{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T17:48:37Z","timestamp":1777571317337,"version":"3.51.4"},"reference-count":50,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T00:00:00Z","timestamp":1614124800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T00:00:00Z","timestamp":1614124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Taipei Medical University (Taipei, Taiwan) for New Faculty Research","award":["TMU103-AE1-B22"],"award-info":[{"award-number":["TMU103-AE1-B22"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hypertension in childhood and adolescence is associated with adult cardiovascular morbidity and mortality. However, the reported prevalence of pediatric hypertension varies considerably. We conducted a pioneer nationwide population-based study to investigate the prevalence of hypertension among children and adolescents. Pediatric patients who had been diagnosed with hypertension between 2000 and 2013 were selected from the National Health Insurance Research Database in Taiwan. Other metabolic syndrome-related diseases that would increase cardiovascular risk, including diabetes mellitus (DM), hyperlipidemia, and obesity, were also retrieved for further evaluation. In total, 10,364 children and adolescents diagnosed with hypertension were identified. The prevalence of pediatric hypertension in Taiwan ranged from 0.19 to 0.38 per 1000 children and adolescents between 2000 and 2013. Essential hypertension was most commonly coded (90.6%), which was much more than secondary hypertension (14.3%). Children and adolescents with hypertension were often associated with DM, hyperlipidemia, and obesity, with the odds ratios as 14.05 (95% confidence interval (CI) 11.74\u201316.81, p\u2009&lt;\u20090.001), 10.65 (95% CI 9.48\u201311.97, p\u2009&lt;\u20090.001), and 19.08 (95% CI 15.65\u201323.26, p\u2009&lt;\u20090.001), respectively. To improve lifelong cardiovascular health, our results emphasize the importance of early proper recognition and suitable management of hypertension, as well as metabolic syndrome-related diseases, among children and adolescents.<\/jats:p>","DOI":"10.1038\/s41598-021-84001-6","type":"journal-article","created":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T11:03:35Z","timestamp":1614164615000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["A reappraisal of the prevalence of pediatric hypertension through a nationwide database in Taiwan"],"prefix":"10.1038","volume":"11","author":[{"given":"Wan-Fu","family":"Hsu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Wei","family":"Kao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingchih","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huei-Chen","family":"Chiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Yen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng-Che","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben-Chang","family":"Shia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai-Sheng","family":"Hsieh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,2,24]]},"reference":[{"key":"84001_CR1","doi-asserted-by":"publisher","first-page":"1903","DOI":"10.1016\/S0140-6736(02)11911-8","volume":"360","author":"S Lewington","year":"2002","unstructured":"Lewington, S., Clarke, R., Qizilbash, N., Peto, R. & Collins, R. Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 360, 1903\u20131913 (2002).","journal-title":"Lancet"},{"key":"84001_CR2","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1056\/NEJM199601043340103","volume":"334","author":"MJ Klag","year":"1996","unstructured":"Klag, M. J. et al. Blood pressure and end-stage renal disease in men. N. Engl. J. Med. 334, 13\u201318 (1996).","journal-title":"N. Engl. J. Med."},{"key":"84001_CR3","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1161\/CIRCULATIONAHA.115.018912","volume":"134","author":"KT Mills","year":"2016","unstructured":"Mills, K. T. et al. Global disparities of hypertension prevalence and control. Circulation 134, 441\u2013450 (2016).","journal-title":"Circulation"},{"key":"84001_CR4","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1161\/HYPERTENSIONAHA.117.09537","volume":"70","author":"W Shen","year":"2017","unstructured":"Shen, W. et al. Race and sex differences of long-term blood pressure profiles from childhood and adult hypertension: The Bogalusa Heart Study. Hypertension 70, 66\u201374 (2017).","journal-title":"Hypertension"},{"key":"84001_CR5","doi-asserted-by":"publisher","first-page":"3171","DOI":"10.1161\/CIRCULATIONAHA.107.730366","volume":"117","author":"X Chen","year":"2008","unstructured":"Chen, X. & Wang, Y. Tracking of blood pressure from childhood to adulthood: A systematic review and meta-regression analysis. Circulation 117, 3171\u20133180 (2008).","journal-title":"Circulation"},{"key":"84001_CR6","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1542\/peds.2006-2543","volume":"119","author":"SS Sun","year":"2007","unstructured":"Sun, S. S. et al. Systolic blood pressure in childhood predicts hypertension and metabolic syndrome later in life. Pediatrics 119, 237\u2013246 (2007).","journal-title":"Pediatrics"},{"key":"84001_CR7","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1016\/0895-7061(95)00116-7","volume":"8","author":"W Bao","year":"1995","unstructured":"Bao, W., Threefoot, S. A., Srinivasan, S. R. & Berenson, G. S. Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: The Bogalusa Heart Study. Am. J. Hypertens. 8, 657\u2013665 (1995).","journal-title":"Am. J. Hypertens."},{"key":"84001_CR8","doi-asserted-by":"publisher","first-page":"2514","DOI":"10.1161\/CIRCULATIONAHA.110.966465","volume":"122","author":"M Juonala","year":"2010","unstructured":"Juonala, M. et al. Influence of age on associations between childhood risk factors and carotid intima-media thickness in adulthood: The cardiovascular risk in young finns study, the childhood determinants of adult health study, the bogalusa heart study, and the muscatine st. Circulation 122, 2514\u20132520 (2010).","journal-title":"Circulation"},{"key":"84001_CR9","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1111\/j.1751-7176.2011.00471.x","volume":"13","author":"EM Urbina","year":"2011","unstructured":"Urbina, E. M. et al. Cardiac and vascular consequences of pre-hypertension in youth. J. Clin. Hypertens. 13, 332\u2013342 (2011).","journal-title":"J. Clin. Hypertens."},{"key":"84001_CR10","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1007\/s00467-008-1077-6","volume":"24","author":"R Lubrano","year":"2009","unstructured":"Lubrano, R. et al. Blood pressure load, proteinuria and renal function in pre-hypertensive children. Pediatr. Nephrol. 24, 823\u2013831 (2009).","journal-title":"Pediatr. Nephrol."},{"key":"84001_CR11","doi-asserted-by":"publisher","first-page":"e1425","DOI":"10.1542\/peds.2010-1899","volume":"126","author":"HR Adams","year":"2010","unstructured":"Adams, H. R., Szilagyi, P. G., Gebhardt, L. & Lande, M. B. Learning and attention problems among children with pediatric primary hypertension. Pediatrics 126, e1425\u2013e1429 (2010).","journal-title":"Pediatrics"},{"key":"84001_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13690-018-0265-5","volume":"76","author":"N Shah","year":"2018","unstructured":"Shah, N., Shah, Q. & Shah, A. J. The burden and high prevalence of hypertension in Pakistani adolescents: A meta-analysis of the published studies. Arch. Public Health. 76, 1\u201310 (2018).","journal-title":"Arch. Public Health."},{"key":"84001_CR13","first-page":"S65","volume":"5","author":"T Anand","year":"2014","unstructured":"Anand, T., Ingle, G. K., Meena, G. S., Kishore, J. & Kumar, R. Hypertension and its correlates among school adolescents in Delhi. Int. J. Prev. Med. 5, S65-70 (2014).","journal-title":"Int. J. Prev. Med."},{"key":"84001_CR14","doi-asserted-by":"crossref","first-page":"14","DOI":"10.4172\/2161-1165.1000130","volume":"03","author":"JS Sundar","year":"2013","unstructured":"Sundar, J. S. et al. Prevalence and determinants of hypertension among urban school children in the age group of 13\u201317 years in, Chennai, Tamilnadu. Epidemiol. Open Access 03, 14\u201320 (2013).","journal-title":"Epidemiol. Open Access"},{"key":"84001_CR15","first-page":"55","volume":"18","author":"JK Liew","year":"2019","unstructured":"Liew, J. K. et al. Prevalence and factors associated with hypertension among adolescents in Malaysia. Int. Med. J. Malaysia 18, 55\u201364 (2019).","journal-title":"Int. Med. J. Malaysia"},{"key":"84001_CR16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0210591","volume":"14","author":"Z Fan","year":"2019","unstructured":"Fan, Z., Liao, Z., Zong, X. & Zhang, S. Differences in prevalence of prehypertension and hypertension in children and adolescents in the eastern, central and western regions of China from 1991\u20132011 and the associated risk factors. PLoS ONE 14, 1\u201314 (2019).","journal-title":"PLoS ONE"},{"key":"84001_CR17","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1161\/CIRCULATIONAHA.110.014399","volume":"124","author":"YH Khang","year":"2011","unstructured":"Khang, Y. H. & Lynch, J. W. Exploring determinants of secular decreases in childhood blood pressure and hypertension. Circulation 124, 397\u2013405 (2011).","journal-title":"Circulation"},{"key":"84001_CR18","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1038\/s41440-019-0284-9","volume":"42","author":"S Umemura","year":"2019","unstructured":"Umemura, S. et al. The Japanese Society of Hypertension Guidelines for the management of hypertension (JSH 2019). Hypertens. Res. 42, 1235\u20131481 (2019).","journal-title":"Hypertens. Res."},{"key":"84001_CR19","doi-asserted-by":"publisher","first-page":"e20171904","DOI":"10.1542\/peds.2017-1904","volume":"140","author":"JT Flynn","year":"2017","unstructured":"Flynn, J. T. et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 140, e20171904 (2017).","journal-title":"Pediatrics"},{"key":"84001_CR20","unstructured":"Lurbe, E. et al. 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J. Hypertens. 34, 1887\u20131920 (2016)."},{"key":"84001_CR21","doi-asserted-by":"publisher","first-page":"349","DOI":"10.2147\/CLEP.S196293","volume":"11","author":"C-Y Hsieh","year":"2019","unstructured":"Hsieh, C.-Y. et al. Taiwan\u2019s National Health Insurance Research Database: Past and future. Clin. Epidemiol. 11, 349\u2013358 (2019).","journal-title":"Clin. Epidemiol."},{"key":"84001_CR22","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/j.ijcard.2016.04.069","volume":"215","author":"S-F Sung","year":"2016","unstructured":"Sung, S.-F. et al. Validation of algorithms to identify stroke risk factors in patients with acute ischemic stroke, transient ischemic attack, or intracerebral hemorrhage in an administrative claims database. Int. J. Cardiol. 215, 277\u2013282 (2016).","journal-title":"Int. J. Cardiol."},{"key":"84001_CR23","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1002\/pds.1877","volume":"19","author":"J Li","year":"2010","unstructured":"Li, J. et al. Longitudinal study on pediatric dyslipidemia in population-based claims database. Pharmacoepidemiol. Drug Saf. 19, 90\u201398 (2010).","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"84001_CR24","doi-asserted-by":"publisher","first-page":"1246","DOI":"10.1161\/CIRCULATIONAHA.117.029726","volume":"137","author":"J Koskinen","year":"2018","unstructured":"Koskinen, J. et al. Impact of lipid measurements in youth in addition to conventional clinic-based risk factors on predicting preclinical atherosclerosis in adulthood international childhood cardiovascular cohort consortium. Circulation 137, 1246\u20131255 (2018).","journal-title":"Circulation"},{"key":"84001_CR25","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1001\/jama.2012.9630","volume":"308","author":"HM DenRuijter","year":"2012","unstructured":"DenRuijter, H. M. et al. Common carotid intima-media thickness measurements in cardiovascular risk prediction: A meta-analysis. JAMA 308, 796\u2013803 (2012).","journal-title":"JAMA"},{"key":"84001_CR26","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1161\/01.cir.0000437738.63853.7a","volume":"129","author":"NJ Stone","year":"2014","unstructured":"Stone, N. J. et al. 2013 ACC\/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: A report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines. Circulation 129, S1-45 (2014).","journal-title":"Circulation"},{"key":"84001_CR27","doi-asserted-by":"crossref","unstructured":"Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents &National Heart, Lung, and B. I. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: Summary report. Pediatrics 128(Suppl), S213\u201356 (2011).","DOI":"10.1542\/peds.2009-2107C"},{"key":"84001_CR28","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1016\/S0140-6736(14)60460-8","volume":"384","author":"M Ng","year":"2014","unstructured":"Ng, M. et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980\u20132013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet 384, 766\u2013781 (2014).","journal-title":"Lancet"},{"key":"84001_CR29","doi-asserted-by":"publisher","first-page":"2065","DOI":"10.1542\/peds.2005-1716","volume":"117","author":"R Jago","year":"2006","unstructured":"Jago, R. et al. Prevalence of abnormal lipid and blood pressure values among an ethnically diverse population of eighth-grade adolescents and screening implications. Pediatrics 117, 2065\u20132073 (2006).","journal-title":"Pediatrics"},{"key":"84001_CR30","doi-asserted-by":"publisher","first-page":"1587","DOI":"10.1016\/j.amjcard.2015.02.063","volume":"115","author":"M Flechtner-Mors","year":"2015","unstructured":"Flechtner-Mors, M. et al. Blood pressure in 57,915 pediatric patients who are overweight or obese based on five reference systems. Am. J. Cardiol. 115, 1587\u20131594 (2015).","journal-title":"Am. J. Cardiol."},{"key":"84001_CR31","doi-asserted-by":"publisher","first-page":"1563","DOI":"10.1097\/HJH.0b013e328302842b","volume":"26","author":"S Genovesi","year":"2008","unstructured":"Genovesi, S. et al. Usefulness of waist circumference for the identification of childhood hypertension. J. Hypertens. 26, 1563\u20131570 (2008).","journal-title":"J. Hypertens."},{"key":"84001_CR32","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1136\/jech-2017-209491","volume":"71","author":"MK Kwok","year":"2017","unstructured":"Kwok, M. K., Tu, Y. K., Kawachi, I. & Schooling, C. M. Age-period-cohort analysis of trends in blood pressure and body mass index in children and adolescents in Hong Kong. J. Epidemiol. Community Health 71, 1161\u20131168 (2017).","journal-title":"J. Epidemiol. Community Health"},{"key":"84001_CR33","doi-asserted-by":"publisher","first-page":"e20161433","DOI":"10.1542\/peds.2016-1433","volume":"139","author":"EL Cheung","year":"2017","unstructured":"Cheung, E. L. et al. Race and obesity in adolescent hypertension. Pediatrics 139, e20161433 (2017).","journal-title":"Pediatrics"},{"key":"84001_CR34","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.jpeds.2010.02.021","volume":"157","author":"BL Rodriguez","year":"2010","unstructured":"Rodriguez, B. L. et al. Prevalence and correlates of elevated blood pressure in youth with diabetes mellitus: The search for diabetes in youth study. J. Pediatr. 157, 245-251.e1 (2010).","journal-title":"J. Pediatr."},{"key":"84001_CR35","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.2337\/dc05-2470","volume":"29","author":"MC Eppens","year":"2006","unstructured":"Eppens, M. C. et al. Prevalence of diabetes complications in adolescents with type 2 compared with type 1 diabetes. Diabetes Care 29, 1300\u20131306 (2006).","journal-title":"Diabetes Care"},{"key":"84001_CR36","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1007\/s00125-007-0921-8","volume":"51","author":"HD Margeirsdottir","year":"2008","unstructured":"Margeirsdottir, H. D., Larsen, J. R., Brunborg, C., \u00d8verby, N. C. & Dahl-J\u00f8rgensen, K. High prevalence of cardiovascular risk factors in children and adolescents with type 1 diabetes: A population-based study. Diabetologia 51, 554\u2013561 (2008).","journal-title":"Diabetologia"},{"key":"84001_CR37","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1111\/pedi.12179","volume":"15","author":"P Zeitler","year":"2014","unstructured":"Zeitler, P. et al. Type 2 diabetes in the child and adolescent. Pediatr. Diabetes 15, 26\u201346 (2014).","journal-title":"Pediatr. Diabetes"},{"key":"84001_CR38","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1007\/BF00865475","volume":"8","author":"MY Arar","year":"1994","unstructured":"Arar, M. Y., Hogg, R. J., Arant, B. S. & Seikaly, M. G. Etiology of sustained hypertension in children in the Southwestern United States. Pediatr. Nephrol. 8, 186\u2013189 (1994).","journal-title":"Pediatr. Nephrol."},{"key":"84001_CR39","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1111\/j.1751-7176.2012.00656.x","volume":"14","author":"WP Welch","year":"2012","unstructured":"Welch, W. P., Yang, W., Taylor-Zapata, P. & Flynn, J. T. Antihypertensive drug use by children: Are the drugs labeled and indicated?. J. Clin. Hypertens. (Greenwich) 14, 388\u2013395 (2012).","journal-title":"J. Clin. Hypertens. (Greenwich)"},{"key":"84001_CR40","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1111\/j.1751-7176.2009.00195.x","volume":"12","author":"G Kapur","year":"2010","unstructured":"Kapur, G. et al. Secondary hypertension in overweight and stage 1 hypertensive children: A Midwest Pediatric Nephrology Consortium report. J. Clin. Hypertens. (Greenwich) 12, 34\u201339 (2010).","journal-title":"J. Clin. Hypertens. (Greenwich)"},{"key":"84001_CR41","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1053\/j.ackd.2005.07.002","volume":"12","author":"IF Shatat","year":"2005","unstructured":"Shatat, I. F. & Flynn, J. T. Hypertension in children with chronic kidney disease. Adv. Chronic Kidney Dis. 12, 378\u2013384 (2005).","journal-title":"Adv. Chronic Kidney Dis."},{"key":"84001_CR42","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1161\/HYPERTENSIONAHA.111.189266","volume":"60","author":"J Samuels","year":"2012","unstructured":"Samuels, J. et al. Ambulatory blood pressure patterns in children with chronic kidney disease. Hypertens. (Dallas, Tex. 1979) 60, 43\u201350 (2012).","journal-title":"Hypertens. (Dallas, Tex. 1979)"},{"key":"84001_CR43","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1161\/HYPERTENSIONAHA.108.110635","volume":"52","author":"JT Flynn","year":"2008","unstructured":"Flynn, J. T. et al. Blood pressure in children with chronic kidney disease: A report from the Chronic Kidney Disease in Children study. Hypertens. (Dallas, Tex. 1979) 52, 631\u2013637 (2008).","journal-title":"Hypertens. (Dallas, Tex. 1979)"},{"key":"84001_CR44","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1001\/jama.298.8.874","volume":"298","author":"ML Hansen","year":"2007","unstructured":"Hansen, M. L., Gunn, P. W. & Kaelber, D. C. Underdiagnosis of hypertension in children and adolescents. JAMA 298, 874\u2013879 (2007).","journal-title":"JAMA"},{"key":"84001_CR45","doi-asserted-by":"crossref","unstructured":"National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114, 555\u201376 (2004).","DOI":"10.1542\/peds.114.2.S2.555"},{"key":"84001_CR46","doi-asserted-by":"crossref","unstructured":"Whelton, P. K. et al. 2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: Executive summary: A report of the American college of cardiology\/American Heart Association task. Hypertension 71, (2018).","DOI":"10.1161\/HYP.0000000000000075"},{"key":"84001_CR47","unstructured":"Williams, B. et al. 2018 practice guidelines for the management of arterial hypertension of the European society of cardiology and the European society of hypertension ESC\/ESH task force for the management of arterial hypertension. J. Hypertens. 36, (2018)."},{"key":"84001_CR48","first-page":"1","volume":"3","author":"DR Ewald","year":"2016","unstructured":"Ewald, D. R. & Haldeman, L. A. Risk factors in adolescent hypertension. Glob. Pediatr. Health. 3, 1\u201326 (2016).","journal-title":"Glob. Pediatr. Health."},{"key":"84001_CR49","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/S2352-4642(18)30095-6","volume":"2","author":"HH Kyu","year":"2018","unstructured":"Kyu, H. H. et al. Causes of death among children aged 5\u201314 years in the WHO European Region: A systematic analysis for the Global Burden of Disease Study 2016. Lancet. Child Adolesc. Health. 2, 321\u2013337 (2018).","journal-title":"Lancet. Child Adolesc. Health."},{"key":"84001_CR50","doi-asserted-by":"publisher","first-page":"2468","DOI":"10.1056\/NEJMsr1804754","volume":"379","author":"RM Cunningham","year":"2018","unstructured":"Cunningham, R. M., Walton, M. A. & Carter, P. M. The major causes of death in children and adolescents in the United States. N. Engl. J. Med. 379, 2468\u20132475 (2018).","journal-title":"N. Engl. J. Med."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-84001-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-84001-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-84001-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,24]],"date-time":"2024-08-24T19:45:37Z","timestamp":1724528737000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-84001-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,24]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["84001"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-84001-6","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,24]]},"assertion":[{"value":"11 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 February 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"4475"}}