{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T20:10:54Z","timestamp":1772827854828,"version":"3.50.1"},"reference-count":50,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,5]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Neurosurgery, particularly pediatric neurosurgery, is associated with high malpractice risks due to the complexity of procedures and potential for severe complications. However, comprehensive reviews of medical malpractice cases specifically involving pediatric neurosurgeons are scarce. This study aimed to analyze trends in malpractice litigation within the pediatric neurosurgical field in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A search was conducted of the LexisNexis and Westlaw legal databases for medical malpractice cases involving pediatric neurosurgeons from 1979 to 2022. Cases were included if they involved a pediatric neurosurgical condition, a patient younger than 21 years of age, and at least one defendant who was a pediatric neurosurgeon. Fourteen cases met the inclusion criteria and were analyzed for clinical conditions, allegations, outcomes, and other relevant factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Most cases originated from the southern United States, with spina bifida\/tethered cord and subdural hematomas being the most cited conditions. Allegations predominantly focused on failure to diagnose or treat (57%, 8\/14 cases) particularly in relation to hydrocephalus and spina bifida. Nine cases favored the defendant, 1 resulted in a plaintiff\u2019s verdict, and the outcome of 4 cases was unknown or a mixed verdict. Plaintiff age typically ranged from younger than 3 years to more than 13 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>These findings highlight the prevalence of specific conditions such as spina bifida and hydrocephalus in malpractice cases involving pediatric neurosurgeons. While most cases favored the defendant, these conditions and the high acuity of pediatric neurosurgical care continue to present significant risks. Future research incorporating insurance provider data could offer further insights into malpractice trends in this field. This study provides a detailed overview of malpractice claims in pediatric neurosurgery, identifying key conditions and trends. Understanding these patterns is crucial for enhancing risk management and patient care in pediatric neurosurgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.5.peds2575","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T17:42:46Z","timestamp":1765215766000},"page":"99-105","source":"Crossref","is-referenced-by-count":0,"title":["Pediatrics neurosurgical malpractice claims: a 43-year review of legal databases"],"prefix":"10.3171","volume":"37","author":[{"given":"George W.","family":"Koutsouras","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Upstate University Hospital, Syracuse, New York; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra K.","family":"Blomfield","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Upstate University Hospital, Syracuse, New York; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Mazzola","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New Jersey Pediatric Neuroscience Institute, Morristown, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"9","key":"b1","series-title":"Health Aff (Millwood)","first-page":"1569","article-title":"National costs of the medical liability system","volume":"29","author":"Mello MM","year":"2010","unstructured":"Mello MM, Chandra A, Gawande AA, Studdert DM. National costs of the medical liability system. Health Aff (Millwood). 2010;29(9):1569\u20131577."},{"issue":"5","key":"b2","series-title":"Neurosurgery","first-page":"997","article-title":"Review of neurosurgery medical professional liability claims in the United States","volume":"83","author":"Elsamadicy AA","year":"2018","unstructured":"Elsamadicy AA, Sergesketter AR, Frakes MD, Lad SP. Review of neurosurgery medical professional liability claims in the United States. Neurosurgery. 2018;83(5):997\u20131006."},{"issue":"5","key":"b3","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Overview of medical malpractice in neurosurgery","volume":"49","author":"Larkin CJ","year":"2020","unstructured":"Larkin CJ, Roumeliotis AG, Karras CL,  Overview of medical malpractice in neurosurgery. Neurosurg Focus. 2020;49(5):E2."},{"key":"b4","article-title":"A guide to fee-based U.S. legal research databases. Hauser Global Law School Program, NYU School of Law","author":"Rumsey M","unstructured":"Rumsey M, Lee J, Agrawal NK, Strojny B. A guide to fee-based U.S. legal research databases. Hauser Global Law School Program, NYU School of Law.Accessed August 26, 2025.http:\/\/www.nyulawglobal.org\/globalex\/US_Fee-Based_Legal_Databases1.html"},{"issue":"2","key":"b5","series-title":"Childs Nerv Syst","first-page":"337","article-title":"Pediatric neurosurgery malpractice claims in Germany","volume":"35","author":"Beez T","year":"2019","unstructured":"Beez T, Steiger HJ, Weber B, Ahmadi SA. Pediatric neurosurgery malpractice claims in Germany. Childs Nerv Syst. 2019;35(2):337\u2013342."},{"issue":"7","key":"b6","series-title":"N Engl J Med","first-page":"629","article-title":"Malpractice risk according to physician specialty","volume":"365","author":"Jena AB","year":"2011","unstructured":"Jena AB, Seabury S, Lakdawalla D, Chandra A. Malpractice risk according to physician specialty. N Engl J Med. 2011;365(7):629\u2013636."},{"key":"b7","series-title":"World Neurosurg","first-page":"e552","article-title":"Medical malpractice in neurosurgery: a comprehensive analysis","volume":"110","author":"Thomas R","year":"2018","unstructured":"Thomas R, Gupta R, Griessenauer CJ,  Medical malpractice in neurosurgery: a comprehensive analysis. World Neurosurg. 2018;110:e552\u2013e559."},{"issue":"3","key":"b8","series-title":"Am J Med Qual","first-page":"263","article-title":"The impact of tort reform and quality improvements on medical liability claims: a tale of 2 states","volume":"30","author":"Illingworth KD","year":"2015","unstructured":"Illingworth KD, Shaha SH, Tzeng TH, Sinha MS, Saleh KJ. The impact of tort reform and quality improvements on medical liability claims: a tale of 2 states. Am J Med Qual. 2015;30(3):263\u2013270."},{"key":"b9","series-title":"Forbes","article-title":"States most affected by medical malpractice","author":"Edwards S","unstructured":"Edwards S. States most affected by medical malpractice. Forbes.December 18, 2023. Accessed August 26, 2025.https:\/\/www.forbes.com\/advisor\/legal\/medical-malpractice\/medical-malpractice-cases-by-state\/"},{"issue":"16","key":"b10","series-title":"N Engl J Med","first-page":"1564","article-title":"New directions in medical liability reform","volume":"364","author":"Kachalia A","year":"2011","unstructured":"Kachalia A, Mello MM. New directions in medical liability reform. N Engl J Med. 2011;364(16):1564\u20131572."},{"key":"b11","article-title":"State Laws Chart I: Liability Reforms","unstructured":"State Laws Chart I: Liability Reforms. Advocacy Resource Center. American Medical Association.Accessed August 26, 2025.https:\/\/www.ama-assn.org\/system\/files\/mlr-state-laws-chart-I.pdf"},{"key":"b12","series-title":"Nat Rev Dis Primers","first-page":"15007","article-title":"Spina bifida","volume":"1","author":"Copp AJ","year":"2015","unstructured":"Copp AJ, Adzick NS, Chitty LS, Fletcher JM, Holmbeck GN, Shaw GM. Spina bifida. Nat Rev Dis Primers. 2015;1:15007."},{"issue":"5","key":"b13","series-title":"N Engl J Med","first-page":"444","article-title":"Spina bifida","volume":"387","author":"Iskandar BJ","year":"2022","unstructured":"Iskandar BJ, Finnell RH. Spina bifida. N Engl J Med. 2022;387(5):444\u2013450."},{"issue":"5","key":"b14","series-title":"Pediatr Neurosurg","first-page":"267","article-title":"Complications of myelomeningocele closure","volume":"17","author":"McLone DG","year":"1991","unstructured":"McLone DG, Dias MS. Complications of myelomeningocele closure. Pediatr Neurosurg. 1991;17(5):267\u2013273."},{"issue":"3","key":"b15","series-title":"Pediatr Neurosurg","first-page":"114","article-title":"Spina bifida outcome: a 25-year prospective","volume":"34","author":"Bowman RM","year":"2001","unstructured":"Bowman RM, McLone DG, Grant JA, Tomita T, Ito JA. Spina bifida outcome: a 25-year prospective. Pediatr Neurosurg. 2001;34(3):114\u2013120."},{"issue":"5","key":"b16","series-title":"J Neurosurg Pediatr","first-page":"498","article-title":"Spinal cord tethering following myelomeningocele repair","volume":"6","author":"Mehta VA","year":"2010","unstructured":"Mehta VA, Bettegowda C, Ahmadi SA,  Spinal cord tethering following myelomeningocele repair. J Neurosurg Pediatr. 2010;6(5):498\u2013505."},{"issue":"1","key":"b17","series-title":"Eur J Med Res","first-page":"168","article-title":"Hydrocephalus: historical analysis and considerations for treatment","volume":"27","author":"Hochstetler A","year":"2022","unstructured":"Hochstetler A, Raskin J, Blazer-Yost BL. Hydrocephalus: historical analysis and considerations for treatment. Eur J Med Res. 2022;27(1):168."},{"issue":"10020","key":"b18","series-title":"Lancet","first-page":"788","article-title":"Hydrocephalus in children","volume":"387","author":"Kahle KT","year":"2016","unstructured":"Kahle KT, Kulkarni AV, Limbrick DD Jr, Warf BC. Hydrocephalus in children. Lancet. 2016;387(10020):788\u2013799."},{"issue":"1","key":"b19","series-title":"Childs Nerv Syst","first-page":"101","article-title":"Surgical complication index for pediatric patients (SCIPP): a novel pediatric frailty index predicting postoperative complications in a study of 133 pediatric neurosurgical patients","volume":"41","author":"Khurana E","year":"2025","unstructured":"Khurana E, Welch J, Collins J, Ammar A, Mazzola CA. Surgical complication index for pediatric patients (SCIPP): a novel pediatric frailty index predicting postoperative complications in a study of 133 pediatric neurosurgical patients. Childs Nerv Syst. 2025;41(1):101."},{"issue":"3","key":"b20","series-title":"Biomed J","first-page":"240","article-title":"Pediatric abusive head trauma","volume":"43","author":"Hung KL","year":"2020","unstructured":"Hung KL. Pediatric abusive head trauma. Biomed J. 2020;43(3):240\u2013250."},{"issue":"4","key":"b21","series-title":"J Neurosurg Pediatr","first-page":"382","article-title":"Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study","volume":"17","author":"Riva-Cambrin J","year":"2016","unstructured":"Riva-Cambrin J, Kestle JRW, Holubkov R,  Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study. J Neurosurg Pediatr. 2016;17(4):382\u2013390."},{"issue":"4","key":"b22","series-title":"Heliyon","first-page":"e14885","article-title":"Medical malpractice and intracranial hemorrhages in the U.S.: an analysis of 121 cases over 35 years","volume":"9","author":"Pecorari IL","year":"2023","unstructured":"Pecorari IL, Flaquer I, Bergemann R, Funari A, Alvi MA, Agarwal V. Medical malpractice and intracranial hemorrhages in the U.S.: an analysis of 121 cases over 35 years. Heliyon. 2023;9(4):e14885."},{"key":"b23","series-title":"World Neurosurg","first-page":"e714","article-title":"Medical malpractice and vestibular schwannomas: a nationwide review","volume":"150","author":"Bader ER","year":"2021","unstructured":"Bader ER, Boyke A, Alvi MA, Sethi A, Funari A, Agarwal V. Medical malpractice and vestibular schwannomas: a nationwide review. World Neurosurg. 2021;150:e714\u2013e726."},{"issue":"3","key":"b24","series-title":"Otol Neurotol","first-page":"391","article-title":"Medical malpractice of vestibular schwannoma: a 40-year review of the United States legal databases","volume":"40","author":"Birkenbeuel J","year":"2019","unstructured":"Birkenbeuel J, Vu K, Lehrich BM,  Medical malpractice of vestibular schwannoma: a 40-year review of the United States legal databases. Otol Neurotol. 2019;40(3):391\u2013397."},{"issue":"11","key":"b25","series-title":"Arch Intern Med","first-page":"892","article-title":"Outcomes of medical malpractice litigation against US physicians","volume":"172","author":"Jena AB","year":"2012","unstructured":"Jena AB, Chandra A, Lakdawalla D, Seabury S. Outcomes of medical malpractice litigation against US physicians. Arch Intern Med. 2012;172(11):892\u2013894."},{"issue":"9","key":"b1","series-title":"Health Aff (Millwood)","first-page":"1569","article-title":"National costs of the medical liability system","volume":"29","author":"Mello MM","year":"2010","unstructured":"Mello MM, Chandra A, Gawande AA, Studdert DM. National costs of the medical liability system. Health Aff (Millwood). 2010;29(9):1569\u20131577."},{"issue":"5","key":"b2","series-title":"Neurosurgery","first-page":"997","article-title":"Review of neurosurgery medical professional liability claims in the United States","volume":"83","author":"Elsamadicy AA","year":"2018","unstructured":"Elsamadicy AA, Sergesketter AR, Frakes MD, Lad SP. Review of neurosurgery medical professional liability claims in the United States. Neurosurgery. 2018;83(5):997\u20131006."},{"issue":"5","key":"b3","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Overview of medical malpractice in neurosurgery","volume":"49","author":"Larkin CJ","year":"2020","unstructured":"Larkin CJ, Roumeliotis AG, Karras CL,  Overview of medical malpractice in neurosurgery. Neurosurg Focus. 2020;49(5):E2."},{"key":"b4","article-title":"A guide to fee-based U.S. legal research databases. Hauser Global Law School Program, NYU School of Law","author":"Rumsey M","unstructured":"Rumsey M, Lee J, Agrawal NK, Strojny B. A guide to fee-based U.S. legal research databases. Hauser Global Law School Program, NYU School of Law.Accessed August 26, 2025.http:\/\/www.nyulawglobal.org\/globalex\/US_Fee-Based_Legal_Databases1.html"},{"issue":"2","key":"b5","series-title":"Childs Nerv Syst","first-page":"337","article-title":"Pediatric neurosurgery malpractice claims in Germany","volume":"35","author":"Beez T","year":"2019","unstructured":"Beez T, Steiger HJ, Weber B, Ahmadi SA. Pediatric neurosurgery malpractice claims in Germany. Childs Nerv Syst. 2019;35(2):337\u2013342."},{"issue":"7","key":"b6","series-title":"N Engl J Med","first-page":"629","article-title":"Malpractice risk according to physician specialty","volume":"365","author":"Jena AB","year":"2011","unstructured":"Jena AB, Seabury S, Lakdawalla D, Chandra A. Malpractice risk according to physician specialty. N Engl J Med. 2011;365(7):629\u2013636."},{"key":"b7","series-title":"World Neurosurg","first-page":"e552","article-title":"Medical malpractice in neurosurgery: a comprehensive analysis","volume":"110","author":"Thomas R","year":"2018","unstructured":"Thomas R, Gupta R, Griessenauer CJ,  Medical malpractice in neurosurgery: a comprehensive analysis. World Neurosurg. 2018;110:e552\u2013e559."},{"issue":"3","key":"b8","series-title":"Am J Med Qual","first-page":"263","article-title":"The impact of tort reform and quality improvements on medical liability claims: a tale of 2 states","volume":"30","author":"Illingworth KD","year":"2015","unstructured":"Illingworth KD, Shaha SH, Tzeng TH, Sinha MS, Saleh KJ. The impact of tort reform and quality improvements on medical liability claims: a tale of 2 states. Am J Med Qual. 2015;30(3):263\u2013270."},{"key":"b9","series-title":"Forbes","article-title":"States most affected by medical malpractice","author":"Edwards S","unstructured":"Edwards S. States most affected by medical malpractice. Forbes.December 18, 2023. Accessed August 26, 2025.https:\/\/www.forbes.com\/advisor\/legal\/medical-malpractice\/medical-malpractice-cases-by-state\/"},{"issue":"16","key":"b10","series-title":"N Engl J Med","first-page":"1564","article-title":"New directions in medical liability reform","volume":"364","author":"Kachalia A","year":"2011","unstructured":"Kachalia A, Mello MM. New directions in medical liability reform. N Engl J Med. 2011;364(16):1564\u20131572."},{"key":"b11","article-title":"State Laws Chart I: Liability Reforms","unstructured":"State Laws Chart I: Liability Reforms. Advocacy Resource Center. American Medical Association.Accessed August 26, 2025.https:\/\/www.ama-assn.org\/system\/files\/mlr-state-laws-chart-I.pdf"},{"key":"b12","series-title":"Nat Rev Dis Primers","first-page":"15007","article-title":"Spina bifida","volume":"1","author":"Copp AJ","year":"2015","unstructured":"Copp AJ, Adzick NS, Chitty LS, Fletcher JM, Holmbeck GN, Shaw GM. Spina bifida. Nat Rev Dis Primers. 2015;1:15007."},{"issue":"5","key":"b13","series-title":"N Engl J Med","first-page":"444","article-title":"Spina bifida","volume":"387","author":"Iskandar BJ","year":"2022","unstructured":"Iskandar BJ, Finnell RH. Spina bifida. N Engl J Med. 2022;387(5):444\u2013450."},{"issue":"5","key":"b14","series-title":"Pediatr Neurosurg","first-page":"267","article-title":"Complications of myelomeningocele closure","volume":"17","author":"McLone DG","year":"1991","unstructured":"McLone DG, Dias MS. Complications of myelomeningocele closure. Pediatr Neurosurg. 1991;17(5):267\u2013273."},{"issue":"3","key":"b15","series-title":"Pediatr Neurosurg","first-page":"114","article-title":"Spina bifida outcome: a 25-year prospective","volume":"34","author":"Bowman RM","year":"2001","unstructured":"Bowman RM, McLone DG, Grant JA, Tomita T, Ito JA. Spina bifida outcome: a 25-year prospective. Pediatr Neurosurg. 2001;34(3):114\u2013120."},{"issue":"5","key":"b16","series-title":"J Neurosurg Pediatr","first-page":"498","article-title":"Spinal cord tethering following myelomeningocele repair","volume":"6","author":"Mehta VA","year":"2010","unstructured":"Mehta VA, Bettegowda C, Ahmadi SA,  Spinal cord tethering following myelomeningocele repair. J Neurosurg Pediatr. 2010;6(5):498\u2013505."},{"issue":"1","key":"b17","series-title":"Eur J Med Res","first-page":"168","article-title":"Hydrocephalus: historical analysis and considerations for treatment","volume":"27","author":"Hochstetler A","year":"2022","unstructured":"Hochstetler A, Raskin J, Blazer-Yost BL. Hydrocephalus: historical analysis and considerations for treatment. Eur J Med Res. 2022;27(1):168."},{"issue":"10020","key":"b18","series-title":"Lancet","first-page":"788","article-title":"Hydrocephalus in children","volume":"387","author":"Kahle KT","year":"2016","unstructured":"Kahle KT, Kulkarni AV, Limbrick DD Jr, Warf BC. Hydrocephalus in children. Lancet. 2016;387(10020):788\u2013799."},{"issue":"1","key":"b19","series-title":"Childs Nerv Syst","first-page":"101","article-title":"Surgical complication index for pediatric patients (SCIPP): a novel pediatric frailty index predicting postoperative complications in a study of 133 pediatric neurosurgical patients","volume":"41","author":"Khurana E","year":"2025","unstructured":"Khurana E, Welch J, Collins J, Ammar A, Mazzola CA. Surgical complication index for pediatric patients (SCIPP): a novel pediatric frailty index predicting postoperative complications in a study of 133 pediatric neurosurgical patients. Childs Nerv Syst. 2025;41(1):101."},{"issue":"3","key":"b20","series-title":"Biomed J","first-page":"240","article-title":"Pediatric abusive head trauma","volume":"43","author":"Hung KL","year":"2020","unstructured":"Hung KL. Pediatric abusive head trauma. Biomed J. 2020;43(3):240\u2013250."},{"issue":"4","key":"b21","series-title":"J Neurosurg Pediatr","first-page":"382","article-title":"Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study","volume":"17","author":"Riva-Cambrin J","year":"2016","unstructured":"Riva-Cambrin J, Kestle JRW, Holubkov R,  Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study. J Neurosurg Pediatr. 2016;17(4):382\u2013390."},{"issue":"4","key":"b22","series-title":"Heliyon","first-page":"e14885","article-title":"Medical malpractice and intracranial hemorrhages in the U.S.: an analysis of 121 cases over 35 years","volume":"9","author":"Pecorari IL","year":"2023","unstructured":"Pecorari IL, Flaquer I, Bergemann R, Funari A, Alvi MA, Agarwal V. Medical malpractice and intracranial hemorrhages in the U.S.: an analysis of 121 cases over 35 years. Heliyon. 2023;9(4):e14885."},{"key":"b23","series-title":"World Neurosurg","first-page":"e714","article-title":"Medical malpractice and vestibular schwannomas: a nationwide review","volume":"150","author":"Bader ER","year":"2021","unstructured":"Bader ER, Boyke A, Alvi MA, Sethi A, Funari A, Agarwal V. Medical malpractice and vestibular schwannomas: a nationwide review. World Neurosurg. 2021;150:e714\u2013e726."},{"issue":"3","key":"b24","series-title":"Otol Neurotol","first-page":"391","article-title":"Medical malpractice of vestibular schwannoma: a 40-year review of the United States legal databases","volume":"40","author":"Birkenbeuel J","year":"2019","unstructured":"Birkenbeuel J, Vu K, Lehrich BM,  Medical malpractice of vestibular schwannoma: a 40-year review of the United States legal databases. Otol Neurotol. 2019;40(3):391\u2013397."},{"issue":"11","key":"b25","series-title":"Arch Intern Med","first-page":"892","article-title":"Outcomes of medical malpractice litigation against US physicians","volume":"172","author":"Jena AB","year":"2012","unstructured":"Jena AB, Chandra A, Lakdawalla D, Seabury S. Outcomes of medical malpractice litigation against US physicians. Arch Intern Med. 2012;172(11):892\u2013894."}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/37\/2\/article-p99.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/37\/2\/article-p99.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/37\/2\/article-p99.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T13:46:12Z","timestamp":1772804772000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/37\/2\/article-p99.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,5]]},"references-count":50,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2025.5.peds2575","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,5]]}}}