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

{"title":"Postnatal dexamethasone treatment for preterm infants at high risk for bronchopulmonary dysplasia is associated with improved regional brain volumes: a prospective cohort study.","authors":"Rahul Chandwani, Julia Kline, Mekibib Altaye, Nehal Parikh","doi":"10.1136/archdischild-2024-328438","DOIUrl":"10.1136/archdischild-2024-328438","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of low-dose postnatal dexamethasone therapy for bronchopulmonary dysplasia (BPD) prevention/treatment on MRI-derived regional brain volumes at term-equivalent age (TEA) and neurodevelopmental outcomes in a regional cohort of preterm infants.</p><p><strong>Study design: </strong>We prospectively recruited 392 preterm infants (≤32 weeks gestational age (GA)), who underwent structural MRI (3T Philips Ingenia) at TEA. We automatically segmented T2-weighted MRI scans using the Developing Human Connectome Project pipeline to derive a priori selected, two primary outcomes of interest: volumes of the cerebellum and subcortical grey matter. We estimated propensity scores for subjects with a logistic regression model and used weighted linear regression to determine the independent effects of dexamethasone on primary and two secondary outcomes: cortical surface area at TEA and motor scores at 2 years corrected age.</p><p><strong>Results: </strong>Of 392 infants, 41 were treated with low cumulative dose dexamethasone (total 0.89 mg/kg) initiated at 36 days (median) of age for evolving BPD: 21 males; mean (SD) GA was 25.5 (1.6) weeks; postmenstrual age at MRI was 43.7 (1.2) weeks; and 33 had severe BPD. In multivariable linear regression, dexamethasone was significantly correlated with larger cerebellar (difference=0.510; 95% CI: 0.079 to 0.941) and subcortical grey matter volume (difference=0.138; 95% CI: 0.014 to 0.263). Dexamethasone was also positively correlated with motor scores (difference=5.220; 95% CI: 0.845 to 9.594).</p><p><strong>Conclusion: </strong>Low-dose dexamethasone therapy after the first postnatal week for evolving/established BPD did not result in adverse macrostructural effects and may have a protective effect on motor development in preterm infants.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966121","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":"Function over diagnoses: parents of extremely preterm infants give recommendations to clinicians about their information needs.","authors":"Emilie Thivierge, Thuy Mai Luu, Claude Julie Bourque, Rebecca Pearce, Magdalena Jaworski, Keith J Barrington, Laurie-Anne Duquette, Annie Janvier","doi":"10.1136/archdischild-2024-328249","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328249","url":null,"abstract":"<p><strong>Objectives: </strong>Extremely preterm children may have a prolonged neonatal intensive care unit (NICU) stay. Their parents interact with clinicians both before and after birth. There is little information about parental satisfaction with the information received and what they would want to improve. The objective of this study was to explore parental perspectives regarding their information needs.</p><p><strong>Methods: </strong>Over 1 year, parents of children born at <29 weeks' gestational age (GA), who were aged between 18 months and 7 years old and came for their follow-up visit were invited to participate. They were asked to answer this question in their own words: \"Knowing what you know now, what do you wish doctors would have told you about prematurity before and/or after your child's birth?\" Mixed method analysis included thematic analysis performed by a multidisciplinary group, including parents, and logistic regression to compare parental responses.</p><p><strong>Results: </strong>Among parents (n=248, 98% of parents coming to follow-up), 45% were satisfied. When parents had recommendations, the main themes invoked improving communication about (1) preparing for discharge and life after the NICU in a stepwise, personalised and practical manner (40%), (2) more practical and functional information about being a parent in the NICU during the whole clinical trajectory (35%) and (3) more optimistic conversations with clinicians about the function of babies/families (as opposed to diagnoses) (26%).</p><p><strong>Conclusion: </strong>Although half the parents are satisfied with the information received, many recommended improvements in clinician-parent communication, mainly to make it more accessible, personalised, positive and practical.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155913","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":"Prevention and treatment of autoimmune-mediated congenital heart block: practice provider survey from UK cardiac centres.","authors":"Abhishek Agarwal, Sophia Khan, Melonie Johns, Colin J McMahon, Leila Rittey, Sophie Duignan, Peter John Lillitos, Nicola Boyd, David Black, Suhair Shebani, Abdulla Tarmahomed, Konta Laura, Olga Panagiotopoulou, Daniel Hawcutt","doi":"10.1136/archdischild-2024-328428","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328428","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141218","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":"Treatment of Hypotension of Prematurity: a randomised trial.","authors":"Thomas Alderliesten, Emad Arasteh, Anne van Alphen, Floris Groenendaal, Jeroen Dudink, Manon Jnl Benders, Frank van Bel, Pma Lemmers","doi":"10.1136/archdischild-2024-328253","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328253","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether a perfusion-based approach (permissive hypotension, PH) for idiopathic low mean arterial blood pressure (MABP) during the first 72 hours after birth in preterm infants without overt sepsis affects neurodevelopmental outcome (NDO) at 24 months of age.</p><p><strong>Design: </strong>Randomised controlled trial. Outcome assessors were blinded.</p><p><strong>Setting: </strong>Single centre.</p><p><strong>Patients: </strong>Infants <30 weeks gestational age (GA) with MABP in mm Hg <GA in weeks during the first 72 hours after birth, without overt signs of sepsis.</p><p><strong>Intervention: </strong>Random assignment to PH, initiating treatment on signs of low perfusion and/or a MABP 5 mm Hg below their GA in weeks, or standard treatment (ST), initiating treatment when MABP was <GA in weeks.</p><p><strong>Main outcome measures: </strong>Death, NDO at 24 months, and composite adverse outcome (death <i>or</i> cognitive <i>and/or</i> motor NDO below -1 SD).</p><p><strong>Results: </strong>86 infants were included, 57.3% of projected inclusions. Both cognitive NDO (PH-ST mean difference 0.8 (95% CI -5.6 to 7.3)) and motor NDO (mean difference 3.7 (-3.3 to 10.7)) were comparable. The relative risks for death (1.4 (0.6 to 3.7)) and composite adverse outcome (0.8 (0.5 to 1.3)) were comparable. The number of infants with inotropic support (n=19 (42.5%) vs 7 (15.2%), p=0.004) and duration of support (median 48.0 hours (IQR 26.8 to 77.5) vs 17.0 (14.0 to 37.0)) was lower in the PH group, with comparable MABPs.</p><p><strong>Conclusion: </strong>A PH approach in preterm infants is feasible. It leads to comparable blood pressures with less inotrope administration. Though underpowered, we did not detect a major negative impact of PH on short-term or long-term outcomes.</p><p><strong>Trial registration number: </strong>NCT01434251.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141153","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":"Relationship between applied face mask force and mask leak during simulated neonatal ventilation: a randomised simulation study.","authors":"Jacqueline Hannan, Gary Weiner, Leia Stirling","doi":"10.1136/archdischild-2024-328378","DOIUrl":"10.1136/archdischild-2024-328378","url":null,"abstract":"<p><strong>Objective: </strong>Assess the relationship between applied face mask force and leak during simulated ventilation using different ventilating devices and mask holds.</p><p><strong>Design: </strong>Randomised cross-over simulation study.</p><p><strong>Setting: </strong>Quiet, non-clinical room in children's hospital.</p><p><strong>Participants: </strong>Twenty-four experienced neonatal healthcare providers.</p><p><strong>Interventions: </strong>Ventilate a manikin for 2 min per trial, each with three trial conditions: self-inflating bag (SIB) with one-hand hold, T-piece with one-hand hold, T-piece with two-hand hold.</p><p><strong>Main outcome measures: </strong>Applied force (newtons (N)) measured under the head and at four locations on the manikin's face (nasal bridge, mentum, left and right zygomatic arches), force asymmetry applied to the mask rim, and mask leak.</p><p><strong>Results: </strong>Under-head force was greatest using the SIB with one-hand hold (mean (SD) 20.53 (5.87) N) and least using the T-piece with one-hand hold (mean (SD) 17.58 (6.11) N). While mask leak was reduced with increasing force, leak-free ventilation was achieved by some participants in all trial conditions with low (<10 N) under-head force. Force asymmetry on the manikin's face was similar using a one-hand hold compared with a two-hand hold. With both holds, forces were greater on the side of the face corresponding to the operator's non-dominant hand.</p><p><strong>Conclusion: </strong>Applied force and leak varied between devices and mask holds. Force asymmetry was present with both mask holds. Leak-free ventilation could be achieved with small forces using either an SIB or T-piece and either mask hold. Force feedback during training may improve the effectiveness and safety of neonatal ventilation.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109465","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":"Automated tactile stimulation in response to cardiorespiratory events in preterm infants: a feasibility study.","authors":"Sophie J E Cramer, Stuart B Hooper, Hylke H Salverda, Ryanne Koster, Janneke Dekker, Arjan B Te Pas","doi":"10.1136/archdischild-2024-328123","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328123","url":null,"abstract":"<p><strong>Objective: </strong>Assess the feasibility and safety of a purpose-built automated tactile stimulation device (ATSD) responding to cardiorespiratory events in preterm infants.</p><p><strong>Design: </strong>Randomised cross-over study.</p><p><strong>Setting: </strong>Level-III neonatal intensive care unit in the Netherlands.</p><p><strong>Patients: </strong>Infants born between 24 and 30 weeks gestational age, receiving non-invasive respiratory support and experiencing apnoea, bradycardia and/or hypoxia for>10 s.</p><p><strong>Interventions: </strong>Infants underwent two study periods of 24 hours. In the control period, the ATSD was attached but inactive. In the intervention period, ATSD was activated and used in addition to standard care, providing direct vibratory stimulation in response to clinical alarms.</p><p><strong>Main outcome measure: </strong>Feasibility of using ATSD, expressed by the number of infants completing the study, the ability to provide stimulation on the skin and the perceived feasibility by the nurses.</p><p><strong>Results: </strong>16 infants were included, of which 14 (88%) completed both study periods. Two infants were withdrawn from the study prematurely: one infant required intubation for cyanotic spells and the other developed local non-blanching erythema consistent with a mild pressure ulcer, on which the device was removed. During the intervention period, ATSD correctly detected 84% of the cardiorespiratory events, with automatic stimulation following 100% of the events. Nurses found the ATSD easy to use and rated the clinical utility neutral to positive.</p><p><strong>Conclusion: </strong>Applying automated tactile stimulation in preterm infants using a purpose-built device is feasible, was well tolerated by infants and nurses considered our device useful and easy to use.</p><p><strong>Trial registration details: </strong>Dutch national trial register, NL9606.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109369","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":"Aicardi-Goutières syndrome as a rare cause of neonatal intracranial calcifications.","authors":"Adriel Kwok Huang Chen, Laura Daniela Valderrama Penagos, Khadidja Belkhatir","doi":"10.1136/archdischild-2025-328751","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328751","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085679","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":"Dynamic lung aeration after birth does not impede pulmonary blood flow in preterm lambs.","authors":"Arun Sett, Jennifer Truong, Anna Crotty, Ellen Douglas, Joel Hodder, Qi Hui Poh, Kelly R Kenna, Magdy Sourial, Monique Fatmous, Prue M Pereira-Fantini, David Gerald Tingay","doi":"10.1136/archdischild-2024-328401","DOIUrl":"https://doi.org/10.1136/archdischild-2024-328401","url":null,"abstract":"<p><strong>Rationale: </strong>Stepwise positive end-expiratory pressure at birth (dynamic PEEP) reduces lung injury in preterm lambs; however, the impact of dynamic PEEP on pulmonary blood flow (PBF) during immediate (ICC) and deferred cord clamping (DCC) is unknown.</p><p><strong>Objectives: </strong>To determine the impact of dynamic PEEP on PBF during DCC and ICC.</p><p><strong>Methods: </strong>Preterm lambs (n=22) received a ventilation strategy with either dynamic PEEP (between 8 and 14 cmH₂O) or static PEEP (8 cmH₂O) after birth. Lambs were managed with either DCC or ICC (30 s clamp to ventilation) (n=5-6 per group). Left pulmonary artery flow was measured using echocardiography as a surrogate for PBF. Ventilation parameters and PBF were measured every 20 s until 180 s and at 5, 10 and 15 min from ventilation onset.</p><p><strong>Results: </strong>There was no significant difference in PBF between dynamic and static PEEP applied during DCC (mean (SD) 183 (66) vs 125 (43) mL/kg/min, mean (SD) difference=-58 (103) mL/kg/min, p=0.09) or ICC (124 (26) vs 120 (31) mL/kg/min, mean difference=-4(184), p=0.94). PBF significantly increased over time (p<0.01; mixed effects) in all groups regardless of cord management. This was associated with an increase in the velocity time integral (p<0.01) but no difference in heart rate. Cerebral blood flow reduced over time during DCC (p<0.01) with no change observed during ICC. There was no difference in lung mechanics apart from higher respiratory system compliance in the ICC Dynamic PEEP group (mean difference 0.08 (0.05) mL/kg/cmH₂O, p<0.01).</p><p><strong>Conclusions: </strong>Elective lung recruitment after birth using a dynamic PEEP does not impede PBF in preterm lambs.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957414","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":"Diagnostic accuracy of an over-the-counter infant pulse oximeter for cardiorespiratory events.","authors":"Colm P Travers, Arie Nakhmani, Kimberly M Armstead, Rachel L Benz, Kathryn M Foshee, Waldemar A Carlo","doi":"10.1136/archdischild-2025-328540","DOIUrl":"10.1136/archdischild-2025-328540","url":null,"abstract":"<p><strong>Objective: </strong>To determine the diagnostic accuracy of an over-the-counter infant pulse oximeter for cardiorespiratory events.</p><p><strong>Design: </strong>Single-centre prospective diagnostic accuracy study.</p><p><strong>Setting: </strong>University of Alabama at Birmingham.</p><p><strong>Patients: </strong>Infants weighing ≥1500 g, <44 weeks' postmenstrual age (PMA) and off ventilator/continuous positive airway pressure support.</p><p><strong>Interventions: </strong>Test device for 48 hours in addition to standard hospital monitors, ECG and pulse oximetry.</p><p><strong>Main outcome measures: </strong>Data were time aligned and analysed using MATLAB. The coprimary outcomes were the diagnostic accuracy of the test device for the detection of events with heart rate (HR) <50 beats per minute (bpm) and events with oxygen saturations (SpO₂) <80% for ≥3 s.</p><p><strong>Results: </strong>66 infants with a median gestational age of 31 weeks (range 23-40) were studied at a median 35 weeks' PMA (range 32-42) weighing 1930 g (range 1500-3605 g) from April to July 2023. The sensitivity for detection of HR <50 bpm ≥3 s was 6% and 39% for smoothed and raw data, respectively, while the specificity was >99% for both smoothed and raw data. The sensitivity for SpO₂ <80% ≥3 s was 14% and 74%, while the specificity was >99% and 96% for smoothed and raw data, respectively. Sensitivity for bradycardia events was higher for events with longer durations and/or when using higher thresholds. Sensitivity was higher for hypoxaemia events with longer durations and/or when using higher thresholds.</p><p><strong>Conclusion: </strong>An over-the-counter infant pulse oximeter had high specificity for bradycardia and hypoxaemia events consistent with a low false alarm rate. Sensitivity improved with longer events and higher event thresholds.</p><p><strong>Trial registration number: </strong>NCT05774470.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12353594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952575","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":"Effect of gestational age on special education: a population-based matched cohort analysis.","authors":"Tessa de Baat, Anita C J Ravelli, Cornelieke S H Aarnoudse-Moens, Ameen Abu-Hanna, Aleid G Leemhuis","doi":"10.1136/archdischild-2025-328599","DOIUrl":"https://doi.org/10.1136/archdischild-2025-328599","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of gestational age on special education use at primary school age, and to examine specific groups with elevated risk.</p><p><strong>Design, setting and patients: </strong>Population-based matched cohort study linking data from the Dutch national perinatal registry (PERINED) of all singleton surviving children without major congenital abnormalities, born between 25⁺⁰ and 42⁺⁶ weeks of gestation between 1999 and 2009, with data of the mandatory special education registry of Statistics Netherlands.</p><p><strong>Main outcome measures: </strong>Use of special education at primary school age.</p><p><strong>Results: </strong>1 814 540 children were included. Overall prevalence of special education was 6.6%, with highest rates in children born at 25 weeks (34.7%) and lowest at 40 weeks (5.7%). Elevated adjusted ORs for special education compared with the reference of 40 weeks were found in all gestational age groups (25-29 weeks, 30-31 weeks, 32-36 weeks, 37-39 weeks and 41-42 weeks), with the highest adjusted OR (3.50 (95% CI, 3.26 to 3.77)) in children born at 25-29 weeks. Comparable ORs were obtained after 1 to 1 exact matching with controls born at 40 weeks. Low maternal education, male sex, small for gestational age and 5-min Apgar score<7 increased special education use at week 25 and above.</p><p><strong>Conclusion: </strong>There is a strong inverse effect of gestational age on special education use in this complete nationwide, decennium birth cohort. Increased risk of special education use is still present in late preterms and those born at early-term or post-term.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966595","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}