Archives of Disease in Childhood - Fetal and Neonatal Edition最新文献

{"title":"Suboptimal BMI at 5 years after very preterm birth: too early to conclude?","authors":"Cornelia Wiechers","doi":"10.1136/archdischild-2025-329567","DOIUrl":"10.1136/archdischild-2025-329567","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257228","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":"Surgeons and neonatologists views about surgical decision-making in necrotising enterocolitis.","authors":"George S Bethell, Nigel J Hall, Cheryl Battersby, Marian Knight, Anne-Sophie Darlington","doi":"10.1136/archdischild-2025-328480","DOIUrl":"10.1136/archdischild-2025-328480","url":null,"abstract":"<p><strong>Objective: </strong>To understand why surgical decision-making in necrotising enterocolitis (NEC) is challenging and to explore what is required to optimise this.</p><p><strong>Design: </strong>Three semi-structured in-person focus groups exploring surgical decision-making in NEC. Reflexive thematic analysis of the focus group transcript was undertaken.</p><p><strong>Participants: </strong>22 consultant participants (15 paediatric surgeons and 7 neonatologists).</p><p><strong>Main outcome measures: </strong>Themes addressing what informs, the challenges of and how to improve surgical decision-making in NEC.</p><p><strong>Results: </strong>10 themes addressed what informs decision-making in NEC, 6 themes addressed why this is challenging and 5 themes explained what is required to address the challenges of decision-making. Themes regarding challenges of decision-making were: diagnostic uncertainty, variable threshold for referral/transfer, lack of continuity of care, absence of clear criteria for surgery, uncertainty surrounding surgery and fear. Subthemes regarding fear were fear of (1) poor clinical outcome, (2) criticism from colleagues and (3) undertaking unnecessary surgery.Themes in all three areas were related to infant, clinician and system-based factors. These included themes regarding indications for surgical intervention, indications for referral and transfer of infants, and reducing variability in practice.</p><p><strong>Conclusions: </strong>This study identified themes that illuminate the difficulties experienced by neonatologists and surgeons regarding surgical decision-making in NEC. Clinicians of both specialties would welcome changes to current practice focused particularly around standardisation of practice and greater objectivity around several aspects of surgical decision-making. These insights can be used to focus further research and implement practice change around surgical decision-making in NEC with the ultimate aim of facilitating early and accurate decision-making.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"595-601"},"PeriodicalIF":3.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960516","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":"Seven-day versus 14-day antibiotic course for culture-proven neonatal sepsis: a multicentre randomised non-inferiority trial in a low and middle-income country.","authors":"Sourabh Dutta, Sushma Nangia, Mamta Jajoo, MangalaBharathi Sundaram, Mala Kumar, Niranjan Shivanna, Geeta Gathwala, Saudamini Nesargi, Suksham Jain, Praveen Kumar, Arvind Saili, Arun Karthik, Shalini Tripathi, Prathik Bandiya, Poonam Dalal, Pallab Ray, Valinderjeet Singh Randhawa, Karnika Saigal, Devasena Radhakrishnan, Vimla Venkatesh, Bhavana Jagannatha, Madhu Sharma, Savitha Nagaraj, Meenakshi Malik, Sarita Dogra, Suruchi Mittal, Anumeet Saini, Nisha Makkar, Maitreyi Dhir, Asmita Chandramohan, R A Pragati, Tanaya Srivastava, Lakshmi Mukundan, Naveen Benakappa, Amlin Shukla, Reeta Rasaily","doi":"10.1136/archdischild-2024-328232","DOIUrl":"10.1136/archdischild-2024-328232","url":null,"abstract":"<p><strong>Objective: </strong>Definitive guidance regarding the duration of antibiotics for neonatal sepsis is lacking. We hypothesised that a 7-day antibiotic course is non-inferior to a 14-day course for treating culture-proven sepsis.</p><p><strong>Design: </strong>Randomised, controlled, non-inferiority trial with masked outcome assessment in eight centres in a low and middle-income country.</p><p><strong>Patients: </strong>Neonates with a birth weight (BW) ≥1000 g and blood culture-proven sepsis were randomised on day 7 of sensitive antibiotic therapy provided sepsis had clinically remitted.</p><p><strong>Exclusions: </strong><i>Staphylococcus aureus</i> or fungal sepsis, and infections requiring prolonged antibiotics. We planned to enrol 350 per group, assuming 10% rate of primary outcome, +7% non-inferiority margin, one-sided 5% alpha, 90% power, 10% loss to follow-up.</p><p><strong>Intervention: </strong>7 days (no further treatment); comparison: 14 days (7 days postrandomisation).</p><p><strong>Outcomes: </strong>Primary: relapse (definite or probable) within day 21 postantibiotic completion.</p><p><strong>Secondary outcomes: </strong>composite of mortality or definite/probable/secondary sepsis and duration of hospitalisation. One interim analysis (per protocol (PP)) was planned.</p><p><strong>Results: </strong>126 and 135 subjects were recruited in 7-day and 14-day groups, respectively, with mean (SD) birth weight (BW) 2250.9 (741.1) and 2187.8 (718.8) g. The trial was terminated early, based on interim PP analysis. 2/125 and 6/130 subjects had the primary outcome in 7-day and 14-day groups, respectively (risk difference (RD)=-3.0% (99.5% CI -9.2%, +3.1%), below non-inferiority margin). The composite secondary outcome also favoured the 7-day regimen (RD: -3.7% (99.5% CI -12.4% to +5.1%)). Duration of hospitalisation was shorter in 7-day group (median difference: -4 days (95% CI -5 to -3)).</p><p><strong>Conclusions: </strong>A 7-day course of antibiotics may be non-inferior to a 14-day course for uncomplicated bacterial neonatal sepsis.</p><p><strong>Trial registration number: </strong>NCT03280147.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"586-594"},"PeriodicalIF":3.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964309","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":"Haemoglobin-oxygen affinity and the risk of bronchopulmonary dysplasia.","authors":"Chad Andersen, Danielle Nicole Bailey, Tara Marie Crawford, Michael Stark","doi":"10.1136/archdischild-2025-328784","DOIUrl":"10.1136/archdischild-2025-328784","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"629-630"},"PeriodicalIF":3.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131839","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":"Effects of liberal versus restrictive transfusion strategies on intermittent hypoxaemia in extremely low birthweight infants: secondary analyses of the ETTNO randomised controlled trial.","authors":"Axel R Franz, Corinna Engel, Dirk Bassler, Mario Rüdiger, Ulrich H Thome, Rolf F Maier, Ingeborg Krägeloh-Mann, Jochen Essers, Christoph Bührer, Hans-Jörg Bittrich, Claudia Roll, Thomas Höhn, Harald Ehrhardt, Ralf Boettger, Hans Thorsten Körner, Anja Stein, Patrick Neuberger, Tine Brink Henriksen, Gorm Greisen, Christian F Poets","doi":"10.1136/archdischild-2024-327643","DOIUrl":"10.1136/archdischild-2024-327643","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the effect of liberal versus restrictive transfusion strategies on the proportion of time (%time) spent with intermittent hypoxaemia (IH, ie, arterial haemoglobin oxygen saturation measured by pulse oximetry (SpO₂) <80% lasting ≥60 s) in the 'Effects of Transfusion Thresholds on Neurocognitive Outcome' (ETTNO) population, and to investigate whether infants with above-median exposure to IH might benefit more from liberal transfusion strategies than those with lower exposure.</p><p><strong>Design, setting, patients: </strong>Secondary analysis in all 554/1013 infants of <1000 g birth weight recruited into the ETTNO trial (mean gestational age 26.2 weeks) with >80% completeness of SpO₂ recordings during postnatal days 8-49.</p><p><strong>Intervention: </strong>Randomly assigned liberal (n=268) or restrictive (n=286) transfusion strategies, defining transfusion triggers based on postnatal age and health status.</p><p><strong>Main outcome measures: </strong>%time with IH, rate and mean duration of IH episodes during postnatal days 8-49. Interaction between exposure to IH and transfusion strategies with respect to ETTNO's composite primary outcome, death or disability at 24 months corrected age.</p><p><strong>Results: </strong>The median (quartile 1-quartile 3) %time with IH was similar between treatment groups (0.91% (0.13%-2.83%) with liberal vs 0.79% (0.16%-2.44%) with restrictive transfusions). There was no interaction between exposure to IH and transfusion strategies on outcome at 24 months.</p><p><strong>Conclusions: </strong>In infants <1000 g birth weight, a liberal transfusion strategy did not reduce IH. Blood transfusions should not be administered 'liberally' to reduce IH or to improve neurocognitive outcome in infants with above-average exposure to IH.</p><p><strong>Trial registration number: </strong>NCT01393496.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"564-570"},"PeriodicalIF":3.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727642","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":"Minimisation of blood sampling losses in preterm neonates: a systematic review and meta-analysis.","authors":"Prathamesh Khedkar, Abhishek Srinivas, Haribalakrishna Balasubramanian, Mayuri Bhanushali, Anitha Ananthan, Diwakar Mohan, Nandkishore Kabra, Shripada C Rao, Sanjay K Patole","doi":"10.1136/archdischild-2024-328337","DOIUrl":"10.1136/archdischild-2024-328337","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of minimising blood sampling losses on red blood cell (RBC) transfusion-related outcomes in preterm infants <37 weeks' gestation.</p><p><strong>Study design: </strong>We searched PubMed, Embase, Web of Science and Google Scholar from inception to October 2024 for studies that evaluated sampling stewardship practices (SSP) in preterm infants during initial hospitalisation. Two authors independently screened articles that evaluated one or more sampling approaches to minimise blood loss or non-invasive methods to avoid sampling losses. Meta-analysis was conducted using a random effects model.</p><p><strong>Results: </strong>Eighteen studies (4 randomised controlled trials (RCTs) and 14 non-randomised studies) were included. Five studies used umbilical cord blood sampling, four used protocol-based sampling and two used retransfusion of sampled blood back to the infant as an SSP. Sampling care bundles were used in seven studies. Meta-analysis showed that SSP reduced early RBC transfusion rates (RCTs: Relative risk(RR) =0.50, 95% CI 0.36, 0.68; non-RCTs: RR=0.78, 95% CI 0.69, 0.90), the average number of transfusions per infant (RCTs: mean difference=-0.4 transfusions, 95% CI -0.68, -0.05; non-RCTs: standardised mean difference=-0.40, 95% CI -0.55, -0.25) and the rates of multiple transfusions (non-RCTs: RR=0.51, 95% CI 0.42, 0.62). There were no significant effects on mortality and other morbidities. Certainty of evidence was high for transfusion-related outcomes and moderate for other outcomes.</p><p><strong>Conclusion: </strong>SSPs are associated with a significant reduction in RBC transfusion rates among very and extremely preterm infants. Large RCTs are required to assess the effects of SSP on other important outcomes.</p><p><strong>Prospero registration number: </strong>CRD42024539665.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"532-541"},"PeriodicalIF":3.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555701","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":"Near-infrared spectroscopy during respiratory support at birth: a systematic review.","authors":"Vix Monnelly, Firdose Nakwa, Justin B Josephsen, Georg M Schmölzer, Anne Lee Solevåg, Yacov Rabi, Myra H Wyckoff, Gary M Weiner, Helen G Liley","doi":"10.1136/archdischild-2025-328577","DOIUrl":"10.1136/archdischild-2025-328577","url":null,"abstract":"<p><strong>Objective: </strong>During perinatal transition, compromised cerebral oxygenation may contribute to neonatal morbidity and mortality. Near-infrared spectroscopy measures cerebral regional tissue oxygen saturations (crSO₂) and may guide delivery room respiratory management. This review evaluated whether crSO₂ monitoring in addition to routine assessment (clinical assessment, pulse oximetry +/- ECG) compared with routine assessment alone improves neonatal outcomes.</p><p><strong>Design: </strong>Systematic review and meta-analysis based on Ovid MEDLINE, Embase, and Cochrane CENTRAL searches (16 February and 5 November 2024).</p><p><strong>Setting: </strong>Delivery room.</p><p><strong>Patients: </strong>Newborn infants of all gestations, born via any mode, receiving continuous positive airway pressure and/or intermittent positive pressure ventilation during stabilisation/resuscitation.</p><p><strong>Intervention: </strong>crSO₂ monitoring with a dedicated treatment guideline in addition to routine assessment compared with routine assessment alone.</p><p><strong>Main outcome measures: </strong>Survival without neurodevelopmental impairment, survival, severe intraventricular haemorrhage and periventricular leukomalacia (infants <34 weeks); and crSO₂ <10th percentile.</p><p><strong>Results: </strong>Among 566 articles, 3 articles reporting outcomes from 2 randomised controlled trials (RCTs) (667 preterm infants) were identified. No data were found for survival without neurodevelopmental impairment. We could not exclude benefit or harm from delivery room monitoring of crSO₂ for survival (relative risk (RR) 1.02, 95% CI 0.99 to 1.05), severe intraventricular haemorrhage (RR 0.76, 95% CI 0.38 to 1.54), periventricular leukomalacia (RR 1.93, 95% CI 0.66 to 5.70) (n=667; two RCTs) and crSO₂ <10th percentile (RR 1.00, 95% CI 0.78 to 1.29) (n=60; one RCT).</p><p><strong>Conclusions: </strong>The limited evidence could not exclude benefit or harm from delivery room monitoring of crSO₂ with a dedicated treatment guideline in preterm infants.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"602-609"},"PeriodicalIF":3.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957324","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":"Reducing device-related pressure injuries in high-risk neonates receiving nasal continuous positive airway pressure: a quality improvement study.","authors":"Margaret Broom, Alison L Kent, Tejasvi Chaudhari","doi":"10.1136/archdischild-2024-327798","DOIUrl":"10.1136/archdischild-2024-327798","url":null,"abstract":"<p><strong>Objective: </strong>Neonates requiring Non-InVasive respiratory Support (NIVS) are at high risk of device-related pressure injury (DRPI), with incidence rates of 20%-60% in extremely premature infants. Over a 4-year period, our team undertook a Quality Improvement Project to review aspects of the clinical management of NIVS: types of interfaces, introduction of hydrocolloid dressing and the development and implementation of nasal injury care plan (NICP) to reduce DRPI in high-risk neonates.</p><p><strong>Design: </strong>A prospective descriptive study was completed in three stages: trial of nCPAP interfaces, preintroduction NICP (2016-2018), post-NICP (2018-2020) and (2021-2022) to measure sustainability of implementation. Data included: gestational age (GA), birth weight, NIVS days, incidence, grade and day of DRPI. Statistical analysis of incidence rate ratio was completed between pre and postgroups.</p><p><strong>Setting: </strong>Australian neonatal intensive care unit.</p><p><strong>Patients: </strong>All neonates ≤32 weeks requiring nCPAP.</p><p><strong>Interventions: </strong>Evaluation of types of interfaces, introduction of hydrocolloid dressing and the development and implementation of NICPMain outcome measures: incidence and severity of DRPI.</p><p><strong>Results: </strong>Total DRPI recorded in all CPAP babies pre/post NICP were (59/659 (9.0%), 26/574 (4.5%), p=0.0032, respectively). Analysis showed DRPI incidence rates per 1000 NIVS days ((10.6, 5.5), p=0.0001, respectively). 75 (88%) of DRPI occurred in the ≤32 week group of neonates requiring NIVS. Review of babies ≤32 weeks across the three intervals showed significant improvement with time (55 (19%); 27 (13%); 19 (9%), p=0.0001).</p><p><strong>Conclusions: </strong>Preferred nCPAP interface, nasal dressing and NICP have reduced the incidence and severity of DRPI in the NICU.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"571-576"},"PeriodicalIF":3.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727645","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":"Outcomes of extremely preterm infants who participated in a randomised trial of dopamine for treatment of hypotension (the HIP trial) at 2 years corrected age.","authors":"Neil Marlow, Keith J Barrington, Colm Patrick Finbarr ODonnell, Jan Miletin, Gunnar Naulaers, Po-Yin Cheung, John David Corcoran, Afif El-Khuffash, Geraldine B Boylan, Vicki Livingstone, Gerard Pons, Zbyněk Straňák, David Van Laere, Jozef Macko, Hana Wiedermannova, Eugene M Dempsey","doi":"10.1136/archdischild-2024-327894","DOIUrl":"10.1136/archdischild-2024-327894","url":null,"abstract":"<p><strong>Objective: </strong>To determine survival and neurodevelopmental outcomes in the Hypotension in Preterm (HIP) trial.</p><p><strong>Design: </strong>Prospective follow-up of infants enrolled in randomised controlled trial.</p><p><strong>Participants: </strong>58 infants born before 28 weeks of gestation with low mean arterial blood pressure.</p><p><strong>Intervention: </strong>Random allocation to treatment of low blood pressure values with infusion of dopamine or placebo.</p><p><strong>Primary outcome: </strong>Survival without neurodevelopmental impairment to 24 months corrected age (CA).</p><p><strong>Results: </strong>The HIP trial stopped early due to logistic and recruitment difficulties. Outcomes were determined for 55 infants (27 in the dopamine group and 28 in the placebo group) at 24 months CA. Survival without impairment was present in 13 (48%) infants in the dopamine group and 7 (25%) infants in the placebo group (OR 2.79 (95% CI 0.89, 8.72); p=0.078). The components of the primary outcome were similarly distributed between the two arms. Mean Bayley composite scores and the frequency of somatic impairments did not differ significantly between groups but infants were shorter and lighter at 2 years of age after dopamine administration.</p><p><strong>Conclusion: </strong>In this placebo-controlled trial of the treatment of hypotension in extremely preterm infants, dopamine administration did not increase survival without impairment at 2 years CA. However, the study was not sufficiently powered and a clinically important effect cannot be excluded. The role of inotropic medication in facilitating good outcomes requires further study.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"542-547"},"PeriodicalIF":3.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998936","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":"How is mum? Think herpes in unwell mother and baby pairs: a multicentre case series.","authors":"Annalie Shears, Srinivasa Rambhatla, Alasdair Bamford, Katy Fidler, Hermione Lyall","doi":"10.1136/archdischild-2025-329323","DOIUrl":"10.1136/archdischild-2025-329323","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"631-632"},"PeriodicalIF":3.6,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999538","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}