+everolimus has a manageable safety profile in this pediatric population. Despite unmet efficacy endpoints, the antitumor activity observed in RMS and EWS may warrant further study in select pediatric solid tumors.</p><p><strong>Clinicaltrials: </strong></p><p><strong>Gov number: </strong>NCT03245151.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31692"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986878","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":"Pediatric Head and Neck Germ Cell Tumors: Current Management and Risk of Malignant Transformation.","authors":"Estelle Hadjean, Matthieu Carton, Vincent Couloigner, Romain Luscan, Thierry Van Den Abbeele, Natacha Teissier, Cecile Faure-Conter, Brice Fresneau, Guillaume Morcrette, Brigitte Lacour, Jacqueline Clavel, Emmanuel Desandes, Coralie Mallebranche, Michel Mondain, Liana Carausu, Pierre Fayoux, Cecile Dumesnil, Cecile Boulanger, Cecile Vérité, Judith Landman-Parker, Helene Sudour-Bonnange, Rémi Marianowski, Nicolas Leboulanger, Dominique Plantaz, Sonia Ayari, Mohamed Akkari, Thomas Sagardoy, Marie-Noelle Calmels, Daniel Orbach","doi":"10.1002/pbc.31747","DOIUrl":"https://doi.org/10.1002/pbc.31747","url":null,"abstract":"<p><strong>Background and aims: </strong>Head and neck germ cell tumors (HN-GCTs), excluding the central nervous system, are rare and frequently contain mature or immature teratoma (MIT) compounds. The aims of this study were to analyze the risk of malignant transformation after MIT HN-GCTs, to describe treatments and sequelae, and to propose recommendations for the follow up of these patients.</p><p><strong>Methods: </strong>National multicentric retrospective study of all patients aged from birth to 17 years, treated in France between 2000 and 2021 for a HN-GCT of all histotypes. Patients were selected from various sources: French National Registry of Childhood Cancers, SFCE (Société Française des Cancers de l'Enfant) centers and pediatric ENT (ear, nose and throat) surgical centers.</p><p><strong>Results: </strong>A total of 152 patients were selected. Median age at diagnosis was 9 months (range, 0-190), with 34 diagnosed antenatally. Overall, 150 tumors contained MIT and two were malignant yolk sac GCT (YST). All patients, except for two cases with early postpartum death, underwent surgery, preceded in 12 cases by an EXIT (Ex Utero Intra Partum) procedure. After a median follow-up of 47 months (range, 11-124), four patients with MIT developed a localized mature teratoma relapse, three developed a localized secreting malignant HN-GCT (including two malignant degenerations after MIT), and one had a thoracic neuroblastoma. All patients survived. 9% of survivors developed moderate to severe sequelae.</p><p><strong>Conclusions: </strong>Due to the low rate of malignant degeneration (two out of 148, 1.3%), this study does not support systematic oncologic long-term monitoring after neonatal MIT HN-GCT. However, regular clinical examination is required to detect and treat locoregional sequelae.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31747"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037282","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":"Utility and Safety of Romiplostim as an Alternative to Platelet Transfusion for Neonates.","authors":"Rachel N Zeno, Sara Awad, Harry Lesmana","doi":"10.1002/pbc.31753","DOIUrl":"https://doi.org/10.1002/pbc.31753","url":null,"abstract":"<p><p>Thrombocytopenia is a common challenge in the neonatal intensive care unit, traditionally managed with platelet transfusions. However, transfusions are associated with significant risks, including increased mortality and neurodevelopmental impairment. This case series highlights the use of romiplostim, a thrombopoietin receptor agonist, in three neonates with thrombocytopenia. Each case demonstrated notable improvements in platelet counts without adverse events, reducing dependency on transfusions. These findings underscore romiplostim's potential as a safer alternative for managing neonatal thrombocytopenia. This report advocates for further research to explore romiplostim's efficacy and safety in this vulnerable population, emphasizing its promise in improving neonatal outcomes.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31753"},"PeriodicalIF":2.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034723","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":"Risk of Metabolic Syndrome and Glucose Homeostasis Among Childhood and Young Adult Acute Lymphoblastic Leukemia Survivors: Part of the ALL-STAR Study.","authors":"Mette Tiedemann Skipper, Niels Birkebæk, Rikke Beck Jensen, Bente Lomholt Langdahl, Ruta Tuckuviene, Peder Skov Wehner, Kjeld Schmiegelow, Thomas Leth Frandsen, Liv Andrés-Jensen, Birgitte Klug Albertsen","doi":"10.1002/pbc.31705","DOIUrl":"https://doi.org/10.1002/pbc.31705","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome (MetS), a risk factor for early cardiovascular morbidity and mortality, is seen in up to 34% of survivors of childhood acute lymphoblastic leukemia (ALL).</p><p><strong>Procedure: </strong>We performed a Danish, national cross-sectional study of ALL survivors (aged 1-45 years at diagnosis) treated according to the NOPHO ALL2008 protocol, examined at least 1 year after treatment cessation. The study included non-cancer community controls, matched on sex and age. We explored the prevalence and components of the MetS criteria (hyperglycemia, hypertension, increased waist circumference (WC), and dyslipidemia) and glucose homeostasis (insulin and C-peptide).</p><p><strong>Results: </strong>We included 366 survivors of ALL (participation rate 84%) and 368 controls. Median age (IQR) at follow-up examination was 14.1 (10.8-21.8) years, and follow-up time after the ALL diagnosis was 6.9 (4.7-9.1). The prevalence of MetS in survivors was 7.6% and in controls 3.8 % (p = 0.039). The increased MetS prevalence was driven by ALL patients undergoing total body irradiation (TBI), and age and body mass index (BMI) percentile ≥95 at diagnosis (p ≤ 0.01). The MetS prevalence in non-TBI patients did not differ from controls (p = 0.43), but non-TBI patients more often fulfilled the MetS criteria WC and/or elevated high-density lipoprotein (p < 0.03). Survivors had higher serum insulin and C-peptide than controls (p < 0.01).</p><p><strong>Conclusions: </strong>ALL survivors have an increased risk of MetS compared with controls, essentially driven by the patients treated with TBI. The MetS frequency in non-TBI patients is equal to controls, but non-TBI patients more often have one or two components of Mets. ALL survivors seem slightly more insulin-resistant than controls.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31705"},"PeriodicalIF":2.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993680","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":"Assessment of Clinical Characteristics and Sociocontextual Factors on Medication Adherence in Children and Adolescents With Hemophilia.","authors":"Natasha S Bala, Paula Aristizabal, Euyhyun Lee, Lin Liu, Courtney D Thornburg","doi":"10.1002/pbc.31712","DOIUrl":"https://doi.org/10.1002/pbc.31712","url":null,"abstract":"<p><strong>Introduction: </strong>Sociocontextual factors, including social determinants of health (SDOH), affect health outcomes and clinical progression in chronic blood diseases such as hemophilia. Continuous prophylaxis with intravenous clotting factor concentrates or subcutaneous factor VIII mimetic agents reduces bleeding and improves quality of life. However, adherence to prophylaxis is challenging.</p><p><strong>Aim: </strong>To investigate the impact of clinical and sociocontextual factors, including SDOH, on adherence to prophylaxis in children and adolescents with hemophilia.</p><p><strong>Methods: </strong>In this cross-sectional study, parent and adolescent participants were enrolled from 2018 to 2023. Adherence to prophylaxis was measured by Hemophilia Regimen Treatment Adherence Scale-Prophylaxis as overall adherence as well as \"time,\" \"dose,\" \"plan,\" \"remember,\" \"skip,\" and \"communicate\" subscales. Sociocontextual factors were assessed by self-reported validated surveys. Linear regression analysis was performed.</p><p><strong>Results: </strong>Of 41 parent participants, 56% were Hispanic. There was no difference in adherence scores between Hispanic and non-Hispanic parents (p = 0.97). Older age of child (p = 0.002), prophylaxis via peripheral intravenous route (vs. central line, p = 0.004), and use of Spanish language for medical communication (vs. English, p = 0.002) were associated with lower adherence. Higher trust in provider was associated with higher adherence (p = 0.051).</p><p><strong>Conclusion: </strong>Our findings may help guide tailored interventions to improve adherence, including targeting older children/adolescents as they become independent in their care, language-concordant education, and measures to improve social support and enhance trust in healthcare providers.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31712"},"PeriodicalIF":2.4,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034775","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":"Strategies for the Treatment of Desmoplastic Small Round Cell Tumor: A Case Series.","authors":"Rachel Offenbacher, Paige Lazar, Lara Fabish, Jana Fox, Alice Lee, David M Loeb, Alissa Baker","doi":"10.1002/pbc.31734","DOIUrl":"https://doi.org/10.1002/pbc.31734","url":null,"abstract":"<p><p>Desmoplastic small round cell tumor (DSRCT) is a rare, aggressive pediatric sarcoma that has a poor prognosis despite a multimodal approach of surgical resection, chemotherapy, and radiation. Incidence is only approximately 0.2 cases per million, limiting clinical trials from which to derive a standard of treatment. Advancement instead relies on case reports and series. The Children's Hospital at Montefiore in the Bronx, New York, a tertiary care hospital associated with the Montefiore Einstein Comprehensive Cancer Center, has treated eight such patients in the last decade, resulting in one of the largest single-institution case series of DSRCT patients to date. Though these patients are demographically unusual for DSRCT, including two women and two with rare extra-abdominal tumors of the brain and bone, through treatment of these patients we have accrued experience regarding various treatment strategies in both primary and refractory DSRCT. We treat primary DSRCT with interval-compressed vincristine/doxorubicin/cyclophosphamide alternating with cycles of ifosfamide/etoposide and irinotecan/temozolomide/temsirolimus (ITT). This is the first descriptive series of this size describing the use of ITT in DSRCT. Treatment for refractory cases focuses on targeted therapies when available, emphasizing the personalization that DSRCT treatment requires.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31734"},"PeriodicalIF":2.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049649","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":"Relationship Between Total Parenteral Nutrition, Ventilation, and Hepatoblastoma: A Study of 258,929 Neonatal Intensive Care Unit Admissions.","authors":"Zane J Hellmann, Shahyan Rehman, Leanne M Brown, Juan C Vasquez, Daniel G Solomon, Emily R Christison-Lagay","doi":"10.1002/pbc.31741","DOIUrl":"https://doi.org/10.1002/pbc.31741","url":null,"abstract":"<p><strong>Introduction: </strong>Gestational age, low birth weight, and overgrowth syndromes are associated with the diagnosis of hepatoblastoma. Previous studies have come to mixed conclusions regarding the contribution of other neonatal intensive care unit (NICU) exposures to hepatoblastoma development. We hypothesized that total parenteral nutrition (TPN) and mechanical ventilation during index NICU admission would correlate with the development of hepatoblastoma.</p><p><strong>Methods: </strong>The Pediatric Health Information System (PHIS) was queried for all infants admitted to the NICU with birthdates between 2016 and 2022. From this set, patients subsequently admitted to a PHIS hospital between 2016 and 2023 with a diagnosis code for hepatoblastoma were identified. Billing information was used to calculate the number of days of TPN and mechanical ventilation exposure during NICU hospitalization.</p><p><strong>Results: </strong>A total of 258,929 patients were included, with 51 patients diagnosed with hepatoblastoma. Patients with any duration of TPN (OR = 8.51, 95% CI 4.00-18.09) or mechanical ventilation (OR = 8.21, 95% CI 4.30-15.69) developed hepatoblastoma more frequently. Matched conditional logistic regression, on gestational age and birth weight, showed a significant increase in hepatoblastoma for each additional 10 days of TPN (OR = 1.25, 95% CI 1.06-1.50) and mechanical ventilation (OR = 1.21, 95% CI 1.06-1.39).</p><p><strong>Discussion: </strong>Leveraging the magnitude of the PHIS, we were able to demonstrate a significant relationship between the duration of exposure to both TPN and mechanical ventilation and the later diagnosis of hepatoblastoma. Although the PHIS lacks granularity in reporting clinical characteristics (e.g., mode and concentration of oxygen delivery and composition of TPN) of these common NICU interventions, future investigations should be directed at the role they may play in hepatoblastoma oncogenesis.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31741"},"PeriodicalIF":2.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036829","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":"Optic Nerve Sheath Meningiomas in Children: Diagnostic Challenges Based on a Case Series.","authors":"Deysha Ratnasingham, George Lawson, Harpreet Hyare, Sam Gurney, John Apps, Ian Reekie, Sucheta Vaidya, Carmen Soto, Kavitha Srivatsa, Jaroslaw Peregud-Pogorzelski, Andrzej Brodkiewicz, Owase Jeelani, Mette Jorgensen, Sarita Depani, Darren Hargrave, Elwira Szychot","doi":"10.1002/pbc.31739","DOIUrl":"https://doi.org/10.1002/pbc.31739","url":null,"abstract":"<p><p>The diagnosis of optic nerve sheath meningiomas (ONSM) in children and teenagers remains challenging despite advances in high-quality imaging. We identified seven children diagnosed with ONSM in four tertiary paediatric oncology centres in the United Kingdom. Our case series highlighted the value of PET-DOTATATE scans in assisting diagnosis when biopsy was considered high risk. Computed tomography (CT) scan may be useful for demonstrating calcification within the meningioma, a relatively specific finding occurring in 20%-50% of ONSM cases. Unfortunately, despite optimal treatment, vision loss is unavoidable in some patients. To improve outcomes, prompt consultation with a multidisciplinary team is recommended.</p>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":" ","pages":"e31739"},"PeriodicalIF":2.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049697","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}