{"id":"https://openalex.org/W7223667043","doi":"https://doi.org/10.3389/fped.2026.1983146","title":"Severe bronchial obstruction and lung atelectasis following suspected massive inhalation of gluten-free flour: a case report","display_name":"Severe bronchial obstruction and lung atelectasis following suspected massive inhalation of gluten-free flour: a case report","publication_year":2026,"publication_date":"2026-10-26","ids":{"openalex":"https://openalex.org/W7223667043","doi":"https://doi.org/10.3389/fped.2026.1983146"},"language":"en","primary_location":{"id":"doi:10.3389/fped.2026.1983146","doi":"https://doi.org/10.3389/fped.2026.1983146","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fped.2026.1983146","pdf_url":"https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2026.1983146/pdf","source":{"id":"https://openalex.org/S2596117549","display_name":"Frontiers in Pediatrics","issn_l":"2296-2360","issn":["2296-2360"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Pediatrics","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2026.1983146/pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5000871574","display_name":"Federica Porcaro","orcid":"https://orcid.org/0000-0001-7779-728X","observed_orcids":["https://orcid.org/0000-0001-7779-728X"]},"institutions":[{"id":"https://openalex.org/I4210123352","display_name":"Bambino Ges\u00f9 Children's Hospital","ror":"https://ror.org/02sy42d13","country_code":"IT","type":"healthcare","lineage":["https://openalex.org/I4210123352","https://openalex.org/I4210153126"]}],"countries":["IT"],"is_corresponding":true,"raw_author_name":"Federica Porcaro","raw_affiliation_strings":["Pediatric Pulmonology & Cystic Fibrosis Unit, Respiratory Research Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Pediatric Pulmonology & Cystic Fibrosis Unit, Respiratory Research Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS","institution_ids":["https://openalex.org/I4210123352"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5082910551","display_name":"Antonella Coretti","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210123352","display_name":"Bambino Ges\u00f9 Children's Hospital","ror":"https://ror.org/02sy42d13","country_code":"IT","type":"healthcare","lineage":["https://openalex.org/I4210123352","https://openalex.org/I4210153126"]}],"countries":["IT"],"is_corresponding":false,"raw_author_name":"Antonella Coretti","raw_affiliation_strings":["Pediatric Pulmonology & Cystic Fibrosis Unit, Respiratory Research Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Pediatric Pulmonology & Cystic Fibrosis Unit, Respiratory Research Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS","institution_ids":["https://openalex.org/I4210123352"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5082585233","display_name":"Roberto Grandinetti","orcid":"https://orcid.org/0000-0002-1341-761X","observed_orcids":["https://orcid.org/0000-0002-1341-761X"]},"institutions":[{"id":"https://openalex.org/I4210123352","display_name":"Bambino Ges\u00f9 Children's Hospital","ror":"https://ror.org/02sy42d13","country_code":"IT","type":"healthcare","lineage":["https://openalex.org/I4210123352","https://openalex.org/I4210153126"]}],"countries":["IT"],"is_corresponding":false,"raw_author_name":"Roberto Grandinetti","raw_affiliation_strings":["Pediatric Pulmonology & Cystic Fibrosis Unit, Respiratory Research Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Pediatric Pulmonology & Cystic Fibrosis Unit, Respiratory Research Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS","institution_ids":["https://openalex.org/I4210123352"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5112402669","display_name":"Maria Giovanna Paglietti","orcid":"https://orcid.org/0000-0003-2882-2375","observed_orcids":["https://orcid.org/0000-0003-2882-2375"]},"institutions":[{"id":"https://openalex.org/I4210123352","display_name":"Bambino Ges\u00f9 Children's Hospital","ror":"https://ror.org/02sy42d13","country_code":"IT","type":"healthcare","lineage":["https://openalex.org/I4210123352","https://openalex.org/I4210153126"]}],"countries":["IT"],"is_corresponding":false,"raw_author_name":"Maria Giovanna Paglietti","raw_affiliation_strings":["Pediatric Pulmonology & Cystic Fibrosis Unit, Respiratory Research Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Pediatric Pulmonology & Cystic Fibrosis Unit, Respiratory Research Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS","institution_ids":["https://openalex.org/I4210123352"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5030546856","display_name":"Alessandra Ottavianelli","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210123352","display_name":"Bambino Ges\u00f9 Children's Hospital","ror":"https://ror.org/02sy42d13","country_code":"IT","type":"healthcare","lineage":["https://openalex.org/I4210123352","https://openalex.org/I4210153126"]}],"countries":["IT"],"is_corresponding":false,"raw_author_name":"Alessandra Ottavianelli","raw_affiliation_strings":["Diagnostic and Interventional Radiology, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Diagnostic and Interventional Radiology, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS","institution_ids":["https://openalex.org/I4210123352"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5059312635","display_name":"Giovanni Cristalli","orcid":"https://orcid.org/0000-0002-2156-8434","observed_orcids":["https://orcid.org/0000-0002-2156-8434"]},"institutions":[{"id":"https://openalex.org/I4210123352","display_name":"Bambino Ges\u00f9 Children's Hospital","ror":"https://ror.org/02sy42d13","country_code":"IT","type":"healthcare","lineage":["https://openalex.org/I4210123352","https://openalex.org/I4210153126"]}],"countries":["IT"],"is_corresponding":false,"raw_author_name":"Giovanni Cristalli","raw_affiliation_strings":["Unit of Otorhinolaryngology, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Unit of Otorhinolaryngology, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS","institution_ids":["https://openalex.org/I4210123352"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5036973525","display_name":"Renato Cutrera","orcid":"https://orcid.org/0000-0001-7711-5672","observed_orcids":["https://orcid.org/0000-0001-7711-5672"]},"institutions":[{"id":"https://openalex.org/I4210123352","display_name":"Bambino Ges\u00f9 Children's Hospital","ror":"https://ror.org/02sy42d13","country_code":"IT","type":"healthcare","lineage":["https://openalex.org/I4210123352","https://openalex.org/I4210153126"]}],"countries":["IT"],"is_corresponding":false,"raw_author_name":"Renato Cutrera","raw_affiliation_strings":["Pediatric Pulmonology & Cystic Fibrosis Unit, Respiratory Research Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Pediatric Pulmonology & Cystic Fibrosis Unit, Respiratory Research Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS","institution_ids":["https://openalex.org/I4210123352"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5000871574"],"corresponding_institution_ids":["https://openalex.org/I4210123352"],"apc_list":{"value":3150,"currency":"CHF","value_usd":3801},"apc_paid":{"value":3150,"currency":"CHF","value_usd":3801},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.85632426,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"14","issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11910","display_name":"Foreign Body Medical Cases","score":0.9359999895095825,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11910","display_name":"Foreign Body Medical Cases","score":0.9359999895095825,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11260","display_name":"Tracheal and airway disorders","score":0.016599999740719795,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11635","display_name":"Poisoning and overdose treatments","score":0.008500000461935997,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/bronchial-obstruction","display_name":"bronchial obstruction","score":0.7820000052452087},{"id":"https://openalex.org/keywords/atelectasis","display_name":"atelectasis","score":0.9639999866485596},{"id":"https://openalex.org/keywords/acute-hypoxemic-respiratory-failure","display_name":"acute hypoxemic respiratory failure","score":0.8259999752044678},{"id":"https://openalex.org/keywords/pediatric-airway-obstruction","display_name":"pediatric airway obstruction","score":0.7139999866485596},{"id":"https://openalex.org/keywords/foreign-body-aspiration","display_name":"foreign body aspiration","score":0.6940000057220459},{"id":"https://openalex.org/keywords/bronchoalveolar-lavage","display_name":"bronchoalveolar lavage","score":0.8799999952316284},{"id":"https://openalex.org/keywords/particulate-matter-deposition","display_name":"particulate matter deposition","score":0.7570000290870667},{"id":"https://openalex.org/keywords/hydrocolloids","display_name":"hydrocolloids","score":0.6230000257492065},{"id":"https://openalex.org/keywords/mechanical-ventilation","display_name":"mechanical ventilation","score":0.47699999809265137}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9603000283241272},{"id":"https://openalex.org/C2781101014","wikidata":"https://www.wikidata.org/wiki/Q754031","display_name":"Atelectasis","level":3,"score":0.7573000192642212},{"id":"https://openalex.org/C42219234","wikidata":"https://www.wikidata.org/wiki/Q131130","display_name":"Anesthesia","level":1,"score":0.6449999809265137},{"id":"https://openalex.org/C2778996910","wikidata":"https://www.wikidata.org/wiki/Q237232","display_name":"Bronchoscopy","level":2,"score":0.6215000152587891},{"id":"https://openalex.org/C2778333281","wikidata":"https://www.wikidata.org/wiki/Q4330029","display_name":"Airway obstruction","level":3,"score":0.5956000089645386},{"id":"https://openalex.org/C2776954882","wikidata":"https://www.wikidata.org/wiki/Q840343","display_name":"Inhalation","level":2,"score":0.588100016117096},{"id":"https://openalex.org/C2776888751","wikidata":"https://www.wikidata.org/wiki/Q767485","display_name":"Respiratory failure","level":2,"score":0.5651000142097473},{"id":"https://openalex.org/C2777714996","wikidata":"https://www.wikidata.org/wiki/Q7886","display_name":"Lung","level":2,"score":0.5442000031471252},{"id":"https://openalex.org/C534529494","wikidata":"https://www.wikidata.org/wiki/Q7891","display_name":"Respiratory system","level":2,"score":0.5317000150680542},{"id":"https://openalex.org/C105922876","wikidata":"https://www.wikidata.org/wiki/Q1423981","display_name":"Airway","level":2,"score":0.508899986743927},{"id":"https://openalex.org/C2779995113","wikidata":"https://www.wikidata.org/wiki/Q1455142","display_name":"Foreign body","level":2,"score":0.5019999742507935},{"id":"https://openalex.org/C2777961210","wikidata":"https://www.wikidata.org/wiki/Q927148","display_name":"Bronchoalveolar lavage","level":3,"score":0.48739999532699585},{"id":"https://openalex.org/C2778716859","wikidata":"https://www.wikidata.org/wiki/Q939018","display_name":"Intubation","level":2,"score":0.4007999897003174},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.39500001072883606},{"id":"https://openalex.org/C2777080012","wikidata":"https://www.wikidata.org/wiki/Q3766250","display_name":"Mechanical ventilation","level":2,"score":0.38429999351501465},{"id":"https://openalex.org/C2776178081","wikidata":"https://www.wikidata.org/wiki/Q3286546","display_name":"Respiratory disease","level":3,"score":0.35920000076293945},{"id":"https://openalex.org/C2776042228","wikidata":"https://www.wikidata.org/wiki/Q35869","display_name":"Asthma","level":2,"score":0.3555999994277954},{"id":"https://openalex.org/C2778917391","wikidata":"https://www.wikidata.org/wiki/Q352381","display_name":"Positive end-expiratory pressure","level":3,"score":0.3312000036239624},{"id":"https://openalex.org/C2776983577","wikidata":"https://www.wikidata.org/wiki/Q166543","display_name":"General anaesthesia","level":2,"score":0.3059999942779541},{"id":"https://openalex.org/C200457457","wikidata":"https://www.wikidata.org/wiki/Q584049","display_name":"Ventilation (architecture)","level":2,"score":0.2955000102519989},{"id":"https://openalex.org/C2776470362","wikidata":"https://www.wikidata.org/wiki/Q25303650","display_name":"Foreign body aspiration","level":3,"score":0.2791000008583069}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.3389/fped.2026.1983146","doi":"https://doi.org/10.3389/fped.2026.1983146","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fped.2026.1983146","pdf_url":"https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2026.1983146/pdf","source":{"id":"https://openalex.org/S2596117549","display_name":"Frontiers in Pediatrics","issn_l":"2296-2360","issn":["2296-2360"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Pediatrics","raw_type":"journal-article"},{"id":"pmh:oai:doaj.org/article:e4d88e3f3afd4c85ac4b1f99edcaee2b","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/e4d88e3f3afd4c85ac4b1f99edcaee2b","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Pediatrics, Vol 14 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3389/fped.2026.1983146","doi":"https://doi.org/10.3389/fped.2026.1983146","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fped.2026.1983146","pdf_url":"https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2026.1983146/pdf","source":{"id":"https://openalex.org/S2596117549","display_name":"Frontiers in Pediatrics","issn_l":"2296-2360","issn":["2296-2360"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Pediatrics","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320321781","display_name":"Ministero della Salute","ror":"https://ror.org/00789fa95"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7223667043.pdf","grobid_xml":"https://content.openalex.org/works/W7223667043.grobid-xml"},"referenced_works_count":12,"referenced_works":["https://openalex.org/W1972371611","https://openalex.org/W1997327548","https://openalex.org/W2039358983","https://openalex.org/W2039491357","https://openalex.org/W2108162976","https://openalex.org/W2141972042","https://openalex.org/W2154185697","https://openalex.org/W2159131689","https://openalex.org/W3048164028","https://openalex.org/W4281960126","https://openalex.org/W4307401869","https://openalex.org/W4403401837"],"related_works":["https://openalex.org/W2999688539","https://openalex.org/W4281960126","https://openalex.org/W2255388456","https://openalex.org/W2081227674","https://openalex.org/W2462392323","https://openalex.org/W2138448804","https://openalex.org/W2061449281","https://openalex.org/W2900504491","https://openalex.org/W2048216693","https://openalex.org/W1966825572"],"abstract_inverted_index":{"Acute":[0],"respiratory":[1,10,21,38,52,231],"failure":[2,53,232],"in":[3,40,117,225,242],"children":[4],"is":[5],"most":[6],"commonly":[7],"caused":[8],"by":[9],"infections,":[11],"asthma,":[12],"foreign":[13,87],"body":[14],"aspiration,":[15],"trauma,":[16],"and":[17,33,63,69,96,108,124,133,233,249],"disorders":[18],"affecting":[19],"the":[20,24,121,136,147,151,202,206,220],"pump":[22],"or":[23,83],"central":[25],"control":[26],"of":[27,36,120,141,146,156,162,173,177,193,205,222,229],"breathing.":[28],"We":[29,169],"describe":[30],"an":[31],"unusual":[32],"underreported":[34],"cause":[35,82],"severe":[37],"compromise":[39],"a":[41,79,84,163,174,194],"previously":[42],"healthy":[43],"2-year-old":[44],"boy.":[45],"The":[46,128],"patient":[47],"presented":[48],"with":[49,103],"acute":[50,230],"hypoxemic":[51],"that":[54,171],"was":[55,130],"poorly":[56],"responsive":[57],"to":[58,180,201],"inhaled":[59],"bronchodilators,":[60],"systemic":[61],"corticosteroids,":[62],"oxygen":[64],"therapy,":[65],"requiring":[66,246],"endotracheal":[67],"intubation":[68],"invasive":[70],"mechanical":[71],"ventilation.":[72],"Extensive":[73],"diagnostic":[74],"investigations":[75],"did":[76],"not":[77,213],"identify":[78],"common":[80],"infectious":[81],"conventional":[85],"aspirated":[86],"body.":[88],"Chest":[89],"imaging":[90],"demonstrated":[91],"complete":[92],"left":[93],"lung":[94,123],"atelectasis":[95],"right":[97],"upper":[98],"lobe":[99],"atelectasis.":[100],"Flexible":[101],"bronchoscopy":[102],"therapeutic":[104],"bronchoalveolar":[105],"lavage":[106],"revealed":[107],"removed":[109],"abundant":[110],"white,":[111],"highly":[112],"viscous":[113],"endobronchial":[114,207],"material,":[115,208],"resulting":[116],"progressive":[118],"re-expansion":[119],"affected":[122],"marked":[125,203],"clinical":[126,148],"improvement.":[127],"child":[129],"successfully":[131],"extubated":[132],"discharged":[134],"from":[135],"hospital":[137],"after":[138,159],"20":[139],"days":[140],"hospitalization.":[142],"A":[143],"subsequent":[144],"review":[145],"history":[149],"identified":[150],"likely":[152],"precipitating":[153],"event:":[154],"inhalation":[155,172],"gluten-free":[157],"flour":[158],"accidental":[160],"activation":[161],"planetary":[164],"mixer":[165],"during":[166],"cake":[167],"preparation.":[168],"hypothesize":[170],"large":[175],"amount":[176],"powder":[178],"contributed":[179,200],"airway":[181,244],"obstruction":[182,245],"through":[183],"direct":[184],"particulate":[185],"deposition":[186],"and/or":[187],"secondary":[188],"inflammatory":[189],"mucus":[190],"formation;":[191],"hydration":[192],"hydrocolloid":[195],"component":[196],"may":[197,240],"also":[198],"have":[199],"viscosity":[204],"although":[209],"this":[210],"mechanism":[211],"could":[212],"be":[214],"directly":[215],"demonstrated.":[216],"This":[217],"case":[218],"highlights":[219],"importance":[221],"meticulous":[223],"history-taking":[224],"identifying":[226],"rare":[227],"causes":[228],"illustrates":[234],"how":[235],"seemingly":[236],"innocuous":[237],"environmental":[238],"exposures":[239],"result":[241],"life-threatening":[243],"prompt":[247],"recognition":[248],"intervention.":[250]},"counts_by_year":[],"updated_date":"2026-10-29T09:56:32.521200","created_date":"2026-10-27T00:00:00"}