Clinical and Experimental Pediatrics最新文献

{"title":"Prognostic role of midregional proadrenomedullin in predicting infection in pediatric cancer with febrile neutropenia.","authors":"Seham Ragab, Sara El-Deeb, Ahmed Saeed, Asmaa Mahmoud","doi":"10.3345/cep.2024.01620","DOIUrl":"https://doi.org/10.3345/cep.2024.01620","url":null,"abstract":"<p><strong>Background: </strong>Febrile neutropenia (FN) remains an important complication of cytotoxic chemotherapy for which an urgent and appropriate evaluation is imperative.</p><p><strong>Purpose: </strong>To assess the diagnostic and prognostic roles of mid-regional pro-adrenomedullin (MR-ProADM) levels in predicting infection in patients with FN.</p><p><strong>Methods: </strong>This comparative cross-sectional study included 137 patients with chemotherapy-induced FN. Complete blood count, C-reactive protein (CRP), procalcitonin, and MR-ProADM were evaluated on the 1st day of FN. Chest computed tomography (CT) was performed on the 5th day.</p><p><strong>Results: </strong>MR-ProADM levels were significantly higher in patients with FN than in controls. CRP and MR-ProADM levels were significantly higher and ANC was significantly lower in patients with versus without bacterial infections. CRP, procalcitonin, and MR-ProADM levels were significantly negatively correlated with absolute neutrophil count (ANC). CRP, procalcitonin, and MR-ProADM levels were significantly and positively correlated with FN degree, FN duration, and hospital stay length. A multivariate regression analysis showed that a longer FN duration and hospital stay length, along with elevated CRP, procalcitonin, and MR-ProADM levels, were significant risk factors for mortality.</p><p><strong>Conclusion: </strong>MR-ProADM is a reliable prognostic and diagnostic tool for predicting infection in patients with FN.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984915","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":"Short-term outcomes of oropharyngeal administration of colostrum in preterm neonates: a double-blind placebocontrolled randomized trial.","authors":"Ameneh Lamsehchi, Maryam Shokouhi Solgi, Mohammad Kazem Sabzehei, Behnaz Basiri, Elahe Talebi Ghane, Kiana Kimiaei Asadi, Sina Azadnajafabad","doi":"10.3345/cep.2024.00591","DOIUrl":"10.3345/cep.2024.00591","url":null,"abstract":"<p><strong>Background: </strong>The oropharyngeal administration of colostrum (OAC) in neonates has several benefits.</p><p><strong>Purpose: </strong>To investigate the short-term outcomes of OAC in preterm neonates.</p><p><strong>Methods: </strong>We performed this 2-arm, double-blind, placebo-controlled randomized trial at a tertiary neonatal center in Iran in 2021-2023. The intervention and control arms received 0.2 mL of their mother's colostrum or distilled water via oropharyngeal administration every 6 hours for 3 days starting from birth until 72 hours of age. The main study outcomes were neonatal death, the incidence of necrotizing enterocolitis, sepsis, retinopathy of prematurity (ROP), length of hospital stay, and period to full enteral feeding. A regression analysis was used to adjust for possible confounders.</p><p><strong>Results: </strong>A total of 126 neonates (mean gestational age, 30.05 weeks) were randomized to the intervention and placebo groups (n=63 each) and had a mean±standard deviation weight of 1,247±193 g versus 1,156±215 g (P=0.013) and 1- and 5-min Apgar scores of 6.35 versus 5.38 (P=0.003) and 7.84 versus 7.13 (P=0.001), respectively. The mortality rate was 12.7% in the intervention group versus 14.3% in the placebo group (P=0.794). The necrotizing enterocolitis rate was significantly lower in the intervention versus placebo arm (11.1% vs. 28.6%, respectively, P=0.010), as was the clinically suspected sepsis rate (15.9% vs. 39.7%, respectively, P=0.004). The ROP and bronchopulmonary dysplasia rates did not differ significantly between groups after the adjustment for confounders. The mean length of hospital stay was shorter in the intervention group (26.1 days vs. 37.32 days, P=0.023). Moreover, the mean duration of antibiotic therapy and period to full feeding were significantly shorter in the intervention group.</p><p><strong>Conclusion: </strong>OAC could effectively decrease the incidence of complications in preterm infants and facilitate earlier patient discharge.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"73-79"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559028","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":"Adolescent hypertension and carotid intima-media thickness: significance of submillimetric differences.","authors":"Christian Saleh","doi":"10.3345/cep.2024.01466","DOIUrl":"10.3345/cep.2024.01466","url":null,"abstract":"","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"104-105"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751887","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":"Global trends in importance of 24-hour movement behaviors to pediatric health: implications for South Korea.","authors":"Eun-Young Lee, Reyana Jayawardena, Seiyeong Park, Justin Y Jeon, Yeon-Soo Kim, Mark S Tremblay","doi":"10.3345/cep.2024.00178","DOIUrl":"10.3345/cep.2024.00178","url":null,"abstract":"<p><p>Cultivating a 24-hour movement behavioral profile conducive to health and well-being, marked by adequate levels of physical activity, limited screen time, and sufficient sleep, has emerged as an important avenue for promoting pediatric health. We aimed to provide evidence of this potential, this multiphase, multimethod, and integrative review comprehensively investigated the global trends in health promotion initiatives and status of the Korean pediatric population. This integrative review comprised 3 phases employing various review methods: an environmental scan of existing guidelines for 24-hour movement behaviors worldwide, a rapid review of physical activity-related indicators from Global Matrix data, and a systematic review of 24-hour movement behaviors among children and adolescents in South Korea. The growing recognition of a holistic approach to the 24-hour movement behavior paradigm in pediatric health promotion has led to the establishment and adoption of 24-hour movement guidelines in different countries and by the World Health Organization (WHO). Korean health authorities have also responded to this need by releasing a translated report of the WHO guidelines for physical activity and sedentary behavior as well as the 2024 update of the Physical Activity Guidelines for Koreans. Accordingly, actions must be followed in policy, research, and practice. This is critical considering that Korean children and adolescents exhibit an unfavorable profile of 24-hour movement behaviors compared to the global average. Among those aged 0-6 years, the weighted averages for guideline adherence were 18.2% for physical activity, 38.1% for sedentary behavior, and 76.2% for sleep. For those aged 12-18 years, the weighted averages for guideline adherence were 20.4% for physical activity, 55.9% for sedentary behavior, and 26.2% for sleep. Building on these current findings, this integrative review provides 3 priorities for pediatric health promotion policy and practice and 3 recommendations for future research.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"16-29"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629552","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":"A review of vitamin D deficiency and vitamin D receptor polymorphisms in endocrine-related disorders.","authors":"Nur Faten Hafizah Rosli, Noor Shafina Mohd Nor, Rose Adzrianee Adnan, Siti Hamimah Sheikh Abdul Kadir","doi":"10.3345/cep.2024.00227","DOIUrl":"10.3345/cep.2024.00227","url":null,"abstract":"<p><p>The endocrine system is a complex network of glands that produce and release hormones that regulate various physiological processes. In the past few decades, the human skin has been identified as an important peripheral endocrine organ that is the main site for the synthesis of vitamin D through exposure to sunlight. Mutations in downstream vitamin D-related gene pathways are associated with disease development. The vitamin D receptor (VDR) gene, which regulates the pleiotropic effects of vitamin D, has been extensively studied in adult populations. Several studies have reported the prevalence of vitamin D deficiency in children and adolescents. With changes in socioeconomic status and lifestyle, vitamin D-deficient individuals are prone to developing the disease at a young age. However, geographical and racial differences affect the association between VDR gene polymorphisms and vitamin D endocrine disorders, explaining the nonconsensus effects of polymorphisms and their association with disease development across populations. In this review, we discuss the connection between the vitamin D endocrine system and polymorphisms in the gene encoding VDR in children and adolescents, focusing on its effects on growth, puberty, insulin resistance, and the immune system.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"30-52"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629570","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":"Instability of revised Korean Developmental Screening Test classification in first year of life.","authors":"Ji Eun Jeong, You Min Kim, Na Won Lee, Gyeong Nam Kim, Jisuk Bae, Jin Kyung Kim","doi":"10.3345/cep.2024.00619","DOIUrl":"10.3345/cep.2024.00619","url":null,"abstract":"<p><strong>Background: </strong>Early development is characterized by considerable variability.</p><p><strong>Purpose: </strong>This study aimed to examine the stability of developmental classifications using the revised Korean Developmental Screening Test (K-DST) in healthy term infants aged 4-6 and 10-12 months.</p><p><strong>Methods: </strong>Data were obtained from the Korean Children's Environmental Health Study, a nationwide prospective birth cohort. Sixty-nine healthy term infants (26 boys, 43 girls) underwent serial K-DST assessments at 4-6 and 10-12 months of age, between August 2017 and December 2019.</p><p><strong>Results: </strong>At 4-5 months, over 50% of infants were categorized in the ≥-1 standard deviation (SD) group, with the lowest prevalence in the gross motor domain (52.7%). Seven infants (10.1%) scored below -2 SD in at least one domain, most commonly in gross and fine motor domains (7.3%). At 10-12 months, over 70% of infants scored in the ≥-1 SD group, except in the language domain. Six infants (9.5%) scored below -2 SD in at least one domain, (cognition 4.8%, language 3.2%, gross motor 3.2%). Serial follow-up showed significant improvement, with many infants moving to the ≥-1 SD group, particularly in the gross motor domain (33.3%). Of the seven infants scoring below -2 SD at 4-5 months, only two remained in this category at 10-12 months.</p><p><strong>Conclusion: </strong>Infants scoring below -2 SD on the revised K-DST 4-5 months questionnaire, especially in the gross motor domain, should undergo close monitoring and repeated evaluations in the absence of neurological abnormalities or developmental red flags.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"97-103"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629663","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":"Microplastic and human health with focus on pediatric well-being: a comprehensive review and call for future studies.","authors":"Rogers Wainkwa Chia, Ntegang Venant Atem, Jin-Yong Lee, Jihye Cha","doi":"10.3345/cep.2023.01739","DOIUrl":"10.3345/cep.2023.01739","url":null,"abstract":"<p><p>Although humans are highly dependent on plastics from infancy to adolescence, these materials can degrade into ubiquitous microplastics (MPs) that affect individuals at every stage of life. However, information on the sources, mechanisms, detection techniques, and detrimental effects of MPs on children's health from infancy to adolescence is limited. Hence, here we identified and reviewed original research papers published in 2017-2023 across 11 database categories in PubMed, Google Scholar, Scopus, and Web of Science to improve our understanding of MPs with a focus on pediatric well-being. These studies found that milk and infant formulas are common sources of MP exposure in infants. Infant formula is the dominant source of MPs in babies, while plastic toys are a common source of MPs in toddlers. Adolescents are frequently exposed to MPs through the consumption of food contaminated with MPs and the use of plastics in food packaging. Water and air are sources of MP exposure in children from infancy through adolescence. This study thoroughly summarized how MP exposure in children of all ages causes cell damage and leads to adverse health effects such as cancer. With appropriate authorization from the relevant authorities, small amounts of human biological samples (10 g of feces) were collected from volunteers to assess the amounts of MPs in children with the aim of promoting pediatric well-being. The samples were then treated with Fenton's reagent, stored in glass jars, and filtered through nonplastic filters. Finally, MPs in children were quantified using stereomicroscopy and characterized using micro-Fourier transform infrared spectroscopy.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"1-15"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629749","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":"Need for national guidance regarding proactive care of infants born at 22-23 weeks' gestation.","authors":"Ga Won Jeon","doi":"10.3345/cep.2024.01277","DOIUrl":"10.3345/cep.2024.01277","url":null,"abstract":"<p><p>With recent rapid improvements in neonatal intensive care, the limit of viability has shifted downward to 22-23 weeks' gestation. The younger the gestational age of preterm infants, the higher the risk of survival despite severe neurodevelopmental impairments. For infants born at 22-23 weeks' gestation, the limit of viability, neurodevelopmental outcomes, and survival rates may be determined by the quality of proactive care. Owing to the high risk of severe neurodevelopmental impairment in 22-23 weeks' gestation, proactive care is sometimes withheld according to ethical or legal considerations, and there are significant differences in the provision of proactive care and survival rates across countries or institutions. Additionally, there are differing or even lacking guidelines regarding the care of these infants across countries and institutions. Japan and Sweden are countries with well-established national guidance and proactive care for infants born at 22-23 weeks' gestation, resulting in higher survival rates among them. In Korea, where there is an extreme shortage of neonatologists, maternal transfer before delivery at 22-23 weeks' gestation to high-activity regions with appropriate neonatal intensive care unit resources, such as adequate personnel and facilities similar to the centralized care model seen in Sweden, is crucial for improving the survival rates of infants born at 22-23 weeks' gestation. The survival of these infants largely depends on the quality of proactive care provided. This rate is not static and can be improved through proactive care based on national guidance and the implementation of enhanced neonatal intensive care practices, including centralization of care.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"53-61"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629753","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":"Polysomnographic features of children with obesity: body mass index predict severe obstructive sleep apnea in obese children?","authors":"Rungrat Sukharom, Prakarn Tovichien, Kanokporn Udomittipong, Pinyapach Tiamduangtawan, Wattanachai Chotinaiwattarakul","doi":"10.3345/cep.2024.00066","DOIUrl":"10.3345/cep.2024.00066","url":null,"abstract":"<p><strong>Background: </strong>Few studies have explored the polysomnographic features of children with obesity.</p><p><strong>Purpose: </strong>This study aimed to explore the demographic and polysomnographic features of obese children and determine whether body mass index (BMI) could predict severe obstructive sleep apnea (OSA).</p><p><strong>Methods: </strong>This cross-sectional study recruited obese children who underwent diagnostic polysomnography between January 2019 and March 2022. We explored demographic and anthropometric measures as well as polysomnographic abnormalities among them. We used receiver operating characteristic curves and logistic regression analyses to determine the optimal cutoff values of anthropometric variables for predicting severe OSA.</p><p><strong>Results: </strong>A total of 132 children with obesity (76.5% male; mean age, 12.5±3.2 years) were included. Severe OSA was identified in 64 children (48.5%). Desaturation was observed in 59.8%, while 23.5% had hyperarousal, 20.5% had sleep-related hypoventilation, 60.6% had positional OSA, 40.2% had rapid eye movement-related OSA, and 5.0% had obesity hypoventilation syndrome. Among them, BMI (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.05-1.17; P<0.001), neck circumference (OR, 1.15; 95% CI, 1.07-1.25; P<0.001), and waist circumference (OR, 1.04; 95% CI, 1.02- 1.07; P=0.001) were significantly associated with severe OSA. These findings suggest a cutoff BMI for predicting severe OSA of greater than 29.2 kg/m2 with 81.3% sensitivity and 48.5% specificity.</p><p><strong>Conclusion: </strong>Severe OSA is common in children with obesity; thus, we recommend screening children with obesity and a BMI greater than 29.2 kg/m2 for severe OSA.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"80-90"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629761","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":"Carbapenem resistance in gram-negative pathogens in an Iranian hospital: high prevalence of OXA-type carbapenemase genes.","authors":"Setareh Mamishi, Reihaneh Hosseinpour Sadeghi, Sadaf Sajedi Moghaddam, Babak Pourakbari, Shiva Poormohammadi, Maryam Sotoudeh Anvari, Shima Mahmoudi","doi":"10.3345/cep.2023.01774","DOIUrl":"10.3345/cep.2023.01774","url":null,"abstract":"<p><strong>Background: </strong>The widespread dissemination of carbapenem- resistant gram-negative bacteria poses a significant threat to global public health.</p><p><strong>Purpose: </strong>This study aimed to investigate the prevalence of carbapenem resistance in gram-negative bacteria isolated from patients at the Children's Medical Center Hospital, Tehran, Iran, to understand the molecular mechanisms underlying this resistance.</p><p><strong>Methods: </strong>During the period spanning from June 2019 to June 2020, 777 gram-negative bacterial strains were isolated. Antibiotic susceptibility testing was performed according to Clinical and Laboratory Standards Institute. Polymerase chain reaction was used to detect carbapenem resistance genes including bla OXA23, bla OXA24, bla OXA48, bla OXA51, bla OXA58, bla OXA143, bla KPC, bla IMP, bla VIM, and bla NDM.</p><p><strong>Results: </strong>Among the total bacterial isolates, 141 (18.1%) exhibited carbapenem resistance. Escherichia coli was the most prevalent (57.4%), followed by Klebsiella pneumoniae (11.3%), and Acinetobacter baumannii (10.6%). Other notable contributors included Enterobacter spp. (5.7%), Salmonella spp. (3.5%), and Stenotrophomonas maltophilia (2.8%). Citrobacter spp., Proteus mirabilis, and Pseudomonas aeruginosa contributed to the distributions of 2, 1, and 3 isolates, respectively. Notably, bla OXA48 showed the highest prevalence (33%), followed by bla OXA143 and bla OXA5 8 (27% and 24%, respectively). In addition, bla OXA24 was present in 11% of the total isolates, bla OXA23 in 10%, and bla NDM in 10%, whereas bla KPC, bla VIM, and bla IMP were not detected.</p><p><strong>Conclusion: </strong>Our study highlights the prevalence of carbapenemase- producing gram-negative isolates among pediatric patients. Notable resistance patterns, especially in K. pneumoniae and E. coli, underline the urgent need for proactive interventions, including appropriate antibiotic prescription practices and strengthening of antibiotic stewardship programs.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"65-72"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559024","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}