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Zinc as a treatment modality for acute infectious diarrhea in children. 锌是治疗儿童急性感染性腹泻的一种方法。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-10-31 DOI: 10.3345/cep.2024.00381
Ji Sook Park
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引用次数: 0
Carbapenem resistance in gram-negative pathogens in an Iranian hospital: high prevalence of OXA-type carbapenemase genes. 伊朗一家医院革兰氏阴性病原体的碳青霉烯耐药性:OXA 型碳青霉烯酶基因的高流行率。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-10-31 DOI: 10.3345/cep.2023.01774
Setareh Mamishi, Reihaneh Hosseinpour Sadeghi, Sadaf Sajedi Moghaddam, Babak Pourakbari, Shiva Poormohammadi, Maryam Sotoudeh Anvari, Shima Mahmoudi

Background: The widespread dissemination of carbapenem-resistant Gram-negative bacteria poses a significant threat to global public health.

Purpose: This study aimed to investigate the prevalence of carbapenem resistance in Gram-negative bacteria isolated from patients at the Children's Medical Center Hospital, Tehran, Iran, to understand the molecular mechanisms underlying this resistance.

Methods: During the period spanning from June 2019 to June 2020, 777 Gram-negative bacterial strains were isolated. Antibiotic susceptibility testing was performed according to Clinical and Laboratory Standards Institute. Polymerase chain reaction was used to detect carbapenem resistance genes including bla OXA23, bla OXA24, bla OXA48, bla OXA51, bla OXA58, bla OXA143, bla KPC, bla IMP, bla VIM, and bla NDM.

Results: Among the total bacterial isolates, 141 (18.1%) exhibited carbapenem resistance. Escherichia coli was the most prevalent (57.4%), followed by Klebsiella pneumoniae (11.3%) and Acinetobacter baumannii (10.6%). Other notable contributors included Enterobacter spp. (5.7%), Salmonella spp. (3.5%), and Stenotrophomonas maltophilia (2.8%). Citrobacter spp., Proteus mirabilis, and Pseudomonas aeruginosa contributed to the distributions of two, one, and three isolates, respectively. Notably, bla OXA48 showed the highest prevalence (33%), followed by bla OXA143 and bla OXA58 (27% and 24%, respectively). In addition, bla OXA24 was present in 11% of the total isolates, bla OXA23 in 10%, and bla NDM in 10%, whereas bla KPC, bla VIM, and bla IMP were not detected.

Conclusion: Our study highlights the prevalence of carbapenemase-producing Gram-negative isolates among pediatric patients. Notable resistance patterns, especially in K. pneumoniae and E. coli, underline the urgent need for proactive interventions, including appropriate antibiotic prescription practices and strengthening of antibiotic stewardship programs.

背景:耐碳青霉烯类细菌的广泛传播对全球公共卫生构成重大威胁:目的:本研究旨在调查从伊朗德黑兰儿童医学中心医院患者体内分离出的革兰氏阴性细菌对碳青霉烯类耐药的流行情况,以了解这种耐药的分子机制:方法:在 2019 年 6 月至 2020 年 6 月期间,共分离出 777 株革兰阴性细菌。根据临床和实验室标准研究所(Clinical and Laboratory Standards Institute)的规定进行了抗生素药敏试验。聚合酶链反应用于检测碳青霉烯耐药基因,包括 bla OXA23、bla OXA24、bla OXA48、bla OXA51、bla OXA58、bla OXA143、bla KPC、bla IMP、bla VIM 和 bla NDM:结果:在所有细菌分离株中,有 141 株(18.1%)对碳青霉烯类产生耐药性。大肠埃希菌最常见(57.4%),其次是肺炎克雷伯菌(11.3%)和鲍曼不动杆菌(10.6%)。其他主要致病菌包括肠杆菌属(5.7%)、沙门氏菌属(3.5%)和嗜麦芽气单胞菌(2.8%)。柠檬酸杆菌属、奇异变形杆菌和铜绿假单胞菌分别有 2 个、1 个和 3 个分离株。值得注意的是,bla OXA48 的感染率最高(33%),其次是 bla OXA143 和 bla OXA58(分别为 27% 和 24%)。此外,在所有分离株中,有 11% 存在 bla OXA24,10% 存在 bla OXA23,10% 存在 bla NDM,而未检测到 bla KPC、bla VIM 和 bla IMP:我们的研究强调了儿科患者中产碳青霉烯酶革兰氏阴性菌分离株的普遍性。值得注意的耐药性模式,尤其是肺炎双球菌和大肠杆菌的耐药性模式,突出表明迫切需要采取积极的干预措施,包括适当的抗生素处方实践和加强抗生素管理计划。
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引用次数: 0
Comparative analysis of rare periodic fever syndromes including the first Korean case of hyperimmunoglobulinemia D and periodic fever syndrome. 罕见周期性发热综合征的比较分析,包括韩国首例高免疫球蛋白血症 D 和周期性发热综合征。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-09-24 DOI: 10.3345/cep.2024.00787
Yoonsun Yoon, Hyun Seo Kim, Jung Ok Shim, JungHwa Lee
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引用次数: 0
Demographic transition in South Korea: implications of falling birth rates. 韩国的人口结构转型:出生率下降的影响。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-06-27 DOI: 10.3345/cep.2023.01599
Chae Young Kim, Sung-Hoon Chung

This review examines the critical issues of declining total fertility rates (TFRs) and aging populations in East Asia with special focus on South Korea. It provides a comprehensive analysis of TFR trends, aging demographics, and the policy responses of these nations to the low-fertility crisis. This study highlights the intricate tapestry of the factors contributing to these demographic shifts, including economic, social, and cultural influences. It also examines the effectiveness of various prenatal policies implemented across these countries, offering insight into their successes and limitations. Furthermore, it explores the role of immigration as a potential solution to the structural challenges posed by low birth rates. This review underscores the importance of multifaceted strategies for addressing the complex demographic challenges faced by South Korea.

这篇综述探讨了东亚地区总和生育率(TFR)下降和人口老龄化的关键问题,并特别关注韩国。它全面分析了总和生育率趋势、人口老龄化以及这些国家应对低生育率危机的政策。本研究强调了导致这些人口变化的错综复杂的因素,包括经济、社会和文化影响。本研究还探讨了这些国家实施的各种产前政策的有效性,深入分析了这些政策的成功之处和局限性。此外,它还探讨了移民作为应对低出生率带来的结构性挑战的潜在解决方案的作用。本综述强调了采取多方面战略应对韩国面临的复杂人口挑战的重要性。
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引用次数: 0
Effect of pesticide exposure on stunting incidence: a systematic review and meta-analysis. 接触杀虫剂对发育迟缓发病率的影响:系统回顾和荟萃分析。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-09-24 DOI: 10.3345/cep.2023.01522
Sani Rachman Soleman, Yaltafit Abror Jeem, Muhammad Fathi Banna Al Faruqi, Mahdea Kasyiva, Vita Widyasari, Kuswati Kuswati, Nur Aini Djunet, Muflihah Rizkawati, Ety Sari Handayani

As an endocrine disruptor chemical, pesticide exposure may affect the regulation of growth hormones such as insulin-like growth factor-1 (IGF-1). A few current studies to date have noted that long-term pesticide exposure disrupted IGF-1, a potential risk of stunting in children. This study aims to evaluate studies to date of the effect of pesticide exposure on stunting incidence. This systematic review and meta-analysis adhered to the PRISMA (Pre-ferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. The PubMed and EBSCO databases were searched for relevant articles without publication restrictions. This review aimed to include reviews, randomized controlled trials (RCT), and cohort, case-control, and cross-sectional studies, which provide actual exposure types of pesticides with stunting measurement by height-age z score. A screening, extraction, and synthesis were conducted, leading to a consensus for reaching mutual agreement. The analysis was performed using Microsoft Excel 2017 for the screening and extraction, Revman version 5.4 software for the meta-analysis, and OpenMEE software for the meta-regression. Of the 13 studies subjected to the qualitative analysis, 6 were eligible for inclusion in the meta-analysis: 2 reviews, 2 RCTs, 2 cohorts, 2 case-control, and 5 cross-sectional studies. Exposure to organophosphate and pyrethroid pesticides was not associated with stunting (P=0.78; odds ratio [OR], 1.11; 95% confidence interval [CI], 0.65-1.88). Heterogeneity existed for 79% of the meta-analysis (P≤0.000; z=-5.37; 95% CI, -0.034 to -0.016), and the meta-regression identified age as the causative covariate. Pesticide exposure, regardless of type, is not associated with stunting in children.

作为一种干扰内分泌的化学物质,接触杀虫剂可能会影响生长激素的调节,如胰岛素样生长因子-1(IGF-1)。迄今为止的一些研究指出,长期接触杀虫剂会破坏 IGF-1,这是导致儿童发育迟缓的潜在风险。本研究旨在评估迄今为止有关农药暴露对发育迟缓发病率影响的研究。本系统综述和荟萃分析遵循了 PRISMA(系统综述和荟萃分析的首选报告项目)指南。我们在 PubMed 和 EBSCO 数据库中搜索了相关文章,没有出版限制。本综述旨在纳入综述、随机对照试验(RCT)、队列研究、病例对照研究和横断面研究,这些研究提供了农药的实际暴露类型,并通过身高-年龄 z 分数测量了发育迟缓情况。通过筛选、提取和综合,最终达成了共识。分析使用 Microsoft Excel 2017 进行筛选和提取,使用 Revman 5.4 版软件进行荟萃分析,使用 OpenMEE 软件进行荟萃回归。在接受定性分析的 13 项研究中,有 6 项符合纳入荟萃分析的条件:2 项综述、2 项 RCT、2 项队列、2 项病例对照和 5 项横断面研究。有机磷农药和拟除虫菊酯农药暴露与发育迟缓无关(P=0.78;比值比 [OR],1.11;95% 置信区间 [CI],0.65-1.88)。79%的荟萃分析存在异质性(P≤0.000;z=-5.37;95% CI,-0.034 至-0.016),荟萃回归确定年龄为致病协变量。无论何种类型的农药接触都与儿童发育迟缓无关。
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引用次数: 0
Two- versus one-bag fluid delivery in pediatric and adolescent diabetic ketoacidosis: a systematic review and meta-analysis. 儿科和青少年糖尿病酮症酸中毒的双袋输液与单袋输液:系统回顾和荟萃分析。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-06-27 DOI: 10.3345/cep.2023.01536
Maya L Nasser, Joseph Nasr, Reem B Zalloum, Nathanael Q E Yap, Natalie E Bourdakos, Shahid Miangul, Tara A Betts, Hayato Nakanishi, Christian A Than, Serge Jabbour

Two rehydration protocols currently exist to treat diabetic ketoacidosis (DKA) in pediatric patients aged <21 years: the traditional "one-bag" system and the more recent "two-bag" system. This study aimed to evaluate the safety and efficacy of the newer two-bag system versus the well-established one-bag system. The CiNAHL, Cochrane Library, Embase, PubMed, Scopus, and Web of Science databases were comprehensively searched from inception to June 2023 by 2 independent reviewers using the Preferred Reporting Items for Systematic Reviews and Meta-analysis framework. Eligible studies were those that reported participants <21 years of age who presented to the emergency room with a clinical diagnosis of DKA. This review was prospectively registered on PROSPERO (CRD42023427551). From the initial screening of 42 studies, 8 unique studies encompassing 583 patients met the eligibility criteria. The analysis yielded no significant intergroup differences in hypoglycemia (odds ratio, 0.61; 95% confidence interval [CI], 0.20-1.87; I2=3%) or mean glucose correction rate (mean difference [MD], 0.04 mg/ dL/hr; 95% CI, -13.10 to 13.17; I2=64%). The incidence of cerebral edema was as low (0.17%) across groups, with only one case reported in the one-bag group. Notably, the mean time to DKA resolution (MD, -3.24 h; 95% CI, -5.57 to -0.91; I2=0%) and mean response time for intravenous fluid changes (MD, -32.75 min; 95% CI, -43.21 to -22.29; I2=59%) was lower for the two-bag system. This meta- analysis presents preliminary evidence suggesting that the two-bag system may confer advantages over the one-bag system for selected patients. However, further studies with greater patient stratification based on DKA severity, fluid composition, and protocol are needed to draw definitive conclusions and elucidate the extent of these advantages.

目前有两种补液方案可用于治疗儿科老年患者的糖尿病酮症酸中毒(DKA)。
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引用次数: 0
Skin and oral intervention for food allergy prevention based on dual allergen exposure hypothesis. 基于双重过敏原暴露假说的食物过敏预防皮肤和口腔干预。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2023-06-14 DOI: 10.3345/cep.2023.00045
Kiwako Yamamoto-Hanada, Yukihiro Ohya

Early-onset atopic dermatitis increases an individual's risk of food allergies, suggesting that transcutaneous sensitization may occur through inflamed skin. Regarding food allergy causation, the dual allergen exposure hypothesis proposes that oral allergen exposure leads to immune tolerance, whereas allergen exposure via inflamed skin causes food allergies. This hypothesis suggests that it is important to induce oral immune tolerance and prevent allergic food sensitization through the skin. This review focuses on the breakthrough evidence based on the dual allergen exposure hypothesis that involves both skin and oral interventions for food allergy prevention.

早期发病的特应性皮炎会增加个体发生食物过敏的风险,这表明经皮致敏可能是通过发炎的皮肤发生的。关于食物过敏的成因,双重过敏原接触假说认为,口服过敏原会导致免疫耐受,而通过发炎皮肤接触过敏原则会引起食物过敏。该假说认为,诱导口腔免疫耐受并防止通过皮肤引起食物过敏非常重要。本综述重点介绍基于双重过敏原暴露假说的突破性证据,该假说涉及皮肤和口腔干预以预防食物过敏。
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引用次数: 0
Effect of online infant care training and postpartum counseling based on Meleis' transition theory on mothers' readiness for care and breastfeeding: a randomized controlled trial. 基于 Meleis 过渡理论的在线婴儿护理培训和产后咨询对母亲做好护理和母乳喂养准备的影响:随机对照试验。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-09-27 DOI: 10.3345/cep.2024.00423
Fatma Şule Bilgiç, Gülçin Bozkurt

Background: Mothers must acquire the knowledge and skills needed to fulfill their responsibilities and take care of themselves and their babies.

Purpose: This study aimed to examine the effects of online baby care education and postpartum counseling based on Meleis' transition theory on mothers' readiness for baby care and breastfeeding.

Method: This randomized controlled trial was conducted between May 2022 and May 2023 at the pregnancy follow-up outpatient clinic of a state hospital. The study sample consisted of 102 pregnant women (52 in the intervention group, 50 in the control group).

Results: The mean scores of the intervention group compared to the control group were significantly higher immediately after birth and at 1, 2, and 3 months postpartum. Change over time was significantly higher in repeated measurements of National Institute of Child Health and Human Development scale scores of the intervention and control groups (P=0.001). In the first 24 hours, mothers in the intervention group breastfed more successfully than those in the control group (P<0.001). Mothers in the intervention group exclusively breast fed at a significantly higher rate immediately and at 1, 2, and 3 months postpartum compared to the control group (P<0.001). A statistically significant difference was noted in mean infant height and weight in the intervention group compared to the control group (P<0.05).

Conclusion: Theory-based online education initiated during pregnancy and counseling continued up to 3 months postpartum positively affected the mothers' abilities to care for their infants. Mothers who received education and counseling breastfed their babies more successfully on the first day and breast fed exclusively at a higher rate in the first 3 months.

研究背景目的:本研究旨在探讨基于 Meleis 过渡理论的在线育婴教育和产后咨询对母亲做好育婴和母乳喂养准备的影响:本随机对照试验于 2022 年 5 月至 2023 年 5 月在一家州立医院的孕期随访门诊进行。研究样本包括 102 名孕妇(干预组 52 人,对照组 50 人):结果:与对照组相比,干预组孕妇在产后即刻以及产后 1、2 和 3 个月的平均得分明显更高。干预组和对照组的国家儿童健康与人类发展研究所量表评分的重复测量值随时间的变化明显更高(P=0.001)。在最初的 24 小时内,干预组的母亲比对照组的母亲更成功地进行了母乳喂养(结论:孕期开始的基于理论的在线教育和持续到产后 3 个月的咨询对母亲照顾婴儿的能力产生了积极影响。接受了教育和咨询的母亲在第一天给婴儿喂母乳的成功率更高,在头 3 个月的纯母乳喂养率也更高。
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引用次数: 0
Protective effect of recombinant interleukin-10 on newborn rat lungs exposed to short-term sublethal hyperoxia. 重组白细胞介素-10对暴露于短期亚致死性高氧环境的新生大鼠肺部的保护作用
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-09-27 DOI: 10.3345/cep.2024.01221
Hyeon-Soo Lee, Young-Joon Ryu, Min-Jae Lee

Background: Lung injury imposed by hyperoxia is the main cause of bronchopulmonary dysplasia in newborns. These injuries are generated from the early stage of hyperoxia through the main biologic effects of cell death and inflammatory response. Interleukin (IL)-10 is a potent anti-inflammatory cytokine that may have the inhibitory effects on these biologic actions induced by hyperoxia.

Purpose: Based on our former in vitro studies investigating the effect of recombinant IL-10 (rIL-10) on protecting cultured alveolar type II cells exposed to short-term hyperoxia, we performed the in vivo study to investigate the effect of rIL-10 in newborn rats aged P4 exposed to hyperoxia.

Methods: Rats were classified into 3 groups; the control group exposed to normoxia for 24 hours; the hyperoxia group exposed to 65% hyperoxia for 24 hours; and the IL10 group treated with intratracheal instillation of rIL-10 prior to exposure to 65% hyperoxia for 24 hours. Following each treatment, the rats were euthanized. Individual lobes of the right lung were prepared for hematoxyling and eosin (H&E) staining and immunohistochemical staining for thyroid transcription factor-1 (TTF1). Bronchoalveolar lavage (BAL) was performed in the left lung to analyze cell counts and cytokines.

Results: The IL10 group showed preserved air spaces similar to the control group, with decreased cellularity compared to the hyperoxia group, whereas the hyperoxia group showed markedly reduced air spaces with increased cellularity compared to the IL10 group. And, the IL10 group showed more TTF1-positive cells, which represented alveolar type II cells, compared to the hyperoxia group. Inflammatory cells, such as neutrophils and lymphocytes and proinflammatory cytokines of tumor necrosis factor-α, IL-1α, IL-8, and macrophage inflammatory protein-1α were significantly lower in BAL fluid of the IL10 group compared to the hyperoxia group.

Conclusion: These results indicate that rIL-10 may be a promising pharmaceutical measure for protecting newborn lungs from injury induced at the early stage of hyper oxia.

背景:高氧造成的肺损伤是新生儿支气管肺发育不良的主要原因。这些损伤是在高氧早期通过细胞死亡和炎症反应的主要生物效应产生的。白细胞介素(IL)-10 是一种强效抗炎细胞因子,可能对高氧诱导的这些生物效应有抑制作用。目的:基于我们以前的体外研究,即重组 IL-10 (rIL-10)对保护暴露于短期高氧的培养肺泡 II 型细胞的影响,我们进行了体内研究,以调查 rIL-10 对暴露于高氧的 P4 岁新生大鼠的影响:方法:将大鼠分为三组:暴露于常氧环境 24 小时的对照组;暴露于 65% 高氧环境 24 小时的高氧组;以及在暴露于 65% 高氧环境 24 小时之前气管内灌注 rIL-10 的 IL10 组。每次治疗后,大鼠均被安乐死。制备右肺的单个肺叶,进行苏木精和伊红(H&E)染色以及甲状腺转录因子-1(TTF1)的免疫组化染色。对左肺进行支气管肺泡灌洗(BAL),分析细胞计数和细胞因子:结果:与高氧组相比,IL10 组保留了与对照组相似的气室,但细胞数量减少;而与 IL10 组相比,高氧组气室明显减少,细胞数量增加。而且,与高氧组相比,IL10 组显示出更多的 TTF1 阳性细胞,代表肺泡 II 型细胞。中性粒细胞和淋巴细胞等炎性细胞以及肿瘤坏死因子-α、IL-1α、IL-8和巨噬细胞炎症蛋白-1α等促炎细胞因子在IL10组的痰液中的含量明显低于高氧组:这些结果表明,rIL-10 可能是保护新生儿肺部免受高氧早期损伤的一种有前途的药物措施。
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引用次数: 0
Energy drink consumption among Korean adolescents: prevalence and associated factors. 韩国青少年饮用能量饮料的情况:流行程度和相关因素。
IF 3.2 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-09-24 DOI: 10.3345/cep.2024.00171
Jee-Seon Shim, Jeong Mi Lee

Background: Energy drinks are gaining popularity among young people worldwide. However, little is known about their consumption among Korean adolescents.

Purpose: To examine the prevalence and factors associated with energy drink consumption among Korean adolescents.

Methods: This study used data from the Korea Youth Risk Behavior Surveys conducted in 2014-2017 and in 2019. A total of 325,210 participants aged 12-18 years were included. The prevalence of energy drink consumption (with 95% confidence intervals) was estimated. Multivariable logistic regression analyses examined the association between energy drink consumption and sociodemographic and individual factors.

Results: The prevalence of consuming energy drinks 3 or more times during the previous 7 days increased significantly from 3.2% in 2014 to 12.2% in 2019 (P for trend<0.001). This increasing trend was observed in all subgroups regardless of sex, school grade, region of residence, subjective economic status, family cohabitation status, and academic achievement. Data from the 2014-2017 and 2019 surveys revealed that boys, high schoolers, city-dwelling adolescents, adolescents with low economic status, those not living with their families, and those with low academic achievement were more likely to consume energy drinks. However, the relationship between energy drink consumption and the associated factors differed by survey year and school grade. In 2019, higher energy drink consumption among middle schoolers was associated with sex (male), low economic status, not living with family, and low academic achievement; however, higher energy drink consumption among high schoolers was associated with city-dwelling, high economic status, not living with family, and high academic achievement.

Conclusion: Energy drink consumption is common, has recently increased among Korean adolescents, and varies according to sociodemographic and individual factors. Further research to monitor the energy drink consumption of adolescents and understand their attitudes toward and factors influencing energy drink consumption is needed to develop policies and educational strategies for energy drink consumption.

背景:能量饮料在全球青少年中越来越受欢迎。然而,人们对韩国青少年饮用能量饮料的情况知之甚少:研究韩国青少年饮用能量饮料的情况及其相关因素:本研究使用了2014-2017年和2019年进行的韩国青少年风险行为调查的数据。共纳入 325 210 名 12-18 岁的参与者。研究估算了能量饮料的消费流行率(含 95% 置信区间)。多变量逻辑回归分析检验了能量饮料消费与社会人口和个人因素之间的关联:在过去 7 天内饮用 3 次或更多次能量饮料的比例从 2014 年的 3.2% 显著上升至 2019 年的 12.2%(P 为趋势):能量饮料的消费在韩国青少年中很常见,最近有所增长,并且因社会人口和个人因素而异。需要进一步开展研究,监测青少年的能量饮料消费情况,了解他们对能量饮料消费的态度和影响因素,以制定针对能量饮料消费的政策和教育策略。
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引用次数: 0
期刊
Clinical and Experimental Pediatrics
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