American journal of perinatology最新文献

{"title":"Improved Growth Velocity Using a New Liquid Human Milk Fortifier in Very Low Birth Weight Infants: A Multicenter, Retrospective Study.","authors":"Fernando Moya, Jennifer Fowler, Adrian Florens, Jennifer Dombrowski, Olivia Davis, Tiffony Blanks, Austin Gratton","doi":"10.1055/a-2527-4638","DOIUrl":"10.1055/a-2527-4638","url":null,"abstract":"<p><p>This study aimed to compare growth outcomes and tolerance among very low birth weight (VLBW) infants receiving a new, liquid human milk fortifier (LHMF-NEW) or a human milk fortifier-acidified liquid (HMF-AL).Retrospective, multicenter study of 515 VLBW infants in three regional neonatal intensive care units. The primary objective was to compare growth velocity (g/kg/d) during fortification between groups by repeated measures regression. Secondary outcomes of interest were feeding tolerance and the incidence of late-onset sepsis, necrotizing enterocolitis, and metabolic acidosis. Student's <i>t</i>, analysis of variance, Wilcoxon, and Kruskal-Wallis tests were used for numeric variables, or chi-squared and Fisher's exact test for categorical variables.No demographic differences were identified between the groups (HMF-AL, <i>n</i> = 242; LHMF-NEW, <i>n</i> = 273). Growth velocity during fortification was significantly higher in the group receiving LHMF-NEW, despite relatively similar total fluid, calorie, or protein intake (<i>p</i> = 0.001). Feeding intolerance was comparable between fortifiers. Necrotizing enterocolitis and late-onset sepsis did not differ between groups and metabolic acidosis was diagnosed less frequently with the LHMF-NEW. Anthropometric measures at discharge and length of stay were comparable.Infants receiving human milk fortified with the LHMF-NEW had faster growth velocity during fortification, similar tolerance, and less metabolic acidosis compared with an earlier cohort of infants who received human milk fortified with an HMF-AL. · Among VLBW infants, using an LHMF-NEW resulted in a faster growth velocity in weight during several weeks of fortification than using the previous HMF-AL.. · The incidence of feeding intolerance (stopping feeds >8 hour) in any given week of fortification was low and not different between groups. Also, late-onset sepsis and necrotizing enterocolitis were uncommon with no differences between groups, whereas the incidence of metabolic acidosis was lower in infants receiving the LHMF-NEW.. · No differences in length of stay or anthropometrics at discharge were identified..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Coronavirus Disease 2019 on the Incidence of No Prenatal Care.","authors":"Takaki Tanamoto, Misa Hayasaka, Lindsay Robbins, George Saade, Tetsuya Kawakita","doi":"10.1055/a-2535-8309","DOIUrl":"10.1055/a-2535-8309","url":null,"abstract":"<p><p>This study aimed to examine the impact of coronavirus disease 2019 (COVID-19) on the racial disparity in prenatal care utilization in the United States before and during the pandemic.This was a cross-sectional study using the National Vital Statistics Data from 2018 to 2022. Our focus was on low-risk individuals who delivered singleton pregnancies at term. The analysis was restricted to Black and White individuals to explore racial disparities. The study periods based on the last menstrual period (LMP) were prepandemic (March 2018-February 2020) and pandemic (March 2020-February 2022). The primary outcome was the rate of no prenatal care. We employed interrupted time series analysis, negative binomial regression models, adjusting for confounders, seasonality, and autocorrelation. We conducted postestimation analyses to calculate the counterfactual and actual incidences of outcomes for individuals with an LMP in March 2020 and February 2022. Difference-in-difference (DID) with 95% confidence intervals (95% CI) was estimated.The analysis included 3,511,813 individuals in the prepandemic period and 5,163,486 in the pandemic period. For individuals with LMP in March 2020, the actual incidences of no prenatal care per 100 births were 3.2 (95% CI: 3.0, 3.3) for Black individuals and 1.6 (95% CI: 1.2, 2.0) for White individuals. The difference between counterfactual and actual no prenatal care rates per 100 births for Black individuals was 0.4 (95% CI: 0.2, 0.5), indicating a significant increase in no prenatal care. Conversely, there was no significant difference for White individuals. DID analysis further demonstrated that this increase was greater in Black individuals compared with White individuals (DID per 100 births 0.3 [95% CI: 0.1, 0.5]). For individuals with LMP in February 2022, this difference in disparity further worsened (DID per 100 births 0.8 [95% CI: 0.4, 1.2]).The COVID-19 pandemic increased the incidence of no prenatal care, which disproportionately affected Black individuals. · The COVID-19 pandemic increased racial disparities.. · The increase in no prenatal care among Black individuals.. · White individuals are lower affected during this period..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving First-Attempt Intubation Success Rate in a Level IV Neonatal Intensive Care Unit Through the Use of a Video Laryngoscope: A Quality Improvement Initiative.","authors":"Stephanie Martinez, Monika Bhola, Nori Mercuri Minich, Charlene Nauman, Kathleen Deakins, Allison Oliverio, Gulgun Yalcinkaya","doi":"10.1055/a-2533-2465","DOIUrl":"https://doi.org/10.1055/a-2533-2465","url":null,"abstract":"<p><p>There is increasing evidence that the use of a video laryngoscope improves first-attempt intubation rates in neonates. The goal of this quality improvement initiative was to improve the first-attempt intubation success rate from 45 to 65% in 2.5 years through the introduction and increased use of a video laryngoscope in a level IV neonatal intensive care unit (NICU).We utilized the Model for Improvement with plan-do-study-act cycles targeted at increasing buy-in and comfort with the use of a video laryngoscope. Data on 418 intubations were collected from November 2021 to April 2024.Through increasing routine use of the video laryngoscope, achieved via a staggered introduction of the device, creation of reference materials, and coaching workshops, we improved the overall first-attempt intubation success rate from 45 to 57% during the intervention period.We increased the first-attempt success rate of intubations in the NICU by effectively implementing the use of a video laryngoscope into daily practice. · Neonatal intubations have low success rates, but video laryngoscopy improves success especially for those with less experience.. · This study shows that video laryngoscopy adoption in a neonatal ICU improved first-attempt intubation rates.. · This study contributes to neonatal intubation and video laryngoscopy literature from a quality improvement perspective..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plain Language Summary of Publication: Design of the Phase 3 AZALEA Trial of Nipocalimab in Severe Hemolytic Disease of the Fetus and Newborn.","authors":"Yosuke Komatsu, Victor Olusajo, Leona E Ling, Shumyla Saeed-Khawaja, May Lee Tjoa, Trishan Vaikunthanathan, Arpana Mirza, Kenneth J Moise","doi":"10.1055/a-2529-4150","DOIUrl":"https://doi.org/10.1055/a-2529-4150","url":null,"abstract":"<p><p>This article is a plain language summary of publication (PLSP) of the following article: Design of a phase 3, global, multicenter, randomized, placebo-controlled, double-blind study of nipocalimab in pregnancies at risk for severe hemolytic disease of the fetus and newborn by Komatsu et al published in <i>American Journal of Perinatology</i> on September 17, 2024 (doi:10.1055/a-2404-8089). This PLSP describes the design of the phase 3 AZALEA clinical trial in pregnant participants at risk for developing severe hemolytic disease of the fetus and newborn (HDFN). In this study, researchers will determine if an investigational treatment called nipocalimab can be used safely and effectively to treat pregnant individuals who are at risk for severe HDFN. This PLSP will help members of the public, including individuals and families affected by HDFN, understand the study. It may also be helpful for health care professionals. An infographic summary of this article is available in the Supplementary Material. · Severe HDFN causes serious health issues for babies. · IUTs carry risks of complications and fetal loss. · Nipocalimab reduces fetal anemia and IUTs in HDFN. · AZALEA is testing nipocalimab for severe HDFN.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk and Causes of Early Mortality among Extremely Preterm Infants Born Small for Gestational Age.","authors":"Olasunkanmi Kehinde, Dmitry Tumin, Uduak S Akpan, Martha Naylor","doi":"10.1055/a-2533-2533","DOIUrl":"10.1055/a-2533-2533","url":null,"abstract":"<p><p>Extreme preterm (EPT) delivery, occurring before 28 weeks of gestation, carries high morbidity and mortality risks. Small for gestational age (SGA) infants, approximately 8 to 20% of EPT neonates, face increased risks. Mortality risk varies with gestational age and birth weight, with mixed reports on specific morbidities. This study aims to determine mortality rates and common causes of death among EPT SGA infants.The study used data from the CDC National Vital Statistics System, covering births and deaths from 2016 to 2021, with follow-up through 2022. It included infants born between 22 and 27 weeks gestation who were admitted to the neonatal intensive care unit. The outcome was all-cause in-hospital mortality within 30 days of birth, with causes of mortality classified based on the International Classification of Diseases, 10th revision codes. SGA was the primary independent variable.Based on a sample of <i>n</i> = 96,134 infants, we estimated 13% were born SGA and 30-day mortality rates were higher among SGA compared with non-SGA infants (31 vs. 13%). On multivariable analysis, SGA infants had higher 30-day mortality than non-SGA (odds ratio: 3.82; confidence interval 95% [CI]: 3.64, 4.01; <i>p</i> < 0.001), and were more likely to have death ascribed to complications of short gestation rather than other causes of death (relative risk ratio: 1.42; 95% CI: 1.27, 1.59; <i>p</i> < 0.001).SGA infants receiving intensive care have a high mortality risk, especially due to complications of short gestation and low birth weight complications. · EPT infants face high mortality risk.. · Mortality risk is increased for infants born SGA.. · Mortality in SGA EPT infants is frequently attributed to complications of prematurity and small size..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sinopharm COVID-19 Vaccination during Pregnancy Triggers Thyroid Stimulating Hormone Levels in Newborns.","authors":"Aylar Vatanparast, Faeze Daghigh, Hossein Akbari","doi":"10.1055/a-2526-5326","DOIUrl":"https://doi.org/10.1055/a-2526-5326","url":null,"abstract":"<p><p>The effects of covid vaccination on the fetus and placenta make pregnant women a special group in the vaccination series. Coronavirus vaccines are associated with endocrine complications such as thyroid disease.The study included pregnant women who received the corona virus disease 2019 (COVID-19) vaccine. Pregnant women were divided into three study groups; group A (who have not received the COVID-19 vaccine), group B (who received the Sinopharm vaccine during pregnancy), and group C (who received the Sinopharm vaccine before pregnancy). Blood samples were taken to measure thyroid stimulating hormone (TSH) levels in infants 3 to 5 days old. Neonatal TSH values below 5 mU/L are considered normal.Sinopharm/BBIBP-CorV during and/or before pregnancy was associated with a slight increase in mean TSH in newborns.Vaccination with Sinopharm/BBIBP-CorV during or before pregnancy may slightly increase neonatal TSH levels, but this is not clinically significant. · COVID-19 vaccines linked to endocrine disruption.. · Sinopharm CorV during pregnancy triggers TSH in infants.. · Sinopharm vaccination in pregnancy increases neonatal TSH levels..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preterm Births and Maternal-Fetal Medicine Physician Workforce Location in the United States.","authors":"Andrea L Greiner, Sina Haeri, Nichole L Nidey","doi":"10.1055/a-2531-2783","DOIUrl":"https://doi.org/10.1055/a-2531-2783","url":null,"abstract":"<p><p>Examine for association between geographic disparity in the national maternal-fetal medicine (MFM) physician workforce distribution and preterm birth (PTB) rate in counties without MFM presence.Cohort study of PTBs in the United States from 2015 to 2019, utilizing National Center for Health Statistics natality data. The independent risk factor is the presence of an MFM physician in the county or county equivalent where the pregnant woman resides. Bivariate logistic regression analysis estimated the odds of county-level PTB rates higher than the national average (10.2%, March of Dimes 2019 national data) by MFM physician location.The Northeast, Southeast, and Pacific Coast regions of the United States had the highest density of physician practice locations whereas regions in the Midwest and Western United States had the lowest density. Of the 2,981 counties with PTB rates available, 90.3% (<i>n</i> = 2,691) did not have a practicing MFM physician. U.S. counties without an MFM physician are more likely to have a PTB rate higher than the national average, operating room (OR) = 1.56 (95% confidence interval [CI], 1.22-1.99), compared with a county with at least one MFM physician.Counties with no practicing MFM physician had a 56% increase in the odds of having PTB rates higher than the national average. The lack of proximate high-risk obstetric care is a geographic health disparity associated with PTB. The location of the MFM workforce has implications for both clinical care and health policy. These data suggest that attention should be directed toward where physicians practice and to increase access to care for at-risk pregnant women. · U.S. regions with the highest concentration of MFM physicians remain unchanged from prior publications.. · Only 9.7% of counties reporting PTB data have practicing MFM physicians.. · Counties without an MFM physician have 56% higher odds of exceeding national PTB rates.. · Regional disparities in MFM physician distribution may impact maternal and neonatal outcomes..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Maternal Antioxidant Vitamin Supplementation on Maternal and Cord Blood Adiponectin Concentrations.","authors":"Jessica L Pippen, Paula McGee, James M Roberts, Leslie Myatt, Michael W Varner, Alan T N Tita, Ronald J Wapner, John M Thorp, Brian M Mercer, Beth A Plunkett, Sean C Blackwell, Anthony Sciscione, George R Saade","doi":"10.1055/a-2509-1828","DOIUrl":"https://doi.org/10.1055/a-2509-1828","url":null,"abstract":"<p><p>Adiponectin is a hormone that modulates glucose regulation and fatty acid oxidation. Low adiponectin concentration has been associated with increased insulin resistance. Studies show a beneficial effect of vitamin E supplementation on insulin sensitivity. We aimed to investigate the association of prenatal antioxidant supplementation with increased adiponectin concentrations in pregnant participants and their newborn infants.Secondary analysis of a randomized control trial of prenatal vitamin C and E supplementation to prevent preeclampsia in low-risk nulliparous participants. Plasma of participants at time of randomization (9-16 weeks gestation) and delivery, and neonatal cord blood were analyzed by specific enzyme-linked immunosorbent assay for adiponectin concentration. Multivariable analysis was adjusted for confounders.A total of 198 (98 vitamin, 100 placebo) maternal-neonatal dyad samples were analyzed. Maternal and neonatal characteristics were similar between the vitamin and placebo groups, with the exception of race/ethnicity, with Whites more common in the placebo group (80 vs. 66.3%, <i>p</i> = 0.02). In bivariable analyses, adiponectin concentrations at delivery were higher in the vitamin group compared with the placebo group (29.4 vs. 27.5 µg/mL, <i>p</i> = 0.04), whereas cord blood adiponectin concentrations were similar (26.6 . vs. 27.4 µg/mL, <i>p</i> = 0.47) between the two groups. There was a significant interaction between treatment group and maternal baseline adiponectin level on the adiponectin concentrations at delivery (<i>p</i> = 0.04) and cord blood adiponectin (<i>p</i> < 0.05). For participants whose baseline adiponectin concentrations were in the highest tertile, vitamin supplementation was associated with higher adiponectin concentrations at delivery. However, for participants whose baseline adiponectin concentration were in the lowest tertile, vitamin supplementation was associated with lower cord blood adiponectin concentrations.For participants with high baseline adiponectin concentration, vitamin C and E supplementation is associated with higher adiponectin concentration at delivery. Conversely, vitamin supplementation is associated with lower cord adiponectin concentration among participants with low baseline adiponectin concentration. · Vitamin E is an antioxidant with metabolic properties.. · Adiponectin is a cytokine with metabolic properties.. · Vitamin E is associated with higher pregnancy adiponectin.. · Vitamin E is associated with lower neonatal adiponectin.. · Vitamin E correlated with positive pregnancy and neonatal adiponectin trends..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and Neonatal Risk Factors Associated with Positive Toxicology Results.","authors":"Hannah Pee, Karen Hussein, Gina Del Savio, Prabhakar Kocherlakota","doi":"10.1055/a-2535-5895","DOIUrl":"10.1055/a-2535-5895","url":null,"abstract":"<p><p>The incidence of substance use disorder (SUD) during pregnancy continues to increase; however, the identification of SUD is challenging. The significance of individual risk factors and their association with toxicology is contentious. To identify maternal and neonatal risk factors associated with positive toxicology results for nonprescribed substance use during pregnancy.This retrospective study included pregnant persons and their infants, who were screened for predetermined risk factors for SUD during pregnancy. The toxicology test results of pregnant persons' urine and infants' urine, meconium/umbilical cord were correlated with risk factors.Maternal risk factors (history of prepregnancy or current SUD, on medication for opioid use disorders, insufficient prenatal care, sexually transmitted and blood-borne infections) and neonatal risk factors (neonatal opioid withdrawal syndrome, intrauterine growth restriction) showed a correlation with toxicology results.Combining maternal and neonatal risk factors with toxicology testing may accurately identify SUD in pregnancy. · Minimal prenatal care can be associated with positive infant toxicology.. · Intrauterine growth restriction/small for gestational age can be associated with positive infant toxicology.. · Combined maternal and infant testing is more sensitive at detecting prenatal substance use..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The non-bacterial infant microbiome and necrotizing enterocolitis.","authors":"Nilima Jawale, Jeffrey Shenberger, Ricardo Rodriguez, Avinash K Shetty, Parvesh M Garg","doi":"10.1055/a-2549-6551","DOIUrl":"https://doi.org/10.1055/a-2549-6551","url":null,"abstract":"<p><p>Necrotizing enterocolitis (NEC) is among the most devastating neonatal illnesses of premature infants. Although it is a disease of multifactorial etiology associated with bacterial dysbiosis, several reports of viral and some fungal infections associated with NEC have been published. Despite the abundance of viruses - primarily bacteriophages, and 'virus-like particles' in the normal infant gut flora, there is limited understanding of the contribution of these elements to newborn gut health and disease. This article aims to review existing evidence on normal newborn virome and mycobiome development, and present insights into the complex inter kingdom interactions between gut bacteria, viruses and fungi in the intestinal ecosystem, exploring their potential role in predisposing the preterm infant to NEC.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}