Child's Nervous System最新文献

{"title":"Can the BIG score reliably predict outcomes in pediatric traumatic brain ınjury?","authors":"Abdulrahman Özel, Servet Yüce, Esma Şengenç, Esra Nur İlbeği, İzzettin Kaya, Şevval Özyılmaz Gazneli, Meltem Erol","doi":"10.1007/s00381-025-06809-1","DOIUrl":"https://doi.org/10.1007/s00381-025-06809-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the prognostic value of the BIG score in predicting mortality and functional outcomes in pediatric patients with traumatic brain injury (TBI).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on pediatric TBI patients admitted to the Pediatric Intensive Care Unit (PICU) between 2020 and 2024 at a tertiary hospital. Functional outcomes at discharge were assessed using the Functional Status Scale (FSS). Receiver operating characteristic (ROC) analysis determined the predictive accuracy of the BIG score, Pediatric Trauma Score (PTS), Pediatric Glasgow Coma Scale (pGCS), and Pediatric Risk of Mortality III (PRISM III).</p><p><strong>Results: </strong>A total of 103 patients were included. The mortality rate was 13.6% (n = 14), and 21.4% of survivors had functional impairment at discharge. In non-survivors, the BIG score, PTS, pGCS, and PRISM III were significantly elevated (all p < 0.001). The AUC for predicting mortality was 0.966 (BIG score), 0.911 (PRISM III), 0.909 (pGCS), and 0.827 (PTS). For functional impairment, the AUC values were 0.815 (BIG score), 0.812 (pGCS), 0.715 (PRISM III), and 0.645 (PTS). Correlation analysis showed a strong association between FSS scores and mechanical ventilation duration (r = 0.786, p < 0.001) and PICU length of stay (r = 0.706, p < 0.001).</p><p><strong>Conclusion: </strong>The BIG score is a rapid, reliable predictor of mortality and functional outcomes in pediatric TBI patients, outperforming pGCS in patients with an initial pGCS of 3. Prospective studies are needed for further validation.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"147"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751427","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":"Diencephalic-mesencephalic junction dysplasia: case report and literature review.","authors":"Tenoch Herrada-Pineda, Ana Karen Perez-Vazquez, Salvador Manrique-Guzman, Francisco R Revilla-Pacheco, Eduardo Torres-Olivas, Maria Jose Wilches-Davalos, Tania Ivette Sanchez-Zacarias, Gilda Garza-Mayen, Jorge Arturo Cardona-Perez","doi":"10.1007/s00381-025-06808-2","DOIUrl":"https://doi.org/10.1007/s00381-025-06808-2","url":null,"abstract":"<p><p>Diencephalic-mesencephalic junction (DMJ) dysplasia is a rare congenital brain malformation characterized by a poorly defined junction between the diencephalon and mesencephalon, often associated with a butterfly-like contour of the midbrain on magnetic resonance imaging (MR). We report the case of a newborn female diagnosed prenatally with DMJ dysplasia who presented with severe ventriculomegaly, hydrocephalus, and oligohydramnios. Prenatal MRI at 32 weeks revealed a thickened interthalamic adhesion, an elongated midbrain with ventral cleft, aqueductal stenosis, and corpus callosum dysgenesis. Postnatal MRI confirmed these findings, along with the characteristic \"butterfly\" midbrain morphology. Genetic analysis revealed a pathogenic 11.9 Mb terminal deletion in the 6q25.3q27 region, encompassing candidate neurodevelopmental genes, such as DLL1, and a 3.8 Mb partial duplication in 22q13.31q13.33, of unknown significance. Parental genetic testing revealed a maternal balanced reciprocal translocation between chromosomes 6 and 22 (asymptomatic carrier), which was inherited in an unbalanced form by the proband. A ventriculoperitoneal shunt was placed within the first 48 h of life to manage hydrocephalus, with subsequent adjustments and revisions as needed. This case highlights the importance of advanced prenatal imaging and genetic testing in the diagnosis of complex brain malformations as well as the need for multidisciplinary management of rare congenital anomalies. Further research is essential to elucidate the underlying genetic mechanisms and improve the outcomes in patients with DMJ dysplasia.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"146"},"PeriodicalIF":1.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751429","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":"Surgical management of a giant glial hamartoma in a pediatric patient: a case report.","authors":"Guive Sharifi, Elham Paraandavaji, Shahin Naghizadeh, Yalda Nilipour, Mohammad Ali Kazemi, Sajjad Khanbabazadeh, Farzad Taghizadeh-Hesary","doi":"10.1007/s00381-025-06792-7","DOIUrl":"https://doi.org/10.1007/s00381-025-06792-7","url":null,"abstract":"<p><strong>Introduction: </strong>Glial hamartomas are benign growths of glial cells, and their management is challenging due to their rarity and variable presentation. We present a case of a giant glial hamartoma in a pediatric patient, incidentally discovered during routine imaging for a planned tonsillectomy.</p><p><strong>Case description: </strong>A 7-year-old boy with no prior neurological symptoms was found to have a large glial hamartoma in the right frontal lobe, measuring 67 mm in height and 50 mm in transverse diameter. Imaging studies revealed a hyperdense mass with internal calcifications on CT, hypointense on T1-weighted MRI, and hyperintense on T2-weighted MRI. Histopathology confirmed the diagnosis, showing benign glial cells, Rosenthal fibers, and eosinophilic granular bodies. A multidisciplinary team decided on surgical resection due to the tumor's size. The tumor was resected without complications, and postoperative recovery was uneventful. Follow-up MRIs at 4 months and 2 years post-surgery showed no residual tumor or recurrence.</p><p><strong>Conclusions: </strong>This case underscores the role of radiological evaluation in identifying rare asymptomatic glial hamartomas and supports surgical resection to prevent complications. Comprehensive follow-up is essential for early detection of any recurrence.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"145"},"PeriodicalIF":1.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751457","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":"Subdural collections in childhood.","authors":"José Roberto Tude Melo, Federico Di Rocco","doi":"10.1007/s00381-025-06812-6","DOIUrl":"https://doi.org/10.1007/s00381-025-06812-6","url":null,"abstract":"","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"144"},"PeriodicalIF":1.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751365","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":"Giant calvarial metastasis from secondary Ewing sarcoma with chronic subdural hygroma in a childhood hematological cancer survivor - An unusual case report.","authors":"Praveen Ravichandran, Karthik Nandam, Manoranjithakumari Mani, Sangamithirai K M, Bheemanathi Hanuman Srinivas","doi":"10.1007/s00381-025-06793-6","DOIUrl":"https://doi.org/10.1007/s00381-025-06793-6","url":null,"abstract":"<p><p>We report an unusual case of a 9-year-old boy with Hodgkin lymphoma post chemoradiotherapy, who later developed Ewing sarcoma involving the eighth rib, which had metastasised to the cranial vault with meningeal and subdural involvement. Presenting with seizures, headache and hemiparesis, he underwent craniotomy and gross total tumour resection, with histopathology confirming metastatic Ewing sarcoma. Despite initial improvement, the patient presented with further cranial metastasis on follow-up. This case contributes to the limited literature on Ewing sarcoma metastasis to the CNS in patients with prior hematologic malignancies, questioning potential links between therapeutic chemoradiotherapy exposures and secondary cancer development. This case emphasises the unusual metachronous presentation of Hodgkin lymphoma and Ewing sarcoma and the high risk of recurrence and CNS involvement in cranial Ewing sarcoma, highlighting challenges in management and prognosis.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"143"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735655","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":"Timeliness of surgical repair among infants with myelomeningocele in a tertiary care hospital in Addis Ababa, Ethiopia.","authors":"Kibruyisfaw Zewdie, Bethelehem Yesehak, Amanda Dorsey, Yemisirach Bizuneh Akililu, Addisalem Belete, Yordanos Ashagre, Yakob Ahmed, Patricia O O'Neill, Vijaya Kancherla","doi":"10.1007/s00381-025-06801-9","DOIUrl":"https://doi.org/10.1007/s00381-025-06801-9","url":null,"abstract":"<p><strong>Purpose: </strong>Ethiopia has a high prevalence of myelomeningocele (open spina bifida), a severe and often fatal birth defect affecting the spinal cord in the newborn. Timely surgery is associated with improved health outcomes and survival among those affected. Recent studies on timeliness of myelomeningocele closure surgery and factors associated with it are lacking in Ethiopia.</p><p><strong>Methods: </strong>We conducted an observational study using data from structured electronic medical records stored at the largest surgical and treatment referral hospital for spina bifida care in Ethiopia. We used surgical information on patients with myelomeningocele from January 2020 to June 2022. Surgical timeliness was dichotomized as \"timely\" if the repair occurred within 3 days after birth and \"delayed\" after the 3rd day of birth. Prevalence of timely spina bifida surgery was assessed. Selected demographic and clinical factors associated with timeliness of the repair surgery were examined using logistic regression analysis.</p><p><strong>Results: </strong>Of the 279 eligible patients who received myelomeningocele closure surgery during the study period, only 45 (16.1%) were timely. Family residence in Addis Ababa was significantly associated with a timely repair surgery (delayed surgery aOR = 0.25; 95% CI = 0.11, 0.57), after adjusting for the year of surgery, infant sex, presence of cerebrospinal fluid leak, and spina bifida lesion level.</p><p><strong>Conclusion: </strong>Less than a quarter of patients with myelomeningocele received timely repair surgery in a large tertiary care referral hospital in Addis Ababa, Ethiopia. Promoting timely closure of myelomeningocele while providing equitable access to optimal surgical care for patients will improve health outcomes and prevent mortality.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"142"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735658","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":"Beyond the expected: a supratentorial ependymoma imitating a meningioma.","authors":"Hafsah Binte Sohail, Noman Ahmed, Muhammad Shahzad Shamim, Naureen Mushtaq","doi":"10.1007/s00381-025-06803-7","DOIUrl":"https://doi.org/10.1007/s00381-025-06803-7","url":null,"abstract":"<p><strong>Introduction: </strong>Supratentorial ependymomas are rare tumors, particularly in adults, and can present similarly to more common extra-axial masses like meningiomas on imaging. Differentiating between these lesions is crucial for appropriate management.</p><p><strong>Case presentation: </strong>A 16-year-old girl presented with a 1.5-year history of headaches, occasional blurring of vision, and a recent seizure. MRI revealed a 4.7 × 4.0 × 6.9 cm dural-based, extra-axial lesion in the left parietal-temporal region, initially presumed to be a meningioma. The patient underwent a neuronavigation-guided craniotomy with excision of the lesion. Intraoperative findings described a soft, vascular, solid-cystic extra-axial mass, which was initially diagnosed as a meningioma based on preoperative imaging but later confirmed to be a supratentorial ependymoma, ZFTA fusion-positive, CNS WHO grade 3, through histopathological and molecular analysis. Postoperatively, the patient showed no neurological deficits, and a residual tumor was identified on follow-up imaging.</p><p><strong>Discussion: </strong>This case illustrates the diagnostic challenge posed by the rare presentation of supratentorial, extra-axial ependymomas mimicking meningiomas. Although meningiomas are the most common extra-axial intracranial tumors, some radiological features such as cystic appearance and multiloculation on imaging should raise suspicion for ependymoma or other mimics. However, a definitive diagnosis can only be made through histopathological examination.</p><p><strong>Conclusion: </strong>Supratentorial, extra-axial masses are often misdiagnosed as meningiomas. Such ependymomas can closely resemble meningiomas on imaging. This case underscores the importance of maintaining a broad differential diagnosis for extra-axial masses and highlights the role of certain radiological features that can help with accurate diagnosis or at least raise suspicion of meningioma mimics.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"141"},"PeriodicalIF":1.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708888","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":"Inpatient outcomes in pediatric diffuse axonal injury: high mortality in severe TBI and limited impact of Grade III DAI.","authors":"Sean Inzerillo, Mert Karabacak, Peter Morgenstern, Konstantinos Margetis","doi":"10.1007/s00381-025-06802-8","DOIUrl":"https://doi.org/10.1007/s00381-025-06802-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates key prognostic factors influencing morbidity and mortality in pediatric diffuse axonal injury (DAI) using nationally collected data from the American College of Surgeons (ACS) Trauma Quality Program (TQP) to inform clinical practice and future research.</p><p><strong>Methods: </strong>The ACS-TQP database (2019-2021) was analyzed for pediatric DAI cases, excluding those with intracranial hemorrhages or pre-admission deaths. Demographics and clinical characteristics were compared across age groups (0-3, 4-12, 13-17), and multivariate regression identified predictors of mortality, complications, intensive care unit (ICU) stay, and ventilator duration.</p><p><strong>Results: </strong>Among 533 pediatric DAI patients, the mortality rate was 20.3%, highest in the 0-3 age group (29%) compared to 4-12 (20.8%) and 13-17 (19%) (p = 0.016). Severe traumatic brain injury (TBI) (Glasgow Coma Scale 3-8) and systolic blood pressure < 90 mm Hg were strong mortality predictors (OR 56.9, p < 0.001; OR 9.2, p < 0.001). Prolonged coma (> 24 h) increased mortality odds (OR 7.4, p = 0.018) but did not meet the adjusted threshold. Complications occurred in 16.3% of patients, with severe TBI increasing complication odds (OR 4.1, p = 0.005). ICU stay was longer with surgery (p < 0.001), and prolonged coma predicted longer ventilation (p < 0.001). Grade III DAI was not linked to worse outcomes.</p><p><strong>Conclusion: </strong>Severe TBI and hypotension were significant predictors of mortality and morbidity in pediatric DAI. Grade III DAI was not associated with worse outcomes, highlighting the need for further research to refine prognostic factors.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"140"},"PeriodicalIF":1.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708891","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":"A pre-operative gastrointestinal optimization protocol to improve outcomes after intrathecal baclofen pump surgery.","authors":"Amanda M Mosher, Emma K Hartman, Marcella Ruppert-Gomez, Steven J Staffa, Kristin Buxton, Ann Morgan, Sangeeta Muskar, Scellig Stone, Weston T Northam","doi":"10.1007/s00381-025-06797-2","DOIUrl":"https://doi.org/10.1007/s00381-025-06797-2","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric cerebral palsy patients carry frequent medical comorbidities and disproportionately consume hospital resources after neurosurgical procedures. We implemented an institutional pre-operative gastrointestinal (GI) optimization protocol to improve outcomes and decrease resource utilization.</p><p><strong>Methods: </strong>All 323 intrathecal baclofen surgeries from 2000 to 2023 were categorized relative to protocol implementation on July 1, 2017. Outcomes and resource utilization were compared.</p><p><strong>Results: </strong>The protocol change resulted in significantly fewer hospital readmissions (p = 0.001) for constipation, eliminating them and GI-related emergency visits. There was a reduction of 27 hospital days for constipation-related readmission (median 1 day per patient, IQR 1, 2 days). No differences were reported between the experimental groups including demographics or GI comorbidities. Post-operative complications within 30 days were comparable between groups regarding urinary tract infections, surgical-site infections, and spinal fluid leak. There were no differences in post-operative length of stay between groups.</p><p><strong>Conclusion: </strong>A GI optimization protocol can eliminate a frequent source of hospital readmissions and GI-related emergency department visits after baclofen pump surgery, even accounting for baseline GI comorbidities. Preventing readmissions and emergency visits translates to lower hospital resource utilization and improves quality of care. Future efforts are warranted to improve outcomes and care efficiency for our most complex and resource-intensive patients.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"139"},"PeriodicalIF":1.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691218","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":"Maintenance of construct integrity with subaxial cervical pedicle screws when crossing the cervicothoracic junction in complex pediatric deformity: an international multicenter study.","authors":"David B Kurland, Ritt R Givens, Alondra Concepción-González, Alexander Eremiev, Yosef Dastagirzada, Nikita Alexiades, Benjamin D Roye, Michael G Vitale, Richard C E Anderson","doi":"10.1007/s00381-025-06791-8","DOIUrl":"https://doi.org/10.1007/s00381-025-06791-8","url":null,"abstract":"<p><strong>Objective: </strong>In cases of complex pediatric spinal deformity, posterior spinal instrumentation crossing the cervicothoracic junction (CTJ) may be required. This is most frequently encountered for revision surgery to address proximal junctional kyphosis (PJK). In the cervical spine, lateral mass screws are most commonly used, although they may result in biomechanically weak proximal constructs and predispose to instrumentation failure. The use of supplemental anterior constructs has recently been reported with promising results, but this necessitates an additional surgical procedure. Subaxial cervical pedicle screws can provide good biomechanical fixation without the need for an anterior approach, but outcome data have been very limited. The purpose of this study was to assess radiographic and clinical outcomes at two years in pediatric patients who have undergone posterior spinal instrumentation and fusion (PSIF) crossing the CTJ using subaxial cervical spine pedicle screws.</p><p><strong>Methods: </strong>The Pediatric Spine Study Group (PSSG) registry was queried to identify patients ≤ 21 years old who underwent PSIF crossing the CTJ with two-year minimum clinical and radiographic follow-up. Patients were excluded if they had a history of anterior stabilization or if their fusion construct with subaxial pedicle screws started below C6. Clinical, surgical, and radiographic parameters were assessed, and measurements were compared statistically.</p><p><strong>Results: </strong>Then, 8 patients (6 female and 2 male) met inclusion criteria, with a mean age at surgery of 11.2 ± 3.3 years. All patients underwent PSIF crossing the CTJ (mean levels fused 15.6 ± 6.6). The mean density of subaxial cervical pedicle screws was 61.9% ± 27.8 (range 28.5 to 100%). The major coronal curve averaged 54.7° ± 19.6 preoperatively and 34.5° ± 13.6 postoperatively (41.5% ± 26.5 correction; p = 0.03). The average major sagittal curve was 55.9° ± 20.6 preoperatively and 29.6° ± 9.6 (44.2% ± 18.0 correction; p = 0.01) postoperatively. There were no major intraoperative or postoperative complications. Deformity parameters remained stable without radiographic evidence of PJK in 8/8 patients at minimum 2-year follow-up.</p><p><strong>Conclusions: </strong>In this small preliminary international series of pediatric patients with spinal deformity, the inclusion of subaxial cervical pedicle screws in constructs that span the cervicothoracic junction resulted in good clinical and radiographic outcomes without major complications. Subaxial cervical spine pedicle screws provide enhanced biomechanical stability and may eliminate the need for additional anterior support in pediatric patients.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"138"},"PeriodicalIF":1.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691222","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}