Journal of Pediatrics最新文献

{"title":"Association Between Platelet Count and Bleeding During Central Line Placement in Critically Ill Children.","authors":"Alexandra T Lucas, Walter Dzik","doi":"10.1016/j.jpeds.2025.114539","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114539","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between platelet count and procedure-related bleeding at the time of central venous line (CVL) placement in critically ill children.</p><p><strong>Study design: </strong>A retrospective cohort study was performed capturing patient admissions to the pediatric intensive care unit between January 1, 2012 to March 1, 2022. Critically ill children between 0 months and 19 years who underwent bedside CVL placement were included. A total of 363 were included in the final analysis.</p><p><strong>Results: </strong>Patients' platelet counts prior to line placement ranged from 11,000/uL to 735,000/uL. Bleeding was identified in 26 of 363 (7.2%) of patients, and was categorized as 24 (92%) minimal, 2 (8%) moderate, and none severe. Platelet count and platelet transfusion before line placement were both significantly different between bleeding and non-bleeding patients (p = 0.04 and p = 0.032). Patients with lower platelet counts had a higher proportion of bleeding events. There were no significant differences between the bleeding and non-bleeding groups in age, sex, history of bleeding, or number of attempts at CVL. Patients with bleeding were not significantly sicker. Regression analysis determined that female sex and transfusion before CVL placement were both significantly associated with bleeding.</p><p><strong>Conclusions: </strong>We found that the platelet count prior to CVL placement was not associated with bleeding events in critically ill pediatric patients. Bleeding was more common in patients receiving platelet transfusions. Additional studies are needed to evaluate further the effect of platelet transfusions on procedure-related bleeding.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114539"},"PeriodicalIF":3.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Enteral Feed Type with Neurodevelopmental and Neonatal Outcomes among Infants Born Preterm","authors":"Nicole Bando PhD ,&nbsp;Eugene W. Yoon MSc ,&nbsp;Marc Beltempo MD, MSc ,&nbsp;Cecilia de Cabo MD ,&nbsp;Lindsay Colby RN, BScN, MSN ,&nbsp;Wissam Alburaki MD, MSc ,&nbsp;Thevanisha Pillay MD ,&nbsp;Prakesh S. Shah MD, MSc ,&nbsp;Canadian Neonatal Network and Canadian Neonatal Follow-Up Network Investigators","doi":"10.1016/j.jpeds.2025.114536","DOIUrl":"10.1016/j.jpeds.2025.114536","url":null,"abstract":"<div><h3>Objective</h3><div>To examine associations between enteral feed type with neurodevelopmental and neonatal outcomes among infants born preterm.</div></div><div><h3>Study design</h3><div>This was a retrospective study of enteral feeds in the first 28 postnatal days in infants born &lt;29 weeks of gestation from 2015 through 2020 in neonatal units of the Canadian Neonatal Network and Canadian Neonatal Follow-Up Network. Feeds were examined as a compositional variable comprised of the proportion of days fed mother's milk, donor milk, mixed feeds, and nil per os (NPO), the proportions of which sum to 1. Associations between enteral feed type with neurodevelopmental outcomes at 18 to 24 months of corrected age and neonatal morbidities were examined.</div></div><div><h3>Results</h3><div>Our cohort included 2104 infants with a mean (SD) gestational age of 26.2 (1.5) weeks (52.9% male). Compositional data analysis revealed a 1-day reallocation from mother's milk to donor milk was associated with greater odds of cognitive (aOR 1.028, 95% CI 1.001-1.056) and language impairment (aOR 1.024, 95% CI 1.002-1.047). Replacing 1 day of mixed feeds, donor milk or NPO with mother's milk was associated with improved cognitive, language and motor development. A 1-day reallocation of NPO to either mother's milk, mixed feeds or donor milk decreased odds of significant neurodevelopmental impairment, cerebral palsy and/or necrotizing enterocolitis.</div></div><div><h3>Conclusions</h3><div>Donor milk in place of mother's milk was associated with poorer cognitive and language development. Providing any human milk reduced neurodevelopmental impairment and necrotizing enterocolitis with reallocations involving mother's milk yielding the most benefit. Promoting early enteral nutrition with mother's milk should be a priority in the care of infants born preterm.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114536"},"PeriodicalIF":3.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urine Testing in Children with Viral Symptoms: A Nationwide Analysis of Ambulatory Visits, 2014-2019","authors":"Rachel L. Wattier MD, MHS ,&nbsp;Daniel J. Shapiro MD, MPH ,&nbsp;Hillary L. Copp MD, MS ,&nbsp;Sunitha V. Kaiser MD, MSc ,&nbsp;Adam L. Hersh MD, PhD","doi":"10.1016/j.jpeds.2025.114538","DOIUrl":"10.1016/j.jpeds.2025.114538","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the extent of and factors associated with urine testing in US pediatric ambulatory visits for symptoms commonly associated with viral illness.</div></div><div><h3>Study design</h3><div>We analyzed a nationally representative, cross-sectional sample of ambulatory clinic and emergency department (ED) visits among children 2 months to 17 years old (2014 through 2019 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey). Using reason for visit classification codes, we identified visits for respiratory symptoms, diarrhea, or rash; termed “viral symptoms” without reported localizing genitourinary symptoms. We assessed the proportion of these visits with urine testing (urinalysis and/or urine culture) and evaluated factors associated with urine testing using logistic regression.</div></div><div><h3>Results</h3><div>Of 71.3 million (95% CI 64.7-78.0 million) pediatric ambulatory visits per year, 61% (95% CI 59%-63%) were for viral symptoms without reported genitourinary symptoms. Urine testing at these visits accounted for 38% (95% CI 30%-47%) of overall urine testing. Such testing occurred more frequently at ED visits (8.3%; 95% CI 7.4%-9.3%) compared with clinic visits (4.4%; 95% CI 2.5%-7.7%). At ED visits, the adjusted probability of urine testing in the context of viral symptoms was lowest for males age 2 months to &lt;2 years (5%; 95% CI 3%-6%) and highest for females age 12 through 17 years (20%; 95% CI 16%-24%), and females age 6-11 years (13%; 95% CI 11%-16%).</div></div><div><h3>Conclusions</h3><div>Urine testing in children with symptoms of viral or other non-urinary tract infection illnesses occurs frequently at ambulatory visits. This potentially avoidable testing disproportionately occurred in older age groups that have lower risk of urinary tract infection.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114538"},"PeriodicalIF":3.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Disparities in Diagnosis and Treatment of Heterozygous Familial Hypercholesterolemia.","authors":"Rachel J Shustak, Abigail Perlstein, Amanda S Artis, Alexis Z Tomlinson, Vicky Tam, Giordana Martino, Julie A Brothers","doi":"10.1016/j.jpeds.2025.114537","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114537","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association of social determinants of health and age at heterozygous familial hypercholesterolemia (HeFH) diagnosis and treatment.</p><p><strong>Study design: </strong>We performed a retrospective, single-center study of children with HeFH. Multivariable linear regression models were used to examine the association between Child Opportunity Index (COI) and age at HeFH diagnosis and statin initiation. Additional covariates included sex, race, ethnicity, health insurance type, primary language, body mass index (BMI) percentile, and LDL-C. To explore potential referral bias, we compared the COI of the study cohort with that of the institution's catchment area.</p><p><strong>Results: </strong>We evaluated 577 patients. The median age at presentation was 12 (9, 14) years and the median LDL-C was 199 (169, 235) mg/dL; 58% were prescribed a statin at a median age of 13 (10, 15) years. There was no association between COI and the age at HeFH diagnosis or statin initiation. On multivariable analysis, Black race was associated with older age at HeFH diagnosis but not statin initiation compared with White race (adjusted estimate 1.1 +/- 0.50 yrs, p = 0.023). Higher LDL-C, male sex, and lower BMI percentile were associated with younger age at HeFH diagnosis and statin initiation. The COI of the study cohort was significantly higher than that of the catchment area (p < 0.001).</p><p><strong>Conclusions: </strong>Black race was associated with older age at HeFH diagnosis; however, there were no differences in age at statin initiation. The COI of the cohort was significantly higher than that of the catchment area indicating that low COI populations are likely under-referred for HeFH evaluation.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114537"},"PeriodicalIF":3.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal Neurobehavior Predicts Neonatal Opioid Withdrawal Syndrome Severity Prior to Treatment Interventions","authors":"Sarah E. Maylott PhD ,&nbsp;Madeleine Bruce PhD ,&nbsp;Lydia Brown BS ,&nbsp;Ayla J. Castano BS ,&nbsp;Lynne Dansereau MSPH ,&nbsp;Barry Lester PhD ,&nbsp;Elisabeth Conradt PhD","doi":"10.1016/j.jpeds.2025.114533","DOIUrl":"10.1016/j.jpeds.2025.114533","url":null,"abstract":"<div><h3>Objective</h3><div>To utilize the NeoNatal Neurobehavioral Scale (NNNS-II) as a standardized and reliable tool to help guide treatment of neonatal opioid withdrawal syndrome (NOWS) with the goal of improving the consistency and quality of care provided to opioid-exposed newborns.</div></div><div><h3>Study design</h3><div>We examined NOWS severity through several indicators, including the number of pharmacological treatment medications, maximum dose of medications, length of treatment, and maximum score on NOWS observational tools to create an overall severity score for each newborn. Then we examined whether NOWS risk could be detected as early as 24 hours after birth using the NNNS-II to predict NOWS severity.</div></div><div><h3>Results</h3><div>Newborn neurobehavior prior to signs of NOWS predicted NOWS severity. Newborns who were more hypertonic and had poorer quality of movement had higher severity scores.</div></div><div><h3>Conclusion</h3><div>These findings indicate that NOWS risk detection may be enhanced with an early newborn neurobehavioral assessment.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114533"},"PeriodicalIF":3.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S0022-3476(25)00059-9","DOIUrl":"10.1016/S0022-3476(25)00059-9","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"279 ","pages":"Article 114519"},"PeriodicalIF":3.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurobehavioral Profiles in Opioid-Exposed and Unexposed Neonates","authors":"Stephanie L. Merhar MD, MS ,&nbsp;Kimberly Yolton PhD ,&nbsp;Sara B. DeMauro MD, MSCE ,&nbsp;Traci Beiersdorfer RN, BSN ,&nbsp;Jamie E. Newman PhD ,&nbsp;Scott A. Lorch MD, MSCE ,&nbsp;Deanne Wilson-Costello MD ,&nbsp;Namasivayam Ambalavanan MD ,&nbsp;Ananta Bangdiwala MS ,&nbsp;Myriam Peralta-Carcelen MD ,&nbsp;Brenda B. Poindexter MD ,&nbsp;Jonathan M. Davis MD ,&nbsp;Catherine Limperopoulos PhD ,&nbsp;Carla M. Bann PhD","doi":"10.1016/j.jpeds.2025.114527","DOIUrl":"10.1016/j.jpeds.2025.114527","url":null,"abstract":"<div><h3>Objective</h3><div>To describe distinctive profiles of neurobehavior in opioid-exposed and unexposed neonates.</div></div><div><h3>Study design</h3><div>The Outcomes of Babies with Opioid Exposure study is a multisite, prospective, observational study in neonates born at term with opioid exposure and unexposed controls. As part of the Outcomes of Babies with Opioid Exposure study protocol, certified examiners administered the NeoNatal Neurobehavioral Scales, second edition (NNNS-II) before 6 weeks postnatal age. We used latent profile analysis to determine distinctive classes of neurobehavior and linear mixed effect models to compare NNNS-II scores by exposure status.</div></div><div><h3>Results</h3><div>The study included 291 neonates with NNNS-II, 194 exposed and 97 unexposed. Latent profile analysis resulted in 4 unique classes. Class 4 showed the most signs of stress and included almost exclusively exposed neonates. Scores for exposed neonates were significantly different than unexposed neonates on most NNNS-II subscales. In addition to opioids, associations were found between profile membership and prenatal exposure to benzodiazepines, e-cigarettes/tobacco, and selective serotonin reuptake inhibitors.</div></div><div><h3>Conclusions</h3><div>Neonates with prenatal exposure to opioids and other psychotropic substances have distinctive patterns of neurobehavior. Additional follow-up is needed to determine if these neurobehavioral differences serve as a marker for future problems with attention and behavior.</div></div><div><h3>Clinical Trials.gov Registration</h3><div><span><span>NCT04149509</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114527"},"PeriodicalIF":3.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Well-Being of Children and Adolescents with and without Special Health Care Needs Following the Lifting of Pandemic-Related Restrictions","authors":"Elsa Lorthe RM, PhD ,&nbsp;Roxane Dumont PhD ,&nbsp;Viviane Richard MSc ,&nbsp;Andrea Loizeau PhD ,&nbsp;Géraldine Blanchard-Rohner MD, PhD ,&nbsp;Stephanie Schrempft PhD ,&nbsp;Hélène Baysson PhD ,&nbsp;Maria-Eugenia Zaballa PhD ,&nbsp;Julien Lamour MSc ,&nbsp;Philippe Eigenmann MD ,&nbsp;Stéphanie Garcia-Tarodo MD ,&nbsp;Manel Mejbri MD ,&nbsp;Nathalie Rock MD ,&nbsp;Isabelle Ruchonnet-Métrailler MD, PhD ,&nbsp;Mayssam Nehme MD ,&nbsp;Rémy P. Barbe MD ,&nbsp;Klara M. Posfay-Barbe MD, PhD ,&nbsp;Idris Guessous MD, PhD ,&nbsp;Silvia Stringhini PhD ,&nbsp;Maria-Eugenia Zaballa","doi":"10.1016/j.jpeds.2025.114528","DOIUrl":"10.1016/j.jpeds.2025.114528","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the physical, psychological, and social well-being of children with and without special health care needs (SHCN) after pandemic-related restrictions were lifted.</div></div><div><h3>Study design</h3><div>Drawing on three-wave data from the SEROCoV-KIDS prospective, population-based cohort, we performed an outcome-wide, longitudinal analysis to investigate the association of SHCN (none, moderate, or complex needs) at time 1 (September 2022 through February 2023) with physical, psychological, and social well-being (15 outcomes) at time 2 (May through September 2023), adjusting for characteristics and prior outcome values at time 0 (December 2021 through June 2022).</div></div><div><h3>Results</h3><div>Of 1993 participants aged 2 through 17 years, 1533 completed the time 1 questionnaire (median age 10, 49.6% female) with 10.6% having moderate needs, and 3.3% complex needs. Although children with SHCN had not been more often infected with SARS-CoV-2 than healthy children, in 2023, they experienced more severe psychosocial consequences, especially poorer well-being, with a gradient according to the complexity of their needs. Children with moderate needs had more difficulties with physical (adjusted odds ratio 2.84 [95% confidence interval 1.42-5.67]) and social functioning (2.20 [1.33-3.65]) as well as externalizing difficulties (3.68 [1.67-8.11]) compared with their healthy peers but showed similar levels of prosocial behavior or social support. Those with complex needs were particularly at risk of poor physical, psychological, and social well-being.</div></div><div><h3>Conclusions</h3><div>Children and adolescents with SHCN suffered from poor well-being after pandemic-related restrictions were lifted, with no obvious improvement over time. Establishing sustained monitoring and tailored interventions is crucial to improve their persistent suboptimal well-being as we move beyond the pandemic era.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114528"},"PeriodicalIF":3.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Interaction of Antenatal Steroid Timing and Pre-Eclampsia on Respiratory Outcomes Among Infants Born Preterm","authors":"April W. Tan MD ,&nbsp;Mohamed Hamza MD ,&nbsp;Chanique James MD ,&nbsp;Alini Schott RN, MS ,&nbsp;Ana Cecilia Aguilar RRT ,&nbsp;Eduardo Bancalari MD ,&nbsp;Augusto F. Schmidt MD, PhD ,&nbsp;Nelson Claure MSc, PhD","doi":"10.1016/j.jpeds.2025.114526","DOIUrl":"10.1016/j.jpeds.2025.114526","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of timing of antenatal steroid (ANS) administration and its interaction with pre-eclampsia on respiratory outcome among infants born preterm.</div></div><div><h3>Study design</h3><div>This was an analysis of a prospective, single-center cohort of infants born between 23 and 30 weeks of gestation between 2012 through 2021. End points were severe respiratory distress syndrome (sRDS) and moderate-to-severe bronchopulmonary dysplasia (msBPD). ANS administration was classified as within 7 days of birth or earlier than 7 days before birth. Multivariable generalized estimating equations were used to model the association between ANS timing and pre-eclampsia with the end points.</div></div><div><h3>Results</h3><div>The cohort included 1172 infants, of whom 30% were born to mothers with pre-eclampsia and 83% to mothers who received ANS within 7 days of birth. Compared with non–pre-eclampsia with ANS within 7 days of birth, pre-eclampsia with ANS earlier than 7 days before birth was associated with an increased risk for sRDS. Pre-eclampsia with ANS within 7 days of birth was not associated with an increased risk for sRDS. Compared with non–pre-eclampsia with ANS within 7 days of birth, non–pre-eclampsia with ANS earlier than 7 days of birth, and pre-eclampsia with ANS earlier than 7 days before birth were associated with an increased risk for msBPD. Pre-eclampsia with ANS within 7 days of birth was not associated with increased risk of msBPD.</div></div><div><h3>Conclusions</h3><div>In this cohort, properly timed maternal ANS administration within 7 days of birth was associated with a reduced risk of sRDS and msBPD among infants born preterm to mothers with pre-eclampsia. These findings underscore the need to optimize the timing of ANS administration.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114526"},"PeriodicalIF":3.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Foundational Understanding of Rural-Urban Differences in the Pediatric Workforce for Children with Medical Complexity.","authors":"Caitlin Koob, S Margaret Wright, Carolyn Foster","doi":"10.1016/j.jpeds.2025.114531","DOIUrl":"10.1016/j.jpeds.2025.114531","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114531"},"PeriodicalIF":3.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}