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Heart Healthy Routines in Young Children With Sesame Workshop: A Qualitative Study of Latina Mothers With Economic Hardship. 通过芝麻工作坊®让幼儿养成健康的生活习惯:对经济困难的拉丁裔母亲的定性研究。
IF 3 3区 医学 Q1 PEDIATRICS Pub Date : 2024-09-21 DOI: 10.1016/j.acap.2024.09.006
Carol Duh-Leong, Mary Jo Messito, Leah Kim, David I Cohen, Jeanette Betancourt, Robin Ortiz, Jessica Astudillo, Nikita Nagpal, Michelle W Katzow, Rachel S Gross

Objective: To explore how Sesame Workshop resources are perceived by Latino families with economic hardship and to highlight approaches for early heart healthy routine promotion.

Methods: We performed a purposive sampling of Latina mothers (n = 40) with young children experiencing economic hardship. Using an interview guide informed by the Consolidated Framework for Implementation Research, we recorded Spanish and English semistructured interviews, which were translated and transcribed verbatim. Partnering with Sesame Workshop, we iteratively incorporated Sesame Resources into interviews to query for acceptability. Using reflexive thematic analysis, we coded transcripts through textual analysis until saturation, prioritizing in vivo coding to capture participant voices.

Results: We constructed 3 themes. Parents connected with resources that 1) Reflect lived and multicultural experiences containing recognizable family scenes that can serve as tools to transfer a parent's own early routines or cultural rituals to their child. They appreciated resources that 2) Engage caregivers and children together, featuring elements for both children and adult caregivers with activities to highlight important caregivers and encourage shared play. Participants also reflected on how 3) Routines amplify family strengths and foster resilient reactions with feelings of decreased stress when daily practices become routines, promoting resilient reactions and supporting long-term goals when facing setbacks.

Conclusions: An interdisciplinary partnership leveraged strengths of pediatric practitioners and Sesame Workshop to align future initiatives with the values and priorities of mothers of young children at risk for early obesity. Resultant themes inform strategies to promote heart healthy routines and relational health in young children with economic hardship.

目的探讨经济困难的拉丁裔家庭如何看待芝麻工作坊®的资源,并强调早期心脏健康常规宣传的方法:我们对有经济困难幼儿的拉丁裔母亲(人数=40)进行了有目的的抽样调查。我们使用以 "实施研究综合框架 "为参考的访谈指南,记录了西班牙语和英语半结构式访谈,并逐字翻译和转录。我们与芝麻工作坊(Sesame Workshop®)合作,反复将芝麻资源(Sesame Resources®)纳入访谈,以询问可接受性。我们采用反思性主题分析法,通过文本分析对记录誊本进行编码,直到饱和为止,并优先进行活体编码,以捕捉参与者的声音:我们构建了三个主题。1) 反映生活和多元文化经验的资源,包含可识别的家庭场景,可作为将父母自己的早期常规或文化仪式传递给孩子的工具。他们对以下资源表示赞赏:2)让照顾者和儿童共同参与,为儿童和成年照顾者提供活动元素,突出重要的照顾者并鼓励共同游戏。与会者还反思了 3) 当日常做法成为常规时,如何放大家庭的力量并促进弹性反应,减少压力感,促进弹性反应并支持长期目标,即使在面临挫折时也是如此:跨学科合作利用了儿科医生和芝麻工作坊®的优势,使未来的计划与有早期肥胖风险的幼儿母亲的价值观和优先事项保持一致。由此产生的主题为促进经济困难幼儿的心脏健康常规和关系健康的策略提供了参考。
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引用次数: 0
Faculty Supper Club - Fostering Connection, Mentorship, and Sponsorship through Resident-Faculty Dinners. 教职员晚餐俱乐部 - 通过驻地教职员晚餐,促进联系、指导和赞助。
IF 3 3区 医学 Q1 PEDIATRICS Pub Date : 2024-09-17 DOI: 10.1016/j.acap.2024.09.003
Anthony L Bui, Julianne E Edwards, Elena C Griego, Helene Mollie Grow, Tania M Haag, Krystle M Perez, Tracy L Seimears
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引用次数: 0
Using Insights from Families to Improve Social Needs Screening and Support Community Resource Connection. 利用来自家庭的洞察力改进社会需求筛查并支持社区资源连接。
IF 3 3区 医学 Q1 PEDIATRICS Pub Date : 2024-09-16 DOI: 10.1016/j.acap.2024.09.004
Michael J Luke, Olivia Darko, Aditi Vasan
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引用次数: 0
Bringing Residents Back to the Bedside Through Trading Cards. 通过交易卡让住院病人回到床边。
IF 3 3区 医学 Q1 PEDIATRICS Pub Date : 2024-09-14 DOI: 10.1016/j.acap.2024.09.005
Joshua A Belfer, Kinjal Desai, Hayley Wolfgruber, Myriam Kline, Joseph Castiglione, Stephanie Sayres, Stephen R Barone
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引用次数: 0
Pediatric Coronavirus Disease 2019 Vaccine Experiences, Practices, and Attitudes in Rural Primary Care Clinicians. 农村初级保健临床医生接种小儿 COVID-19 疫苗的经验、做法和态度。
IF 3 3区 医学 Q1 PEDIATRICS Pub Date : 2024-09-13 DOI: 10.1016/j.acap.2024.09.002
David M Higgins, Amanda M Skenadore, Cathryn Perreira, Anna Furniss, Sarah E Brewer, Jessica R Cataldi, Andrea L Nederveld, Laura D Scherer, Rachel Severson, Heather Roth, Sean T O'Leary

Objective: Pediatric coronavirus disease 2019 (COVID-19) vaccination rates remain low in rural areas. A strong clinician recommendation improves vaccine uptake, but the pediatric COVID-19 vaccine recommendation practices of rural primary care clinicians have not been reported. Our objectives were to describe, among rural Colorado pediatric clinicians: 1) recommendation practices for COVID-19 vaccine compared to influenza and school-entry required vaccines, and 2) personal attitudes.

Methods: From July to October 2023, surveys were distributed to clinicians in rural Colorado identified as pediatric vaccine providers in counties designated as rural through the Colorado Immunization Information System using mail and email.

Results: Of 89 survey respondents, 37% of clinicians strongly recommended COVID-19 vaccines for children 6 months-5 years old, compared to 79% for influenza (P = 0.05) and 92% for school-entry required vaccines (P = 0.04). For children 6-11 and 12-17 years old, 43% and 44% of clinicians strongly recommended COVID-19 vaccines, respectively, compared to 71% and 70% for influenza (P < 0.01), and 91% for school-entry required vaccines (P < 0.01). Forty four percent of clinicians agreed that COVID-19 vaccines are important for pediatric patients. The most common clinician-perceived challenges to discussing pediatric COVID-19 vaccines included a lack of parent interest in more information (76% "somewhat" or "strongly" agree), lack of ability to change parents' minds (71%), and concerns that the vaccines are too political (40%).

Conclusions: Most rural Colorado clinicians do not strongly recommend pediatric COVID-19 vaccines compared to influenza and school-entry required vaccines. Efforts to improve pediatric COVID-19 vaccine uptake should aim to strengthen clinicians' recommendations of these vaccines.

目标:农村地区小儿 COVID-19 疫苗接种率仍然很低。临床医生的强烈推荐可提高疫苗接种率,但农村初级保健临床医生的儿科 COVID-19 疫苗推荐做法尚未见报道。我们的目标是描述科罗拉多州农村地区儿科临床医生的情况:1)与流感疫苗和入学所需疫苗相比,COVID-19 疫苗的推荐方法;2)个人态度:从 2023 年 7 月到 10 月,通过邮件和电子邮件向科罗拉多州免疫信息系统指定为农村县的儿科疫苗提供者的科罗拉多州农村地区临床医生发放了调查问卷:在 89 名调查对象中,37% 的临床医生强烈推荐为 6 个月至 5 岁儿童接种 COVID-19 疫苗,而流感疫苗的推荐比例为 79%(P=0.05),入学所需疫苗的推荐比例为 92%(P=0.04)。对于 6-11 岁和 12-17 岁的儿童,分别有 43% 和 44% 的临床医生强烈推荐接种 COVID-19 疫苗,而对于流感,则分别有 71% 和 70% 的临床医生强烈推荐接种 COVID-19 疫苗(P=0.05):与流感疫苗和入学所需疫苗相比,大多数科罗拉多州农村地区的临床医生并不强烈推荐接种小儿 COVID-19 疫苗。为提高小儿 COVID-19 疫苗的接种率,应加强临床医生对这些疫苗的推荐。
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引用次数: 0
Suicide Risk Identified among Transgender and Gender Diverse Youth in the Emergency Department (2019-2022). 在急诊科发现的变性和性别多元化青少年中存在自杀风险(2019-2022 年)。
IF 3 3区 医学 Q1 PEDIATRICS Pub Date : 2024-09-05 DOI: 10.1016/j.acap.2024.08.162
Amanda Burnside, Doug Lorenz, Michael Harries, Aron Janssen, Jennifer Hoffmann

Background and objectives: Suicide risk identified via universal screening in healthcare settings is associated with subsequent suicidal behavior and is an important prevention strategy. The prevalence of positive suicide risk screening among transgender and gender diverse (TGD) youth in the emergency department (ED) has not been described. The current study examined the association between gender identity and suicide risk screening results, adjusted for other demographic and clinical characteristics.

Methods: Retrospective cross-sectional study of electronic medical record data from ED visits November 2019-August 2022 in an urban academic children's hospital. Participants were youth ages 8-25 who received the Ask Suicide-Screening Questions suicide risk screening tool.

Results: Of 12,112 ED visits with suicide risk screening performed (42% male, median age 14 [12, 16]), 24% had positive screens. Of 565 visits by TGD youth, 78.1% had positive screens and 9.5% had active suicidal ideation. Compared to visits by cisgender females, the adjusted odds of positive screens was 5.35 times higher (95% CI 3.99, 7.18) among visits by TGD youth and 0.45 times lower (95% CI 0.40, 0.52) among visits by cisgender males. Compared to visits by cisgender females, the adjusted odds of active suicidal ideation was higher for cisgender males (aOR 1.34, 95% CI 1.07, 1.68) but did not significantly differ for TGD youth.

Conclusions: TGD youth have high rates of positive suicide risk screening in the ED, demonstrating substantial mental health needs. Opportunities may be available to improve detection, evidence-based brief interventions, and linkage to mental health services for this population.

背景和目的:在医疗机构中通过普遍筛查发现的自杀风险与随后的自杀行为有关,是一项重要的预防策略。关于急诊科(ED)中变性和性别多元化(TGD)青年自杀风险筛查阳性的发生率还没有描述。本研究考察了性别认同与自杀风险筛查结果之间的关联,并对其他人口统计学和临床特征进行了调整:方法:对一家城市学术儿童医院 2019 年 11 月至 2022 年 8 月期间急诊科就诊的电子病历数据进行回顾性横断面研究。参与者为接受过 "自杀筛查问题 "自杀风险筛查工具的 8-25 岁青少年:在接受自杀风险筛查的 12112 次急诊就诊中(42% 为男性,中位年龄为 14 [12, 16]),24% 的筛查结果呈阳性。在 565 名 TGD 青少年就诊者中,78.1% 的筛查结果呈阳性,9.5% 有主动自杀倾向。与同性别的女性就诊者相比,TGD 青少年就诊者中筛查呈阳性的调整后几率要高出 5.35 倍(95% CI 3.99,7.18),而同性别的男性就诊者中筛查呈阳性的调整后几率要低 0.45 倍(95% CI 0.40,0.52)。与同性别的女性来访者相比,同性别的男性来访者主动产生自杀念头的调整后几率更高(aOR 1.34,95% CI 1.07,1.68),但在 TGD 青少年中并无显著差异:结论:在急诊室,TGD 青少年的自杀风险筛查阳性率很高,这表明他们有很大的心理健康需求。我们可能有机会改进对这一人群的检测、循证简短干预以及与心理健康服务的联系。
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引用次数: 0
Geographic Patterns of Youth Suicide in San Diego County. 圣地亚哥县青少年自杀的地域模式。
IF 3 3区 医学 Q1 PEDIATRICS Pub Date : 2024-09-05 DOI: 10.1016/j.acap.2024.08.164
Derek Tam, Seema Shah, Steven Campman, Margaret Nguyen

Objective: Our objectives were to evaluate for any cluster patterns of youth suicide deaths and characterize the level of child opportunity in the communities where suicide deaths occurred.

Methods: Decedents <18 years were identified from San Diego County Medical Examiner death reports from 2000 to 2020. We mapped decedents' residential Zone Improvement Plan (ZIP) codes and calculated suicide rates per 10,000 youths. ZIP codes identified in overlapping spatial statistical approaches - the spatial scan statistic and Local Moran with Empirical Bayes (EB) rates - were considered a cluster for the final analysis. We obtained Child Opportunity Index (COI) scores for each ZIP code to determine if there were differences in: 1) ZIP codes with suicide deaths compared to ZIPs with no deaths 2) differences in distribution of suicide death rates across quintiles of COI.

Results: Scan statistic identified 25 ZIP codes within a cluster (RR 2.6, P = 0.00066). Local Moran with EB rates identified two ZIP codes as a high-high cluster (P < 0.05). The location identified as a cluster in both approaches was in Alpine. The median COI for ZIP codes with suicide deaths was higher at 63.5 (IQR 38-83) compared to 47 (IQR 22.5-75.5) for ZIP codes without suicide deaths. There was a significant difference in suicide rates between Very Low and Moderate levels of Overall opportunity (P = .013).

Conclusion: We identified a cluster of youth suicides in one of the most populous counties in the country. These findings serve to inform policies and prevention programs that aim to mitigate youth suicide mortality.

目标我们的目标是评估青少年自杀死亡的任何集群模式,并描述自杀死亡发生社区的儿童机会水平:死者扫描统计发现有 25 个邮政编码属于一个群集(RR 2.6,p = 0.00066)。当地莫兰与 EB 率将两个邮政编码确定为高-高群集(p < 0.05)。在这两种方法中被确定为群集的地点都位于阿尔派恩。有自杀死亡病例的邮政编码的 COI 中位数较高,为 63.5(IQR 38-83),而无自杀死亡病例的邮政编码的 COI 中位数为 47(IQR 22.5-75.5)。总体机会水平极低和中等之间的自杀率存在明显差异(p =.013):我们在美国人口最多的县之一发现了青少年自杀群。这些发现有助于为旨在降低青少年自杀死亡率的政策和预防计划提供信息。
{"title":"Geographic Patterns of Youth Suicide in San Diego County.","authors":"Derek Tam, Seema Shah, Steven Campman, Margaret Nguyen","doi":"10.1016/j.acap.2024.08.164","DOIUrl":"10.1016/j.acap.2024.08.164","url":null,"abstract":"<p><strong>Objective: </strong>Our objectives were to evaluate for any cluster patterns of youth suicide deaths and characterize the level of child opportunity in the communities where suicide deaths occurred.</p><p><strong>Methods: </strong>Decedents <18 years were identified from San Diego County Medical Examiner death reports from 2000 to 2020. We mapped decedents' residential Zone Improvement Plan (ZIP) codes and calculated suicide rates per 10,000 youths. ZIP codes identified in overlapping spatial statistical approaches - the spatial scan statistic and Local Moran with Empirical Bayes (EB) rates - were considered a cluster for the final analysis. We obtained Child Opportunity Index (COI) scores for each ZIP code to determine if there were differences in: 1) ZIP codes with suicide deaths compared to ZIPs with no deaths 2) differences in distribution of suicide death rates across quintiles of COI.</p><p><strong>Results: </strong>Scan statistic identified 25 ZIP codes within a cluster (RR 2.6, P = 0.00066). Local Moran with EB rates identified two ZIP codes as a high-high cluster (P < 0.05). The location identified as a cluster in both approaches was in Alpine. The median COI for ZIP codes with suicide deaths was higher at 63.5 (IQR 38-83) compared to 47 (IQR 22.5-75.5) for ZIP codes without suicide deaths. There was a significant difference in suicide rates between Very Low and Moderate levels of Overall opportunity (P = .013).</p><p><strong>Conclusion: </strong>We identified a cluster of youth suicides in one of the most populous counties in the country. These findings serve to inform policies and prevention programs that aim to mitigate youth suicide mortality.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
When Two Worlds Collide. 当两个世界发生碰撞
IF 3 3区 医学 Q1 PEDIATRICS Pub Date : 2024-09-03 DOI: 10.1016/j.acap.2024.08.161
Grace Black
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引用次数: 0
Addressing the Impacts of Racism on American Indian and Alaska Native Child Health 解决种族主义对美国印第安人和阿拉斯加原住民儿童健康的影响。
IF 3 3区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 DOI: 10.1016/j.acap.2023.11.016
The legacy of racism toward Native Americans is far-reaching. We will review the topic using the conceptual model of racism as a form of violence as it is inherent in racism, as are prejudice and power. Using the basic frameworks of racism as internalized, interpersonal, institutional, and structural, we will discuss the many types of racism affecting Native Americans today. Racism is the bedrock of generations of trauma experienced in Native communities. The generational/historical trauma of racism has led to epigenetic-level changes affecting Native American people today. We will cover the health impacts of racism and the many institutions built in racist frameworks that continue to perpetuate racism, such as family separation and child removal by child protective services, adverse policing, and disparate incarceration. These allow reflection on policies and the intentionality of racist structures. We will conclude with what can and should be done, particularly as clinicians who work within and adjacent to existing systems of oppression.
针对美国原住民的种族主义影响深远。我们将使用种族主义是一种暴力形式的概念模型来回顾这一主题,因为种族主义与偏见和权力一样,都是与生俱来的。我们将利用种族主义的内部化、人际关系、制度和结构等基本框架,讨论当今影响美国原住民的多种类型的种族主义。种族主义是原住民社区世代遭受创伤的基石。种族主义造成的世代/历史创伤导致了影响当今美国原住民的表观遗传学层面的变化。我们将介绍种族主义对健康的影响,以及在种族主义框架下建立的许多继续延续种族主义的机构,如家庭分离和儿童保护服务机构将儿童带走、不利的治安管理和不平等的监禁。这些都允许我们对种族主义结构的政策和意图进行反思。最后,我们将讨论可以做什么,应该做什么,特别是作为在现有压迫体系内和邻近地区工作的临床医生。
{"title":"Addressing the Impacts of Racism on American Indian and Alaska Native Child Health","authors":"","doi":"10.1016/j.acap.2023.11.016","DOIUrl":"10.1016/j.acap.2023.11.016","url":null,"abstract":"<div><div>The legacy of racism toward Native Americans is far-reaching. We will review the topic using the conceptual model of racism as a form of violence as it is inherent in racism, as are prejudice and power. Using the basic frameworks of racism as internalized, interpersonal, institutional, and structural, we will discuss the many types of racism affecting Native Americans today. Racism is the bedrock of generations of trauma experienced in Native communities. The generational/historical trauma of racism has led to epigenetic-level changes affecting Native American people today. We will cover the health impacts of racism and the many institutions built in racist frameworks that continue to perpetuate racism, such as family separation and child removal by child protective services, adverse policing, and disparate incarceration. These allow reflection on policies and the intentionality of racist structures. We will conclude with what can and should be done, particularly as clinicians who work within and adjacent to existing systems of oppression.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anti-Asian American, Native Hawaiian, and Pacific Islander Racism in Academic Pediatrics: Recommendations for Training, Research, and Clinical Practice 学术儿科中的反美籍亚裔、夏威夷原住民和太平洋岛民种族主义:培训、研究和临床实践建议》(Recommendations for Training, Research, and Clinical Practice)。
IF 3 3区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 DOI: 10.1016/j.acap.2024.07.005
This paper discusses how anti-Asian American, Native Hawaiian, and Pacific Islander (AANHPI) racism affects pediatric training, research, and clinical practice. Extant research shows that racism and discrimination are social determinants of health that impact AANHPI populations, including youth. AANHPI youth face significant health disparities and a wide range of barriers to health care access. However, AANHPIs tend to be seen by clinicians and depicted in training as monolithic, high achieving, and a relatively low priority in terms of pediatric workforce recruitment and training and pediatric research. After a brief discussion of US policies that have explicitly aimed to exclude, punish, or imprison AANHPIs, the paper explains AANHPI racism and its consequences. The paper then describes evidence of anti-AANHPI racism in pediatrics and offers recommendations for training, research, and clinical practice.
本文讨论了反亚裔美国人、夏威夷原住民和太平洋岛民(AANHPI)种族主义如何影响儿科培训、研究和临床实践。现有研究表明,种族主义和歧视是影响包括青少年在内的亚裔美国人、夏威夷原住民和太平洋岛民健康的社会决定因素。亚非裔美国人和太平洋岛国青年在健康方面面临着巨大的差异,在获得医疗保健服务方面也面临着广泛的障碍。然而,在临床医生和培训人员的眼中,亚裔美国人、加拿大人和太平洋岛国人往往是单一的、成绩优异的,在儿科人才招聘、培训和儿科研究方面的优先级相对较低。在简要讨论了美国明确旨在排斥、惩罚或监禁亚非裔美国人的政策后,本文解释了亚非裔美国人种族主义及其后果。然后,本文描述了儿科中反亚裔美国人和加拿大人种族主义的证据,并对培训、研究和临床实践提出了建议。
{"title":"Anti-Asian American, Native Hawaiian, and Pacific Islander Racism in Academic Pediatrics: Recommendations for Training, Research, and Clinical Practice","authors":"","doi":"10.1016/j.acap.2024.07.005","DOIUrl":"10.1016/j.acap.2024.07.005","url":null,"abstract":"<div><div>This paper discusses how anti-Asian American, Native Hawaiian, and Pacific Islander (AANHPI) racism affects pediatric training, research, and clinical practice. Extant research shows that racism and discrimination are social determinants of health that impact AANHPI populations, including youth. AANHPI youth face significant health disparities and a wide range of barriers to health care access. However, AANHPIs tend to be seen by clinicians and depicted in training as monolithic, high achieving, and a relatively low priority in terms of pediatric workforce recruitment and training and pediatric research. After a brief discussion of US policies that have explicitly aimed to exclude, punish, or imprison AANHPIs, the paper explains AANHPI racism and its consequences. The paper then describes evidence of anti-AANHPI racism in pediatrics and offers recommendations for training, research, and clinical practice.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Academic Pediatrics
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