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

{"title":"Umbilical cord management strategies and risk of intraventricular haemorrhage in preterm neonates: a systematic review and meta-analysis.","authors":"Ilari Kuitunen, Marjut Haapanen, Maiju Kekki, Panu Kiviranta","doi":"10.1136/archdischild-2025-329006","DOIUrl":"10.1136/archdischild-2025-329006","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the comparative effectiveness of different umbilical cord management strategies for preventing intraventricular haemorrhage (IVH) in preterm neonates.</p><p><strong>Design: </strong>A systematic review and meta-analysis.</p><p><strong>Study sources: </strong>PubMed, Scopus and Web of Science were searched from inception to March 2025 for relevant randomised controlled trials.</p><p><strong>Participants: </strong>All preterm neonates born <37+0 weeks of gestation.</p><p><strong>Interventions: </strong>All umbilical cord management strategies, including immediate cord clamping (ICC), delayed cord clamping (DCC), intact umbilical cord milking (I-UCM), cut umbilical cord milking (C-UCM), intact cord stabilisation (ICS), physiology-based cord clamping and extrauterine placental perfusion.</p><p><strong>Main outcome measures: </strong>Any grade IVH (grades I-IV) and severe IVH (grades III-IV).</p><p><strong>Data synthesis: </strong>Random-effects meta-analyses were conducted to calculate risk ratios (RRs) with 95% CIs. Analyses were stratified for very preterm (<32 weeks) and extremely preterm neonates (<28 weeks).</p><p><strong>Results: </strong>Forty-nine studies with 8706 neonates were included. Thirty-five direct comparisons between strategies were made, but no clear evidence of benefit or harm emerged. Certainty of evidence ranged from moderate to very low, often downgraded due to imprecision, risk of bias and inconsistency. The most frequent comparison was DCC versus ICC, with 14 studies (RR 0.90, CI 0.65 to 1.26) for any grade IVH and 11 studies (RR 1.14, CI 0.69 to 1.87) for severe IVH. The second most common comparison, DCC versus I-UCM, showed no benefit: RR 1.03 (CI 0.80 to 1.32; eight studies, 2200 participants) and RR 0.77 (CI 0.35 to 1.66; seven studies, 2032 participants). ICS versus DCC was the only comparison which was rated as moderate certainty of evidence for both, any grade IVH (RR 0.96, CI 0.82 to 1.13) and severe IVH (RR 0.91, CI 0.62 to 1.35).</p><p><strong>Conclusions: </strong>No umbilical cord management strategy was clearly associated with increased or decreased IVH risk. Evidence certainty was generally low to very low, primarily due to bias and imprecision.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F210-F218"},"PeriodicalIF":3.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231342","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":"Intermittent hypoxia and caffeine in infants born preterm: the ICAF Randomized Clinical Trial.","authors":"Eric Eichenwald, Michael Corwin, Betty McEntire, Susan Knoblach, Catherine Limperopoulos, Kushal Kapse, Stephen Kerr, Timothy C Heeren, Christine Ikponmwonba, Carl E Hunt","doi":"10.1136/archdischild-2025-329230","DOIUrl":"10.1136/archdischild-2025-329230","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether extending caffeine therapy through 43 weeks' postmenstrual age (PMA) decreases intermittent hypoxia (IH) in convalescing preterm infants. Secondary objectives were to assess caffeine effects on changes in inflammation-related plasma biomarkers and brain MRI.</p><p><strong>Design: </strong>Multicentre masked randomised trial.</p><p><strong>Setting: </strong>16 US hospitals.</p><p><strong>Patients: </strong>Infants at <30 weeks + 6 days gestational age on caffeine between 32 weeks and 36+5 days PMA in room air with routine caffeine discontinuation prior to 36 weeks +6 days.</p><p><strong>Intervention: </strong>Randomisation to caffeine or placebo and treated through 42 completed weeks. Pulse oximetry was recorded from enrolment through 1 week after stopping study drug. Blood for 12 inflammation-related biomarkers obtained at enrolment and 38 weeks' PMA and brain imaging after enrolment or <3 days of randomisation, and study end.</p><p><strong>Main outcome measure: </strong>Seconds/hour of oxygen saturation <90% from randomisation to study end.</p><p><strong>Results: </strong>Randomised 160 subjects, 78 placebo, 82 caffeine. IH was less at every PMA with caffeine treatment from 34 (172.7 (123.4, 241.7); 84.7 (64.4, 111.4, p<0.01) through 41 weeks (73.0 (51.3, 103.7); 26.6 (18.5, 38.2, p<0.001). Adjusted TNF-α levels were 23% lower at follow-up in the caffeine group compared with placebo (p<0.02), without other biomarker differences. Paired brain imaging found no significant differences.</p><p><strong>Conclusions: </strong>Extended caffeine reduced the burden of IH in very preterm infants and may reduce inflammation. Further study is needed to determine if this effect of caffeine is associated with reduced risk of adverse outcomes.</p><p><strong>Trial registration number: </strong>NCT03321734.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F249-F255"},"PeriodicalIF":3.5,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145595712","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":"Effects of mother-infant ABO incompatibility on neonates: a cohort study in the Chinese population.","authors":"Yuanjun Wu, Ganping Guo, Yinglin Wu, Liangchang Xiu, Yanli Ji, Minxu Li, Manna Sun, Xinghe Wang, Xuejun Ren, Lan Zhang, Jianqun Li, Shujie Wu, Miaozhen Wen, Jiajun Zeng, Qianquan Yuan, Zhongying Xie, Yong Yang","doi":"10.1136/archdischild-2024-328079","DOIUrl":"10.1136/archdischild-2024-328079","url":null,"abstract":"<p><strong>Background: </strong>It has traditionally been considered that mother-infant ABO incompatibility only causes mild haemolytic disease of the newborn (HDN). However, this view is inconsistent with clinical practice, and large-scale population-based data are lacking to investigate its effects on neonates.</p><p><strong>Methods: </strong>Differences in hospitalisation rates and incidence rates of neonatal hyperbilirubinaemia (NHB) and anaemia among 47 679 Chinese liveborn neonates with different mother-infant ABO combinations, differences in the incidence of ABO-incompatible HDN (ABO-HDN) among neonates with O-B versus O-A mother-infant ABO incompatibility, and the contributions of ABO-HDN to the development of NHB and neonatal anaemia were analysed.</p><p><strong>Results: </strong>Of the 47 679 liveborn neonates, neonates with mother-infant ABO incompatibility had higher rates of hospitalisation and incidence of NHB and anaemia. The hierarchy of the risk of mother-infant ABO incompatibility to the neonate was O-B > O-A > non-O-A/O-B incompatibility. Among neonates with O-B and O-A mother-infant ABO incompatibility, the ABO-HDN incidence rates were 15.27% (513/3359) and 11.33% (417/3680), respectively (95% CI 1.41 (1.23 to 1.62)), and the severe ABO-HDN incidence rates were 2.05% (69/3359) and 1.14% (42/3680), respectively (95% CI 1.82 (1.23 to 2.67)). Among the 7039 neonates with O-A/O-B mother-infant ABO incompatibility, ABO-HDN was an independent aetiological factor in 41.11% (666/1620) of the neonates with NHB, 70.27% (52/74) of the neonates with severe NHB, 42.34% (163/385) of the neonates with anaemia and 18.28% (17/93) of the neonates with severe anaemia.</p><p><strong>Conclusions: </strong>Mother-infant ABO incompatibility often leads to severe HDN and is a dominant cause of NHB and neonatal anaemia, leading to significantly higher neonatal hospitalisation rates.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F236-F242"},"PeriodicalIF":3.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298133","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":"Reduction of IVH in very preterm infants via a two-step quality improvement project: a retrospective study of 14 years' experience.","authors":"Jochen Essers, Manuel Boris Bryant, Cornelia Horsch, Benedikt Winter, Frank Reister, Benjamin Mayer, Harald Ehrhardt, Helmut D Hummler","doi":"10.1136/archdischild-2025-329407","DOIUrl":"10.1136/archdischild-2025-329407","url":null,"abstract":"<p><strong>Objective: </strong>The introduction of quality improvement projects has been reported to be associated with a reduced rate of intraventricular haemorrhage (IVH) rate in some neonatal intensive care units.</p><p><strong>Methods: </strong>In this retrospective single-centre study of 1675 preterm infants <1500 g, we analysed the frequency of overall IVH and severe IVH before and after the introduction of a first (2010) and a second (2019) quality improvement bundle.</p><p><strong>Results: </strong>After the introduction of a first bundle of interventions in 2010, we were able to show a significant reduction of the rate of IVH from 22.2% to 10.5% (p=0002), mainly related to a reduction of severe IVH in the subgroup of infants below 26 weeks of gestational age. By continuous monitoring and implementation of a second intervention bundle in 2019 according to new identified risk factors, we could maintain a low rate of IVH over a 14 year period. With the reduction of the IVH rate, we observed improved long-term neurodevelopmental outcome as indicated by a lower rate of cerebral palsy and improved psychomotor development scores.</p><p><strong>Conclusion: </strong>Our data suggest that implementing an intervention bundle of measures targeted to avoid risk factors may be associated with a significant reduction in IVH rate. By constant monitoring of the effects of the intervention and individual measures and refining the care bundle based on new evidence becoming available, a reduced IVH rate may be maintained despite annual fluctuations in the incidence of IVH. These intensified efforts are justified as IVH is not an inevitable event.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F275-F281"},"PeriodicalIF":3.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145595787","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":"Fantoms.","authors":"Ben J Stenson","doi":"10.1136/archdischild-2026-330738","DOIUrl":"https://doi.org/10.1136/archdischild-2026-330738","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":"111 3","pages":"F185"},"PeriodicalIF":3.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715693","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":"Parental experience of having a child with hypoxic ischaemic encephalopathy: a qualitative study.","authors":"Alexandra Bache, Alastair G Sutcliffe, Monica E Lemmon, Carrie Williams, Chris Gale, Sarah Land, Philippa Rees","doi":"10.1136/archdischild-2025-329374","DOIUrl":"10.1136/archdischild-2025-329374","url":null,"abstract":"<p><strong>Objective: </strong>To explore families' experiences of hypoxic ischaemic encephalopathy (HIE) care in the National Health Service (NHS) and the impact of HIE on families.</p><p><strong>Design: </strong>Semistructured interviews (n=28) sampled to maximise variation, were conducted with parents of infants (born 2010-2024) who underwent therapeutic hypothermia for HIE. Data were analysed with reflexive thematic analysis.</p><p><strong>Setting: </strong>Parents were recruited from across the UK, covering 84.6% (11/13) of the UK's regional neonatal networks, known as Operational Delivery Networks.</p><p><strong>Findings: </strong>Three themes with eight subthemes were generated from the interview data. (1) The life-changing diagnosis of HIE: Parents described loss of stability and opportunity to parent, ongoing mental turmoil, and how the diagnosis led to transformation. (2) Balancing hope with facts: Parents opened up on how treasured their child is, the tension between hope and loss they experienced, and feelings of being kept in the dark. (3) Struggling to meet their child's needs: Parents outlined deficiencies in care infrastructure and battling disability-based discrimination.</p><p><strong>Conclusions: </strong>This study highlights the profound and life-changing impact of HIE on families. Parents described cherishing their children and experiencing personal growth. However, many also characterised how challenges were intensified by disability-based discrimination, poor communication and gaps in support across health, education and social care systems.To prevent further trauma and to support family well-being, this work identifies priority improvement areas. Embedding trauma-informed care, strengthening transparent and sensitive communication around prognostic uncertainty, and improving care coordination will help families feel seen, heard and supported throughout their journey.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F219-F226"},"PeriodicalIF":3.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290744","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":"Long-term neurodevelopmental outcomes in extremely preterm infants born at 22-26 weeks gestation: a follow-up of 2-2.5 years across two Swedish national cohorts from 2004-2007 to 2014-2016.","authors":"Ulrika Ådén, Aijaz Farooqi, Lena Hellstrom-Westas, Karin Sävman, Thomas Abrahamsson, Lars J Björklund, Magnus Domellöf, Anders Elfvin, Fredrik Ingemansson, Fredrik Serenius, Stellan Hakansson, David Ley, Erik Normann, Petra Um Bergström, Karin Kallen, Mikael Norman","doi":"10.1136/archdischild-2024-327919","DOIUrl":"10.1136/archdischild-2024-327919","url":null,"abstract":"<p><strong>Objective: </strong>To compare neurodevelopmental outcomes in extremely preterm (EPT) children born across two epochs in Sweden.</p><p><strong>Design and setting: </strong>Nationwide population-based cohorts of infants born at 22-26 weeks' gestation in 2004-2007 (Cohort 1) and 2014-2016 (Cohort 2), comprising 1606 live births. Survivors were assessed at 2-2.5 years' corrected age using the same protocol design.</p><p><strong>Main outcome: </strong>The primary outcome was neurodevelopmental impairment (NDI), defined as a composite of moderate-severe cerebral palsy (CP), visual or hearing deficits, or moderate-severe cognitive, language or motor impairment assessed with the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III). For children not assessed with Bayley-III, NDI was defined as moderate-severe speech delay, general developmental delay or categories of CP, vision and hearing impairment. Outcomes were compared using logistic regression to evaluate differences between cohorts and perinatal and socioeconomic risk factors.</p><p><strong>Results: </strong>Of 1188 eligible survivors, 1062 (89.3%) were assessed (mean gestational age (GA) 24.8 weeks; 54.9% male). The prevalence of moderate-severe NDI at 22, 23, 24, 25 and 26 weeks' gestation was 60% vs 52%, 51% vs 51%, 34% vs 42%, 27% vs 32% and 17% vs 24% in Cohorts 1 and 2, respectively. Overall prevalence did not differ significantly (27% vs 35%; adjusted OR (AOR) 1.2, 95% CI 0.94 to 1.6). Among 724 (68%) children assessed with Bayley III, Cohort 2 had higher rates of cognitive delay (21.6% vs 11.3%; AOR 1.8, 95% CI 1.1 to 3.4) and language delay (40.9% vs 16.1%; AOR 3.3, 95% CI 1.4 to 4.1). Low GA and maternal country of birth outside the Nordic region were the strongest predictors of NDI and cognitive delay, the latter association confined to Cohort 2.</p><p><strong>Conclusion: </strong>Although survival of EPT infants in Sweden has improved, long-term neurodevelopmental outcomes have not. The root causes of failed improvements in long-term outcomes for EPT infants are complex and need further clarification.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F227-F235"},"PeriodicalIF":3.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298141","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":"Duration of apnoea before start of backup ventilation during nCPAP in extremely preterm infants and time spent within the SpO₂ target: a randomised cross-over study.","authors":"Stephanie Ströbele, Tibor Jung, Dominik Kraft, Nadine Forsteneichner, Eva-Maria Mair, Lisa Schiefele, Sebastian Schmid, Markus Waitz, Vanessa Linhoff, Antje Westhoff, Jens Dreyhaupt, Keywan Sohrabi, Harald Ehrhardt","doi":"10.1136/archdischild-2025-328734","DOIUrl":"10.1136/archdischild-2025-328734","url":null,"abstract":"<p><strong>Objective: </strong>Central apnoea due to immaturity of the respiratory drive constitutes the main cause of frequent and prolonged desaturations in extremely preterm (EPT) infants <28 weeks. We investigated the impact of varying the duration of apnoea before backup ventilation (BUV) on the measures of oxygenation in EPT infants during nasal continuous positive airway pressure (nCPAP) therapy.</p><p><strong>Design: </strong>Single-centre randomised cross-over trial.</p><p><strong>Setting: </strong>Level 3 neonatal intensive care unit.</p><p><strong>Patients: </strong>24 EPT infants on nCPAP with BUV.</p><p><strong>Main outcome measures: </strong>The primary outcome was the time spent within a predefined oxygen saturation (SpO₂) target (88%-95% or ≥88% with fraction of inspired oxygen (FiO₂) =0.21) during start of BUV after 4 s of apnoea duration (AD 4) or 16 s of apnoea duration (AD 16) RESULTS: The study was successfully completed in 22 children (median gestational age 24+5 weeks, birth weight 628 g, postnatal age 48 days). Mean time spent within the SpO₂ target didn't differ between AD 4 and AD 16 (66.9% vs 67.2%, p=0.88). There were no differences in the time below or above the SpO₂ target, prolonged (>30 s, >60 s, >120 s) and severe (<80%, <70%) episodes of hypoxaemias and cerebral tissue oxygenation. Mean FiO₂, mean airway pressure, transcutaneous carbon dioxide pressure, heart rate and respiratory frequency did not differ while the rate of BUV was significantly higher during AD 4.</p><p><strong>Conclusion: </strong>Reducing the time of apnoea until start of BUV didn't improve the time spent within the SpO₂ target in respiratory unstable EPT infants. Our data demand intensified efforts to specify these settings of non-invasive respiratory support that better achieve this important clinical goal.</p><p><strong>Trial registration number: </strong>DRKS00031911.</p>","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F203-F209"},"PeriodicalIF":3.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181883","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":"Trials of medications for neonatal seizures: time for pragmatism.","authors":"George Clough, Christopher Harris, Anne Greenough, Anthony Richard Hart","doi":"10.1136/archdischild-2025-329844","DOIUrl":"10.1136/archdischild-2025-329844","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F286-F288"},"PeriodicalIF":3.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493862","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":"<i>Correction: Neurodevelopmental outcome at 5.5 years in Dutch preterm infants born at 24-26 weeks' gestational age: the EPI-DAF study</i>.","authors":"","doi":"10.1136/archdischild-2023-325732cor1","DOIUrl":"10.1136/archdischild-2023-325732cor1","url":null,"abstract":"","PeriodicalId":8177,"journal":{"name":"Archives of Disease in Childhood - Fetal and Neonatal Edition","volume":" ","pages":"F290"},"PeriodicalIF":3.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556096","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}