{"title":"Prednisolone impairs trabecular bone score changes in adolescents with 21-hydroxylase deficiency.","authors":"Pattara Wiromrat, Yutapong Raruenrom, Phanpaphorn Namphaisan, Nantaporn Wongsurawat, Ouyporn Panamonta, Chatlert Pongchaiyakul","doi":"10.3345/cep.2024.01060","DOIUrl":"10.3345/cep.2024.01060","url":null,"abstract":"<p><strong>Background: </strong>Individuals with 21-hydroxylase deficiency (21OHD) require lifelong glucocorticoid (GC) therapy, which increases their risk of fragility fractures. However, fractures in GC-treated individuals can occur at normal bone mineral density (BMD) levels, suggesting an alteration in the bone microarchitecture.</p><p><strong>Purpose: </strong>To evaluate trabecular bone microarchitecture and its changes in adolescents with 21OHD.</p><p><strong>Methods: </strong>We enrolled 38 adolescents with 21OHD for whom complete clinical data and baseline and follow-up lumbar spine BMD (LSBMD) measurements were available. The mean duration was 1.5±0.6 years. Trabecular bone score (TBS), an indirect measurement of bone microarchitecture, was analyzed using iNsight software version 3.0. Impaired BMD and TBS were defined as z scores ≤ -1.5.</p><p><strong>Results: </strong>At baseline, participants (55% female; 68% salt- wasting type; mean age, 15.2±3.8 years; bone age, 17.5± 2.8 years; mean GC dose, 18.5±6.5 mg/m2/day) had the prevalence of impaired BMD and TBS of 5% and 18%, respectively. During follow-up, adolescents with 21OHD receiving prednisolone showed a lower annual percentage change in TBS than those who received hydrocortisone (P=0.028). A stepwise regression analysis showed that body mass index percentile (P<0.001) and testosterone concentration (P=0.002) were independent positive predictors of the baseline TBS z score, whereas prednisolone use was the only negative predictor of the annual percentage change in TBS (P=0.002).</p><p><strong>Conclusion: </strong>Adolescents with 21OHD have a high prevalence of impaired bone microarchitecture. Furthermore, prednisolone therapy is associated with impaired bone microarchitecture development, suggesting that hydrocortisone may better preserve bone microarchitecture and should be considered the first-line treatment for this population.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"238-246"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Meng-Ju Melody Tsai, Jung-Chi Chang, Heng-Yu Lu, Susan Shur-Fen Gau, Yin-Hsiu Chien, Wuh-Liang Hwu, Yen-Hsuan Ni, Huey-Ling Chen, Ni-Chung Lee
{"title":"Long-term follow-up of neurocognitive function in patients with citrin deficiency and cholestasis.","authors":"Meng-Ju Melody Tsai, Jung-Chi Chang, Heng-Yu Lu, Susan Shur-Fen Gau, Yin-Hsiu Chien, Wuh-Liang Hwu, Yen-Hsuan Ni, Huey-Ling Chen, Ni-Chung Lee","doi":"10.3345/cep.2024.01102","DOIUrl":"10.3345/cep.2024.01102","url":null,"abstract":"<p><strong>Background: </strong>Citrin deficiency is a rare metabolic disorder prevalent in East and Southeast Asia that affects liver or neurological function throughout various life stages. While early diagnosis and dietary management can improve prognosis for infant onset disease, data on long-term neurocognitive outcomes is scarce.</p><p><strong>Purpose: </strong>This study aimed to clarify whether transient metabolic disturbances during early childhood have a lasting effect on the neurocognitive function of individuals with citrin deficiency.</p><p><strong>Methods: </strong>Thirty patients diagnosed with citrin deficiency prior to 1 year of age underwent neuropsychological assessments including attention deficit/hyperactivity disorders (ADHD) and intelligence quotient (IQ). We compared the peak laboratory values during infancy between children who were versus were not later diagnosed with ADHD.</p><p><strong>Results: </strong>Neurocognitive assessments of 30 individuals with citrin deficiency aged 3-25 years revealed that full-scale IQ scores were normally distributed. Of this cohort, 47% (14 of 30) were diagnosed with ADHD: 6, 6, and 2 with the combined, inattentive, and hyperactive-impulsive types, respectively. This prevalence was higher than that in the general population (1.7%-16%). Moreover, a one-unit increase in ammonia levels before 1 year of age was associated with a 1.023-fold increase in the likelihood of future hyperactivity-impulsivity symptoms (P=0.038; 95%confidence interval, 1.001-1.046). Despite these findings, this long-term follow-up of individuals with citrin deficiency indicated that it had minimal impact on neurocognitive function, allowing for a generally normal life.</p><p><strong>Conclusion: </strong>Patients with a history of cholestasis caused by citrin deficiency during infancy have a greater incidence of ADHD than the general population, suggesting that metabolic disturbances during early childhood in individuals with citrin deficiency may have a long-term negative impact on their neurocognitive function.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"257-265"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Practical concepts and strategies for early diagnosis and management of eosinophilic gastrointestinal disorders in East-Asian children.","authors":"Byung-Ho Choe","doi":"10.3345/cep.2024.01165","DOIUrl":"10.3345/cep.2024.01165","url":null,"abstract":"<p><p>Eosinophilic gastrointestinal disorders (EGIDs) are emerging as significant concerns in the Korean pediatric population and transitioning from rare to more commonly diagnosed conditions. This review discusses the increasing prevalence of EGID among children and adolescents and highlights the complexities involved in its diagnosis and management. This review begins with a thorough examination of the diverse clinical presentations of EGIDs in Korean children, with a special focus on common gastrointestinal symptoms such as abdominal pain, diarrhea, and bloody stool. Additionally, we explored extraintestinal manifestations, including growth failure, malnutrition, and associated allergic comorbidities, highlighting their importance in the clinical landscape of EGIDs. Because of its subtle and overlapping symptoms with those of other gastrointestinal disorders, EGID is frequently underdiagnosed. Addressing this challenge requires maintaining a high index of suspicion and employing a comprehensive diagnostic approach to differentiating EGID from functional gastrointestinal disorders and other inflammatory or systemic diseases such as inflammatory bowel disease. The optimal management of EGID requires a collaborative multidisciplinary strategy that includes dietary management, regular monitoring, and tailored medical interventions. This review emphasizes the importance of proactive patient and caregiver education and regular follow-ups to improve long-term outcomes in affected children. Enhanced awareness among healthcare providers and better educational resources for families are critical for the early identification and effective management of EGID among pediatric patients.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"185-198"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pornthep Tanpowpong, Suporn Treepongkaruna, James Guoxian Huang, Kee Seang Chew, Karen Sophia Calixto Mercado, Almida Reodica, Shaman Rajindrajith, Wathsala Hathagoda, Yoko Kin Yoke Wong, Way Seah Lee, Marion Margaret Aw
{"title":"Outcome of pediatric inflammatory bowel disease in Asian children: a multinational 1-year follow-up study.","authors":"Pornthep Tanpowpong, Suporn Treepongkaruna, James Guoxian Huang, Kee Seang Chew, Karen Sophia Calixto Mercado, Almida Reodica, Shaman Rajindrajith, Wathsala Hathagoda, Yoko Kin Yoke Wong, Way Seah Lee, Marion Margaret Aw","doi":"10.3345/cep.2024.01144","DOIUrl":"10.3345/cep.2024.01144","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological data on pediatric inflammatory bowel disease (PIBD) have been reported in Asian countries. However, short-term follow-up data, especially in Southeast Asian countries, are limited.</p><p><strong>Purpose: </strong>Analyze and compare the baseline and 1-year follow-up (1FU) data for PIBD in Asian children.</p><p><strong>Methods: </strong>The multinational network included patients with PIBD (aged <19 years) in 5 Asian countries (Malaysia, Philippines, Singapore, Sri Lanka, and Thailand). The diagnosis of PIBD requires gastrointestinal endoscopy. The patients' demographics, clinical information, disease- related outcomes, and treatment data at 1FU were collected.</p><p><strong>Results: </strong>In 1995-2021, 368 patients were enrolled (Crohn disease [CD], 56.8%; ulcerative colitis [UC], 38%; and inflammatory bowel disease [IBD]-unclassified, 5.2%). At 1FU, symptoms including diarrhea, bloody stools, and nausea/vomiting subsided in <3%, while abdominal pain persisted in 10.5% of patients with CD and 7.1% of patients with UC. Assessment endoscopy was performed at 1FU in 38% of CD and 31% of UC cases, of which 21% and 23% showed mucosal healing, respectively. Oral prednisolone was administered to 55.3% of patients at diagnosis and 26.8% at 1FU, while infliximab was administered to 2.5% and 7.2% of patients at diagnosis and 1FU, respectively. Independent factors of 1-year clinical remission for CD were oral prednisolone (odds ratio [OR], 0.20; 95% confidence interval [CI], 0.06-0.68), antibiotic use (OR, 0.09; 95% CI, 0.01-0.54), and immunomodulator use (OR, 5.26; 95% CI, 1.52-18.22). A history of weight loss at diagnosis was the only independent risk factor of an IBD flare by 1FU (OR, 2.01; 95% CI, 1.12-3.63).</p><p><strong>Conclusion: </strong>The proportion of children with PIBD and abdominal pain at 1FU remained high. The rates of repeat endoscopy and infliximab use were suboptimal with high rates of systemic corticosteroid use. Quality improvement based on the aforementioned predictors may enhance PIBD care in this geographic region or similar settings.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"247-256"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hidden link between endocrine-disrupting chemicals and pediatric obesity.","authors":"Min Won Shin, Shin-Hye Kim","doi":"10.3345/cep.2024.00556","DOIUrl":"10.3345/cep.2024.00556","url":null,"abstract":"<p><p>The increasing prevalence of pediatric obesity has emerged as a significant public health concern. Among various contributing factors, exposure to endocrine-disrupting chemicals (EDCs) has gained recognition for its potential role. EDCs, including bisphenols, phthalates, per- and polyfluoroalkyl substances, polycyclic aromatic hydrocarbons, and organochlorines, disrupt hormonal regulation and metabolic processes, contributing to alterations in fat storage, appetite regulation, and insulin sensitivity. This study offers a comprehensive review of the current research linking EDC exposure to pediatric obesity by integrating the findings from experimental and epidemiological studies. It also addresses the complexities of interpreting this evidence in the context of public health, highlighting the urgent need for further research.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"199-222"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of total serum bilirubin thresholds for discontinuing phototherapy in jaundiced neonates: a randomized study.","authors":"Nidhi Jain, Ajay Kumar","doi":"10.3345/cep.2024.01249","DOIUrl":"https://doi.org/10.3345/cep.2024.01249","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the outcomes of jaundiced neonates using two different total serum bilirubin (TSB) thresholds for discontinuing phototherapy.</p><p><strong>Purpose: </strong>The study aims to evaluate the outcomes of jaundiced neonates by comparing two different total serum bilirubin (TSB) thresholds for discontinuing phototherapy.</p><p><strong>Methods: </strong>All consecutive jaundiced neonates in a tertiary care hospital with a gestational age of ≥35 weeks and ≥3 days postnatal age were randomly assigned to two groups.</p><p><strong>Results: </strong>Eighty neonates were included. The mean ± standard deviation TSB at the time of phototherapy discontinuation was 13.1 ± 2.2 mg/dL in the recommended threshold group and 10.5 ± 2.5 mg/dL in the low threshold group. After discontinuing phototherapy, 17 infants in the recommended threshold group and 21 in the low-threshold group experienced an increased TSB, with three and nine crossing the treatment threshold, respectively. Following the National Institute for Health and Clinical Excellence (NICE) guidelines, there was a 14.3% increase in the reinstitution of treatment, averaging 28.11 h with no reported adverse outcomes.</p><p><strong>Conclusion: </strong>Discontinuation of phototherapy in neonates led to increased total serum bilirubin levels, with a reinstitution rate of 14.3%. While adherence to the NICE guidelines is important, careful post-treatment monitoring is essential. Incorporating the 2022 American Academy of Pediatrics guidelines into future research could provide a more comprehensive understanding of safe practices in this area.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nagwan Saleh, Wafaa Abo El Fotoh, Mona Habib, Salem Deraz
{"title":"Serum amyloid A and proadrenomedullin as early markers in critically ill children with sepsis.","authors":"Nagwan Saleh, Wafaa Abo El Fotoh, Mona Habib, Salem Deraz","doi":"10.3345/cep.2024.01928","DOIUrl":"https://doi.org/10.3345/cep.2024.01928","url":null,"abstract":"<p><strong>Background: </strong>Pro-adrenomedullin (pro-ADM), the most stable part of ADM, serves as an indirect marker of ADM levels. Serum amyloid A (SAA) is a protein produced primarily in the liver during acute inflammation.</p><p><strong>Purpose: </strong>To assess the role of SAA and pro-ADM, individually and in combination, as diagnostic and prognostic markers in pediatric sepsis.</p><p><strong>Methods: </strong>This prospective case-control cohort study included 65 critically ill children admitted to the pediatric intensive care unit (PICU) and 31 controls. The study grouped the cases by confirmed diagnosis of sepsis, severe sepsis, or septic shock. All children included in this study underwent PICU scoring, routine laboratory investigations, and specific serum biomarker assessments (SAA and pro-ADM).</p><p><strong>Results: </strong>The mean SAA and pro-ADM levels were significantly higher in the patients versus controls. Both markers were elevated in patients with sepsis, with even higher levels observed in those with severe sepsis and septic shock. SAA demonstrated greater sensitivity for predicting mortality than pro-ADM (61% vs. 52%, respectively). When used together, the sensitivity of the two tests for predicting mortality increased to 70%. The two tests exhibited fair specificity (57%).</p><p><strong>Conclusion: </strong>SAA and pro-ADM are promising biomarkers for diagnosing and predicting outcomes of pediatric sepsis.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eman Salah Eldeen Arafat, Hasnaa Hesham Abotaleb, Dina Abdel Razek Midan, Abdel Hamid Abdo Ismail, Zeinab Abouzouna
{"title":"Role of microRNA-498 and microRNA-410 in neonatal hypoxic ischemic encephalopathy.","authors":"Eman Salah Eldeen Arafat, Hasnaa Hesham Abotaleb, Dina Abdel Razek Midan, Abdel Hamid Abdo Ismail, Zeinab Abouzouna","doi":"10.3345/cep.2024.01669","DOIUrl":"https://doi.org/10.3345/cep.2024.01669","url":null,"abstract":"<p><strong>Background: </strong>Neonatal asphyxia is the primary cause of hypoxic-ischemic encephalopathy (HIE), a condition characterized by hypoxic and ischemic brain damage. A class of short noncoding RNAs known as microRNAs (miRNAs) have significant regulatory functions, can function as diagnostic and developmental indicators of diseases, and are involved in disease pathophysiology.</p><p><strong>Purpose: </strong>To study the role of microRNA-410 and microRNA-498 in neonatal HIE as well as control and prevention of neonatal encephalopathy.</p><p><strong>Methods: </strong>A case-control study was performed of on 30 full term neonates with proven HIE, and 30 clinically healthy full-term neonates with no evidence of HIE matched for age and sex serving as controls. The expression of microRNA-498 and microRNA-410 were measured using quantitative real-time polymerase chain reaction.</p><p><strong>Results: </strong>Levels of miRNA-410 and miRNA-498 were higher in cases versus controls (1.56 ± 6.43 copies/ml vs 0.58 ± 0.60 copies/ml) and (55.63 ± 118.24 copies/ml vs3.74 ± 7.09 copies/ml), respectively. Of the cases, 66.7% were discharged cases and 33.3% died. Overall miRNA-410 had a sensitivity of 70%, specificity of 60%, and cut-off point of ≤0.242, whereas miRNA-498 had a sensitivity of 70%, specificity of 66.7%, and cut-off point >1.854.</p><p><strong>Conclusion: </strong>These findings suggest that miRNA-498 and miRNA-410 can be auxiliary diagnostic and prognostic tools for neonatal HIE.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Characterization of gut microbiota in very low birth weight infants with versus without bronchopulmonary dysplasia.","authors":"Anucha Thatrimontrichai, Manapat Praditaukrit, Gunlawadee Maneenil, Supaporn Dissaneevate, Kamonnut Singkhamanan, Komwit Surachat","doi":"10.3345/cep.2024.01718","DOIUrl":"https://doi.org/10.3345/cep.2024.01718","url":null,"abstract":"<p><strong>Background: </strong>Gut-lung crosstalk is a pathway involving interactions between the gastrointestinal, respiratory, and immune systems. The immune responses of the gut and lungs are intricately linked, and previous studies demonstrated that the gut microbiota can influence systemic immune responses in the respiratory system as well as bronchopulmonary dysplasia (BPD).</p><p><strong>Purpose: </strong>To analyze the composition of the gut microbiota in very low birth weight infants with versus without BPD.</p><p><strong>Methods: </strong>Secondary data from a previous randomized controlled trial were analyzed. Microbiomes were analyzed using QIIME 2 software. Gut microbiota diversity and abundance were compared between groups.</p><p><strong>Results: </strong>Fifty-one neonates were classified into the BPD (n=24) and non-BPD (n=27) groups, between which no differences were noted in the alpha and beta diversities of the gut microbiota. In both groups, Proteobacteria, Gammaproteobacteria, and Klebsiella were the predominant phyla, class, and genus in gut microbiota, respectively. Enterococcus, Acinetobacter, Elizabethkingia, Clostridium sensu stricto 1, Bacteroides, Streptococcus, and Serratia were more abundant, whereas Klebsiella, Faecalibacterium, Escherichia-Shigella, Enterobacter, Bifidobacterium, Veillonella, Staphylococcus, and Enterobacteriaceae were less abundant in the BPD versus non-BPD group. Faecalibacterium, Roseburia, Clostridium, Eubacterium, and Coprococcus were significantly more abundant in the non-BPD versus BPD group.</p><p><strong>Conclusion: </strong>The alpha and beta diversities of the gut microbiota did not differ significantly between the BPD and non-BPD groups. However, in terms of relative abundance, the presence of common respiratory pathogens was notable in the BPD group. Conversely, the non-BPD group had a significantly higher prevalence of anaerobic taxa known for their capacity to produce butyrate, a key component of postbiotics. Clinical Trial Registration: This trial was prospectively registered at Thai Clinical Trials (https://www.thaiclinicaltrials.org/export/pdf/TCTR20180306002; first posted registration: March 6, 2018).</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}