Ultrasound in Obstetrics & Gynecology最新文献

{"title":"Metagenomic analysis of NIPT raw data suggests high negative predictive value for congenital cytomegalovirus infection screening.","authors":"N Bourgon, I Padioleau, J Guibon, J Fourgeaud, A Lermine, G Meurice, T Guilleminot, L Bussieres, M Leruez-Ville, J-M Dupont, Y Ville","doi":"10.1002/uog.29221","DOIUrl":"https://doi.org/10.1002/uog.29221","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":"65 5","pages":"653-655"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for pre-eclampsia using pregnancy-associated plasma protein-A or placental growth factor measurements in blood samples collected at 8-14 weeks' gestation.","authors":"L Rode, A Wright, D Wright, M Overgaard, L Sperling, P Sandager, P Nørgaard, F S Jørgensen, H Zingenberg, I Riishede, A Tabor, C K Ekelund","doi":"10.1002/uog.29204","DOIUrl":"10.1002/uog.29204","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the value of pregnancy-associated plasma protein-A (PAPP-A) in screening for preterm pre-eclampsia (PE) (delivery < 37 weeks' gestation) measured in maternal blood samples collected before 11 weeks, and to compare the screening performance of PAPP-A with that of placental growth factor (PlGF) from blood samples collected at 8-14 weeks.</p><p><strong>Methods: </strong>This study analyzed data from women who participated in the PRESIDE (Pre-eclampsia Screening in Denmark) study, a prospective, non-interventional multicenter study investigating the predictive performance of the Fetal Medicine Foundation first-trimester screening algorithm for PE in a Danish population. As part of combined first-trimester screening, a routine blood sample was collected at 8-14 weeks' gestation and PAPP-A was measured. Excess serum was stored at -80°C and analyzed for PlGF in batches after delivery. Most women in the PRESIDE study had an extra blood sample collected at the time of the first-trimester scan at 11-14 weeks, which was also analyzed for PlGF and PAPP-A in batches after all the participants had delivered. Screening performance was assessed in terms of the detection rate at a 10% screen-positive rate (SPR) for a combination of PAPP-A or PlGF with maternal factors alone and for a combination of each of these biomarkers with maternal factors, mean arterial pressure (MAP) and uterine artery pulsatility index (UtA-PI).</p><p><strong>Results: </strong>The study population comprised 8386 women who had a routine combined first-trimester aneuploidy screening blood sample collected at 8-14 weeks' gestation. In pregnancies that developed preterm PE, the median PAPP-A multiples of the median from routine blood samples were 0.78 (95% CI, 0.67-0.90) before 10 weeks, 0.80 (95% CI, 0.58-1.10) at 10 weeks and 0.64 (95% CI, 0.53-0.78) at 11-14 weeks. In women with samples collected before 10 weeks, there was no significant improvement in the detection rate of preterm PE when PAPP-A or PlGF was combined with maternal factors alone or when combined with maternal factors, MAP and UtA-PI. In routine samples collected at or after 10 weeks, PAPP-A only increased the detection rate of preterm PE slightly. However, PlGF in samples collected at or after 10 weeks increased the detection rate from 31.3% (95% CI, 16.1-50.0%) to 56.3% (95% CI, 37.7-73.6%) at a 10% SPR, i.e. an increase in the detection rate of 25.0% (95% CI, 4.3-44.4%), when combined with maternal factors alone. When PlGF collected from the PRESIDE sample at 11-14 weeks was combined with maternal factors, MAP and UtA-PI, there was an increase in the detection rate from 50.9% (95% CI, 37.1-64.6%) to 67.3% (95% CI, 53.3-79.3%), i.e. an increase of 16.4% (95% CI, 5.6-29.0%) at a 10% SPR.</p><p><strong>Conclusions: </strong>PAPP-A has limited value in first-trimester screening for PE, whereas PlGF adds significantly to the detection rate of preterm PE at 10-14 weeks' gestation. © 202","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"567-574"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of human cytomegalovirus cell-free DNA in pregnant women with symptomatically infected fetuses: proof-of-concept study.","authors":"B H W Faas, T Meuleman, G Astuti, A Reuss, K Stol, E A Sistermans, J Linthorst, E van Leeuwen, J Rahamat-Langendoen, F A Wilmink","doi":"10.1002/uog.29199","DOIUrl":"10.1002/uog.29199","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the presence and levels of cytomegalovirus (CMV) cell-free DNA (cfDNA) fragments in women pregnant with a fetus with symptomatic congenital CMV (cCMV).</p><p><strong>Methods: </strong>The study comprised nine women whose fetuses were diagnosed with cCMV between June 2019 and July 2024 at 20 + 4 to 34 + 1 weeks' gestation (n = 8) or neonatally (n = 1) after primary or non-primary maternal infection. In eight women, cfDNA sequencing data from a single timepoint were analyzed, either retrospectively, on data generated from 11-13 weeks' gestation (n = 5) or prospectively, on data generated from 20-26 weeks' gestation (n = 3), upon the diagnosis of cCMV. In one woman (Case 6), CMV-cfDNA analysis was performed at four timepoints: at 12 + 5 weeks (routine non-invasive prenatal testing); 23 + 3 weeks (cCMV diagnosis); and 30 min and 12 h after termination of pregnancy (TOP) at 23 + 6 weeks.</p><p><strong>Results: </strong>CMV-cfDNA was detectable in all cases. Mostly low levels of CMV-cfDNA were observed in samples obtained at 11-13 weeks' gestation and consistently high levels of CMV-cfDNA were present in samples obtained at cCMV diagnosis. In Case 6, the level of maternal CMV-cfDNA decreased substantially in the samples tested after TOP, compared with samples obtained before TOP.</p><p><strong>Conclusions: </strong>Low levels of CMV-cfDNA detected between 11 and 13 weeks may be a biomarker for severe fetal cCMV. CMV-cfDNA analysis in the first trimester could be of added value in CMV screening, particularly for non-primary maternal infections that cannot be identified using other methods. However, as CMV-cfDNA is detectable in many pregnant women in the first trimester, further studies are needed to determine the predictive value of CMV-cfDNA as a biomarker for the development of severe fetal cCMV. High levels of CMV-cfDNA at fetal cCMV diagnosis and low levels directly after TOP suggest that the level of CMV-cfDNA in maternal plasma may not necessarily reflect an active maternal infection, but could indicate a placental infection. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"470-477"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ongoing outbreak of maternal parvovirus B19 infections in Germany since end of 2023: consequence of COVID-19 pandemic?","authors":"J Jiménez Cruz, R Axt-Fliedner, C Berg, F Faschingbauer, K O Kagan, J Knabl, A Lauten, H Lehmann, H Stepan, M Tavares de Sousa, S Verlohren, U Germer, J Weichert, B Strizek, A Geipel","doi":"10.1002/uog.29197","DOIUrl":"10.1002/uog.29197","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the ongoing parvovirus B19 (B19V) outbreak among pregnant women in Germany and its connection to the coronavirus disease 2019 (COVID-19) pandemic.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed anonymous data regarding serologically confirmed B19V infections during pregnancy between January 2014 and April 2024 across 13 major fetal medicine centers in Germany. We evaluated the yearly frequency of B19V cases, cases that underwent intrauterine transfusion (IUT), cases presenting with hydrops fetalis and cases of intrauterine fetal death (IUFD) related to B19V infection, and stratified these variables by event occurrence < 20 weeks' gestation or ≥ 20 weeks' gestation. Variables were compared across three subperiods: pre COVID-19 pandemic, during the COVID-19 pandemic and post COVID-19 pandemic.</p><p><strong>Results: </strong>Data from 918 pregnant women with confirmed B19V infection revealed a significant B19V outbreak since the end of 2023. The mean ± SD number of annual cases was 57.3 ± 20.7 pre COVID-19, 20.3 ± 13.5 during COVID-19 and surged to 384.8 ± 299.8 post COVID-19 (P < 0.01). Correspondingly, the number of cases in which the fetus underwent IUT increased post COVID-19. The proportion of B19V diagnoses made before 20 weeks' gestation increased from 32.3% pre COVID-19 to 53.2% post COVID-19 (P < 0.001).</p><p><strong>Conclusions: </strong>These results demonstrate an unforeseen increase in B19V infections during pregnancy after the COVID-19 pandemic, with a consequent rise in B19V cases with fetal anemia. The introduced policies during the COVID-19 pandemic reduced the B19V infection rate but likely conditioned the present ongoing upsurge. Counseling, early detection and access to specialized centers performing IUT are essential measures required to address this outbreak. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"456-461"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pop-off mechanisms in fetal megacystis: extravasation, umbilical cord cyst, ureterocele and megaureter.","authors":"L A M Brinkman, L K Duin, P N Adama van Scheltema, T E Cohen-Overbeek, E Pajkrt, M N Bekker, C Willekes, E J T Verweij, C Bilardo, F Fontanella","doi":"10.1002/uog.29200","DOIUrl":"10.1002/uog.29200","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To analyze comprehensively the incidence, antenatal ultrasound characteristics and prognostic implications of antenatal pop-off mechanisms of the fetal urinary system in pregnancies with suspected fetal megacystis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a retrospective multicenter study of pregnancies with suspected fetal megacystis conducted across all academic hospitals in The Netherlands. Three antenatal pop-off mechanisms were identified: presence of an umbilical cord cyst (UCC), extravasation of urine into the intraperitoneal space (ascites) or perirenal subcapsular (urinoma), and megaureter/ureterocele. Cases that exhibited two different pop-off mechanisms, underwent vesicoamniotic shunt placement or had unclear information regarding shunt placement were excluded. We compared the antenatal ultrasound characteristics and outcomes among pregnancies with UCC, those with extravasation, those with megaureter/ureterocele and those without a pop-off mechanism. Logistic regression analysis was used to evaluate the association of pop-off mechanisms with antenatal characteristics and postnatal outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 543 fetuses with suspected megacystis, 76% exhibited no pop-off mechanism, 7% presented with UCC only, 9% presented with extravasation only, 7% presented with a megaureter/ureterocele only and 1% presented with two pop-off mechanisms. Following exclusions, 511 cases were included in the analysis. The identification of UCC (n = 39) was associated with early-onset megacystis (odds ratio (OR), 4.2 (95% CI, 1.9-9.1); P &lt; 0.001), severe megacystis (OR 2.3 (95% CI, 1.1-5.0); P = 0.033), normal amniotic fluid index (AFI) (OR, 3.3 (95% CI, 1.3-8.2); P = 0.011) and additional associated anomaly (OR, 3.3 (95% CI, 1.7-6.4); P &lt; 0.001), and thus with the highest prevalence of complex diagnosis (66%), primarily represented by anorectal malformation. Extravasation (n = 42) was associated with severe megacystis (OR, 2.4 (95% CI, 1.1-5.4); P = 0.030), abnormal AFI (OR, 2.8 (95% CI, 1.2-6.8); P = 0.022), the keyhole sign (OR, 2.5 (95% CI, 1.1-5.8); P = 0.033) and additional associated anomaly (OR, 2.1 (95% CI, 1.1-4.1); P = 0.026). Megaureter/ureterocele (n = 36) was associated with late-onset megacystis (OR, 4.0 (95% CI, 1.6-9.7); P = 0.003), a thickened bladder wall during pregnancy (OR, 6.6 (95% CI, 1.9-23.1); P = 0.003) and the lowest prevalence of additional associated anomaly (22%). Intrauterine fetal demise was most prevalent in fetuses with UCC (15%), while termination of pregnancy and non-survivors were most common in cases with extravasation (50% and 17%, respectively). The majority of fetuses with megacystis associated with megaureter/ureterocele were still alive during follow-up (72%) and the odds of survival were the highest for this group (OR, 2.7 (95% CI, 1.3-5.7); P = 0.010).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Antenatal pop-off mechanisms may alleviate high intraluminal pressure wi","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"487-494"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"N-terminal pro B-type natriuretic peptide as biomarker to predict pre-eclampsia and maternal-fetal complications.","authors":"M N Nan, C Garrido-Giménez, Á Garcia-Osuna, P Garcia Manau, J Ullmo, J Mora, O Sanchez-Garcia, J Platero, M Cruz-Lemini, E Llurba","doi":"10.1002/uog.29202","DOIUrl":"10.1002/uog.29202","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;A soluble fms-like tyrosine kinase-1 (sFlt-1)-to-placental growth factor (PlGF) ratio cut-off of 38 is currently considered optimal for ruling out pre-eclampsia (PE); however, implementation of this ratio in clinical practice is limited. N-terminal pro B-type natriuretic peptide (NT-proBNP) is elevated in PE owing to the cardiovascular effects of this disease. This study aimed to identify the predictive performance of NT-proBNP to detect PE and placental complications within 1 week after assessment, and compare it with the predictive performance of the sFlt-1/PlGF ratio. High-sensitivity troponin T (hs-TnT) and uric acid were also evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a prospective nested case-control study conducted in five Spanish centers between March 2018 and December 2020, and comprised women with a singleton pregnancy and suspected PE between 24 + 0 and 41 + 0 weeks' gestation. We evaluated the ability of the sFlt-1/PlGF ratio, NT-proBNP, hs-TnT and uric acid to predict the development of any-onset (at any gestational age), early-onset (before 34 weeks) or term (at or after 37 weeks) PE within 1 week or 4 weeks after assessment. Predictive performance was assessed by estimating negative predictive values, positive predictive values, sensitivity, specificity and areas under the receiver-operating-characteristics curves (AUCs) for these biomarkers, with corresponding 95% CIs. We performed post-hoc exploratory analyses of associations between the sFlt-1/PlGF ratio, NT-proBNP, hs-TnT and uric acid in women who developed PE, as well as in women who developed complicated PE (PE plus fetal growth restriction, stillbirth or placental abruption) within 1 week and 4 weeks after assessment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 323 women with suspected PE at or before 41 + 0 weeks were enrolled in the study, of whom seven were lost to follow-up. The final analysis included 316 eligible participants, with 424 samples. The overall incidence of PE was 23.4% (n = 74) and early-onset PE developed in 8.5% (n = 27) of cases. The sFlt-1/PlGF ratio and NT-proBNP exhibited similar abilities to predict early-onset PE within 1 week after assessment (AUC, 0.970 (95% CI, 0.932-1.000) and 0.971 (95% CI, 0.942-1.000), respectively). hs-TnT and uric acid demonstrated inferior predictive capability compared with the sFlt-1/PlGF ratio for the prediction of any-onset PE, early-onset PE and term PE within 1 week and 4 weeks after assessment. The optimal cut-off for NT-proBNP was 116 pg/mL. At this cut-off, NT-proBNP showed a sensitivity of 90.9% (95% CI, 70.8-98.9%) and a specificity of 94.3% (95% CI, 91.2-96.5%), with a positive predictive value of 5.7% (95% CI, 3.7-8.7%) and a negative predictive value of 99.9% (95% CI, 99.9-100%) in predicting early-onset PE within 1 week of assessment, which was comparable with that of the sFlt-1/PlGF ratio. Participants with PE-related complications had higher levels of all biomarkers","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"447-455"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to 'Association between adenomyosis volume and adverse perinatal outcomes: multicenter cohort study'.","authors":"","doi":"10.1002/uog.29180","DOIUrl":"10.1002/uog.29180","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"512"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound demonstration of arterialization in superior sagittal sinus arteriovenous fistula in fetus at 18 + 6 weeks' gestation.","authors":"K Senthilvel, V Ravindran, L Anbuchezhian","doi":"10.1002/uog.27709","DOIUrl":"10.1002/uog.27709","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"513-516"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing fetal cardiac insights: extended implications of iron deficiency anemia on diastolic function and cardiac maturation.","authors":"B Li, Y Feng, R Chen","doi":"10.1002/uog.29193","DOIUrl":"10.1002/uog.29193","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"511"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal intervention in vein of Galen aneurysmal malformation via transuterine ultrasound-guided fetal embolization: call for a global registry.","authors":"R Brawura-Biskupski-Samaha, B Rebizant, K Kosińska-Kaczyńska, S Prasad, M Siergiej, B Kądziołka, A Koleśnik, N Szymecka-Samaha, I Rzucidło-Szymańska, A Khalil","doi":"10.1002/uog.27704","DOIUrl":"10.1002/uog.27704","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"407-413"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}