Pediatric Research最新文献

{"title":"Cardiac adaptations to patent ductus arteriosus ligation in preterm infants: a speckle-tracking study.","authors":"Katsuaki Toyoshima, Hirosato Aoki, Takahiro Noguchi, Naka Saito, Tatsuto Shimizu, Gakuto Ujiie, Takahiro Kemmotsu, Yusuke Morita, Tomoyuki Shimokaze, Tomoko Saito, Jun Shibasaki, Motoyoshi Kawataki, Yurika Furukawa, Toshihide Asou, Tsuyoshi Tachibana, Satoshi Masutani","doi":"10.1038/s41390-025-04182-y","DOIUrl":"https://doi.org/10.1038/s41390-025-04182-y","url":null,"abstract":"<p><strong>Background: </strong>Understanding the complex cardiac adaptations following patent ductus arteriosus (PDA) ligation in preterm infants is essential for optimizing postoperative care. This study tested the hypothesis that left ventricular (LV), left atrial (LA) and right ventricular (RV) longitudinal strain are acutely impaired and then recover after PDA surgery in preterm infants.</p><p><strong>Methods: </strong>Thirty-two preterm infants who underwent PDA ligation (median gestational age: 25 weeks) were evaluated using speckle-tracking echocardiography to quantify LV, RV, and LA longitudinal strain before and at 4-8 and 24-48 h post-surgery. These data were compared with 36 preterm infants without PDA (non-PDA).</p><p><strong>Results: </strong>LV global longitudinal strain (LVGLS) was higher and RV free wall longitudinal strain (RVFWSL) was lower in the PDA group than in the non-PDA group preoperatively (both p < 0.01). In the non-PDA group, LVGLS and RVFWSL were -16% and -28%, respectively. In the PDA group, LVGLS at the three time points was -20%, -13%, and -15%, and RVFWSL was -21%, -21%, and -25%, respectively (all p < 0.05). LA reservoir strain (LASr) initially decreased and then increased.</p><p><strong>Conclusions: </strong>After PDA ligation, LVGLS and LASr transiently decrease then increase within 24-48 h, while RVFWSL normalizes without a decrease.</p><p><strong>Impact: </strong>Preoperatively, preterm infants with PDA had higher left ventricular global longitudinal strain (LVGLS), and lower right ventricular free wall strain (RVFWSL) than those without PDA. After PDA ligation, LVGLS and left atrial reservoir strain (LASr) initially decreased and then recovered within 24-48 h, while RVFWSL rapidly improved. Our findings indicate dynamic and different post-surgical cardiac adaptation in the right ventricle and left ventricle after PDA ligation.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668166","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":"Determinants of overweight and obesity and other cardiometabolic risks in adolescents: a Spanish longitudinal birth study.","authors":"Manuel Lozano, Jorge Vallejo-Ortega, Natalia Marín, Llúcia González-Safont, Ana Esplugues, Maria-Jose Lopez-Espinosa, Andrea Beneito, Sandra González-Palacios, Sabrina Llop, Raquel Soler-Blasco","doi":"10.1038/s41390-025-04273-w","DOIUrl":"10.1038/s41390-025-04273-w","url":null,"abstract":"<p><strong>Background: </strong>To assess the prenatal, early postnatal and adolescent factors associated with overweight/obesity (OwO) and other cardiometabolic risk factors at age 15.</p><p><strong>Methods: </strong>Longitudinal study based on 241 participants from the INMA-Valencia cohort. Z-scores of body mass index (zBMI), waist circumference (zWC), and waist-to-height ratio (WHtR), systolic and diastolic BP (zSBP and zDBP) were evaluated at ages 4, 7, 9, 11 and 15. A cardiometabolic risk score was calculated. Covariates were collected at pregnancy, birth, and age 15.</p><p><strong>Results: </strong>At age 4, 30.7% presented overweight/obesity (zBMI > 1 SD), increasing to 46.1% at age 9, and decreasing to 29.3% at age 15 (29.3%). The proportion of high/excess central adiposity was lower than overweight/obesity at all ages. Adjusted models showed that pre-pregnancy obesity was positively associated with all cardiometabolic outcomes, except zSBP (i.e. β [95% CI]: 0.77 [0.25, 1.29] for zBMI, and 2.31 [0.94, 3.69] for CMR score). Smoking during pregnancy was directly related to zSBP and zBMI. Adolescent physical activity was inversely associated with WHtR, zFM, zWC, zDBP and cardiometabolic risk scores (β -0.65 [95% CI -0.95, -0.36]). Cereal intake and processed meat consumption were positively related to WHtR, zBMI and zWC.</p><p><strong>Conclusion: </strong>Early modifiable factors impact adolescent cardiometabolic health. This information could improve preventive interventions and policies from very early.</p><p><strong>Impact: </strong>This longitudinal study shows how sociodemographic, clinical, and lifestyle factors influence adolescents' cardiometabolic health from very early stages of life until adolescence. Maternal characteristics, such as pre-gestational obesity or tobacco consumption during pregnancy, were directly associated with cardiometabolic risk factors in adolescence, such as BMI, percentage of fat mass, and diastolic blood pressure. Adolescents' intake of cereals, and processed meats, and consumption of less than five dairy meals, were positively related to an increase in cardiometabolic risk factors. Findings from this longitudinal study provide valuable insights for designing early-life interventions in prevention, health promotion, and adolescent health management.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668167","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":"Anti-inflammatory effects of Bifidobacterium infantis M-63 during the early postnatal period in term infants.","authors":"Chendong Xu, Toshitaka Odamaki, Akari Hiraku, Setsuko Nakata, Satoshi Arai, Noriyuki Iwabuchi, Miyuki Tanaka, Takahisa Tsuno, Masahiko Nakamura","doi":"10.1038/s41390-025-04263-y","DOIUrl":"10.1038/s41390-025-04263-y","url":null,"abstract":"<p><strong>Background: </strong>The administration of Bifidobacterium infantis M-63 during the early postnatal period enhances the abundance of gut Bifidobacterium, but its potential effects are still unexplored. The present study aimed to evaluate the impact of B. infantis M-63 on immunity, inflammation, gut-derived metabolites, and gut microbiota composition-based enterotypes in healthy infants.</p><p><strong>Methods: </strong>Fecal samples were collected from 111 healthy infants randomly administered 1.0 × 10⁹ CFU of B. infantis M-63 or placebo daily from 7 d to 3 months of age. Gut microbial composition characterization using 16S rRNA sequencing and genus-level enterotype clustering was performed. Fecal cytokine, metabolite, short-chain fatty acid, calprotectin, and secretory immunoglobulin A (sIgA) levels were measured.</p><p><strong>Results: </strong>Administering Bifidobacterium infantis M-63 significantly increased gut Bifidobacterium, whereas Enterobacteriaceae abundance and proinflammatory cytokine levels decreased. Six enterotypes were identified among the gut microbiota. In Bifidobacterium-dominant enterotypes, there was a significant increase in acetic acid and tryptophan metabolite levels, and a slight increase in sIgA levels. In contrast, levels of calprotectin and inflammatory cytokines were significantly reduced compared to those in the non-Bifidobacterium enterotypes.</p><p><strong>Conclusions: </strong>Bifidobacterium-dominant enterotypes, established in the gut after administration of B. infantis M-63, were strongly associated with anti-inflammatory effects in healthy infants.</p><p><strong>Impact: </strong>This is the first study to demonstrate an anti-inflammatory effect in healthy full-term infants supplemented with Bifidobacterium infantis M-63 alone. Bifidobacterium-dominant enterotypes were associated with reduced levels of inflammatory cytokines and calprotectin, and increased production of beneficial tryptophan metabolites, such as Indole-3-lactic acid (ILA). This study provides evidence that supplementation with B. infantis M-63 in infants may significantly reduce inflammation during the critical early postnatal period.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668165","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":"Oxygen therapy-related risk factors for aggressive retinopathy of prematurity in low-risk preterm neonates.","authors":"Hansang Lee, Jong Rok Oh, Junwon Lee, Min Kim, Eun Young Choi","doi":"10.1038/s41390-025-04276-7","DOIUrl":"https://doi.org/10.1038/s41390-025-04276-7","url":null,"abstract":"<p><strong>Background: </strong>Aggressive retinopathy of prematurity (A-ROP) poses a significant risk for visual impairment in preterm neonates, including those considered at low risk for ROP. Nonetheless, factors influencing A-ROP occurrence in low-risk preterm neonates remain underexplored. We aimed to identify oxygen therapy-related factors associated with A-ROP in this population.</p><p><strong>Methods: </strong>This retrospective case-control study included low-risk preterm neonates (gestational age ≥30 weeks and birth weight ≥1 kg) treated for ROP between January 2005 and May 2023 at two Korean hospitals. Patients were divided into A-ROP and staged ROP groups, and oxygen therapy-related factors were analyzed using logistic regression.</p><p><strong>Results: </strong>Of the 99 neonates included, 72% were diagnosed with A-ROP. No significant between-group differences were observed in the total duration of oxygen therapy or its delivery methods, except for non-invasive positive ventilation. Mean partial pressure of oxygen (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.89-0.99) and its fluctuation (OR, 1.09; 95% CI, 1.03-1.15) were significant risk factors for A-ROP, with cutoff values of <52.8% and >82.3%, respectively.</p><p><strong>Conclusion: </strong>Maintaining stable oxygen levels while avoiding hypoxia may help reduce the risk for A-ROP in low-risk neonates requiring ROP treatment. These findings may help refine oxygen therapy guidelines in neonatal care to improve A-ROP prevention in this population.</p><p><strong>Impact statement: </strong>Aggressive retinopathy of prematurity (A-ROP) can significantly threaten vision, even in preterm neonates considered at low risk for ROP. The contributing factors to A-ROP in this low-risk population have been insufficiently investigated. This study is the first to identify peripheral oxygen levels and their fluctuations as significant factors associated with A-ROP development in low-risk preterm neonates requiring treatment. These findings highlight the importance of maintaining stable oxygenation and preventing hypoxia to reduce the risk of A-ROP in this population.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668171","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":"Interventions for children and adolescents with specific learning disability and co-occurring disorders.","authors":"Daniel R Espinas, Sharon Vaughn, Lynn S Fuchs","doi":"10.1038/s41390-025-04261-0","DOIUrl":"https://doi.org/10.1038/s41390-025-04261-0","url":null,"abstract":"<p><p>Interventions for individuals with specific learning disabilities (SLD) largely focus on performance within a single performance domain (e.g., reading). However, it is more the rule than the exception that individuals with SLD will experience difficulties that span multiple domains (e.g., reading and mathematics), and that co-occur with other disorders (e.g., attention-deficit/hyperactivity disorder). In this article, we discuss what has been learned about supporting children and adolescents with SLD affecting multiple performance domains (i.e., reading and mathematics), and with common co-occurring difficulties with attention and anxiety. We also identify opportunities for future research for students with disabilities in math and reading and/or other disorders, e.g., attention-deficit/hyperactivity disorder. IMPACT: It is common for children and adolescents with specific learning disabilities in reading to present with co-occurring difficulties with mathematics, attention, and anxiety. Compared to children and adolescents whose difficulties are isolated to reading, those with co-occurring difficulties with mathematics, attention, and anxiety often present with more pronounced difficulties in each affected domain. Combined interventions (e.g., reading instruction and anxiety management) show promise for addressing co-occurring learning difficulties. Further research is needed to examine the efficacy and feasibility of interventions for children and adolescents with co-occurring difficulties.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668168","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":"Two sides of the same coin: distinguishing the role of fetal versus maternal placental pathology on brain injury of prematurity.","authors":"Jeffrey B Russ, Dawn Gano","doi":"10.1038/s41390-025-04299-0","DOIUrl":"https://doi.org/10.1038/s41390-025-04299-0","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668172","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":"Nutrition interventions in the first 1000 days and long-term health outcomes: a systematic review.","authors":"Anna Xu, Kathrin Guerlich, Berthold Koletzko, Veit Grote","doi":"10.1038/s41390-025-04215-6","DOIUrl":"https://doi.org/10.1038/s41390-025-04215-6","url":null,"abstract":"<p><strong>Background: </strong>Nutrition in early life can influence health in later life. This systematic review evaluated the impact of nutrition intervention programs in the first 1000 days of life on long-term cardio-metabolic, respiratory, and mental health and dietary behaviour in children.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) from high-income countries were searched in four databases and two trial registries in March 2020, and updated in November 2022. Risk of bias was evaluated using the Cochrane Risk of Bias tool and certainty of results using the GRADE considerations. Results were synthesized narratively.</p><p><strong>Results: </strong>Sixty-three articles covering 20 interventions were included. Most interventions began in early infancy (<6 months of age), lasted 12-36 months and had follow-ups under five years. Initial results showed some positive impact of interventions on cardio-metabolic health (three RCTs). No effect was found on mental health (four RCTs), while no RCT reported on respiratory health. Interventions showed some improvements on dietary behaviour, with mixed results across studies.</p><p><strong>Conclusion: </strong>Trials on early nutritional interventions seldom report health outcomes with long-term follow-ups. There is some evidence of a positive impact on cardio-metabolic health and dietary behaviour.</p><p><strong>Impact: </strong>In the assessed studies, nutritional interventions in the first 1000 days of life mainly had short follow-ups and reported heterogeneous outcomes. There was some evidence that nutritional interventions can improve children's dietary behaviour and cardio-metabolic health, while there was no effect on mental health. We provide a systematic review on the impact of early nutrition intervention programs on long-term health outcomes in children showing research gaps for intervention studies with long-term and clinically relevant outcomes. Understanding the effectiveness and implementation of early nutritional interventions provides insights for preventative population health and affects future intervention planning.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668170","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":"Neurodevelopmental risks of SARS-CoV-2 infection in utero.","authors":"Ariel Dunn, Atul Malhotra","doi":"10.1038/s41390-025-04301-9","DOIUrl":"https://doi.org/10.1038/s41390-025-04301-9","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668169","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":"Longer-term experiences of families of children with dextro-transposition of the great arteries: a qualitative study.","authors":"Karen J Eagleson, Theresa I Chin, Stephen Larmar, Robert N Justo, Nadine A Kasparian, Samudragupta Bora","doi":"10.1038/s41390-025-04201-y","DOIUrl":"https://doi.org/10.1038/s41390-025-04201-y","url":null,"abstract":"<p><strong>Background: </strong>Explore longer-term psychosocial adaptation to congenital heart disease among families of children with dextro-Transposition of the Great Arteries (d-TGA).</p><p><strong>Methods: </strong>In this qualitative study, semi-structured interviews were conducted for 16 families (16 mothers, 12 fathers, 9 siblings) and analyzed using an inductive thematic approach.</p><p><strong>Results: </strong>Key qualitative themes included parents reflecting \"back then\" when 1) navigating hospital and healthcare experiences, 2) challenges to psychosocial wellbeing and family functioning, and 3) coping and support needs were greatest. Parents described 4) key transitions and defining moments, and 5) feeling \"lucky\" and grateful for contemporary cardiac care and when compared to families of children with univentricular conditions and valuing a \"normal\" life. Furthermore, 6) the surgical scar served as a constant reminder of past experiences and 7) uncertainty about the role of the cardiac condition in their child's development persisted for some parents. Key themes among siblings included 1) having a \"normal\" family life, 2) positive and negative aspects of the sibling relationship, and 3) limitations in understanding their sibling's cardiac condition.</p><p><strong>Conclusion: </strong>Families of children with d-TGA value \"normal\" family lives years after surgical intervention. To improve care and support, a focus on positive psychosocial adaptation, including individual and family resilience, parental perceptions of surgical scars, and self-reported sibling experiences, is required.</p><p><strong>Impact: </strong>Families of children with complex congenital heart disease are at risk for psychosocial and family functioning difficulties. Research has focused on early experiences of diagnosis and hospitalization, with limited evidence of longer-term experiences. Using qualitative methodology, we explored the lived experiences of families of children with dextro-Transposition of the Great Arteries concerning longer-term psychosocial adaptation to congenital heart disease. Despite ongoing illness uncertainty and reminders of previous medical experiences, parents and siblings of children with dextro-Transposition of the Great Arteries predominantly described positive adaptation and living and valuing their \"normal\" family lives years after arterial switch operation.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659820","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":"Preterm functional outcomes are reflected in early postnatal proteome changes.","authors":"Magdalena Zasada, Maciej Suski, Natalia Łapińska, Weronika Pogoda, Aleksandra Kowalik, Marta Olszewska, Przemko Kwinta","doi":"10.1038/s41390-025-04227-2","DOIUrl":"10.1038/s41390-025-04227-2","url":null,"abstract":"<p><strong>Background: </strong>Advances in omics technologies have enabled precise analysis of protein abundance. This study applies such methods to investigate urinary proteomic quantitative changes associated with prematurity.</p><p><strong>Methods: </strong>Urine samples were collected from very-low-gestational-age (VLGA) infants (n = 29) without premature brain damage, as assessed using the Kidokoro scale and magnetic resonance imaging at term-equivalent age, and from full-term infants (n = 19) on the 1^st, 2^nd, 3^rd, 4^th, 6^th and 8^th days of life. SWATH-MS analysis of the urine proteome, combined with bioinformatics, was utilized for the identification of regulated urinary proteins and altered functional pathways.</p><p><strong>Results: </strong>We identified 61 proteins that were significantly differentially abundant in urine throughout the study. The regulated urinary proteins were enriched in functional domains related to the immune system, hemostasis, and complement and coagulation cascades, indicating underdevelopment in VLGA infants. Conversely, the augmented pathways included extracellular matrix organization, cholesterol metabolism and PPAR signaling.</p><p><strong>Conclusions: </strong>The urinary proteome of VLGA infants differed significantly from that of term neonates, revealing protein profiles linked to immune system immaturity and hemostasis, altered metabolism and perturbed extracellular matrix metabolism. This study underscores how prematurity affects the urinary proteome, offering insights into the molecular pathways influenced by premature birth.</p><p><strong>Impact: </strong>The urinary proteome of premature newborns differs from the urinary proteome of full-term newborns; analysis of urine proteins indicates the functional consequences of prematurity. In our study, we tested urine on the 1^st, 2^nd, 3^rd, 4^th, 6^th and 8^th days of life, which increased the reliability of the data. Examination of the urinary proteome at the first week of life allows us to demonstrate the functional consequences of prematurity. Category of study: basic science.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659821","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}