Clinical therapeutics最新文献

{"title":"Impact of Semaglutide 2.4 mg on Healthcare Resource Utilization and Medical Costs in Patients With Heart Failure in the United States (SHINE-HF).","authors":"Wojciech Michalak, Zhenxiang Zhao, Mads Faurby, Sara Alvarez, Angela Fitch","doi":"10.1016/j.clinthera.2025.07.018","DOIUrl":"https://doi.org/10.1016/j.clinthera.2025.07.018","url":null,"abstract":"<p><strong>Purpose: </strong>Obesity is a risk factor for premature development of heart failure (HF), one of the costliest obesity-related disorders. Clinical trials have demonstrated the efficacy of semaglutide 2.4 mg in improving outcomes in patients with HF. The study objective is to compare total all-cause medical costs and healthcare resource utilization (HCRU) among patients with overweight or obesity and HF treated with semaglutide 2.4 mg versus those not treated.</p><p><strong>Methods: </strong>This retrospective, noninterventional, cohort study using the Komodo Healthcare Map© included patients with ≥1 inpatient or outpatient claim for HF during the baseline period, with overweight or obesity, and ≥12 months of continuous medical and pharmacy enrollment prior to and after the index date. Patients were included in the treated group if they first filled a prescription for semaglutide 2.4 mg between June 4, 2021-September 30, 2023. Semaglutide-untreated controls were randomly selected and propensity score matched to treated patients based on baseline demographics, clinical characteristics, medical costs, and HCRU. Medical costs and HCRU rates were compared using generalized linear models with a quasi-Poisson distribution.</p><p><strong>Findings: </strong>In the year following treatment initiation with semaglutide 2.4 mg, mean all-cause medical costs were 28% lower (-$8,544) compared with patients not treated with semaglutide 2.4 mg ($19,094 vs $27,638 per patient per year [PPPY]; adjusted cost ratio [aCR] = 0.72, 95% confidence interval [CI] 0.60-0.84]; P < 0.001). Inpatient costs with semaglutide 2.4 mg were 55% lower (-$6,304) than controls ($4,377 vs $10,681; aCR = 0.45 [95% CI 0.26-0.64]; P < 0.001) and the inpatient visit rate PPPY was 42% lower in treated patients versus controls (0.15 vs. 0.26; adjusted inpatient visit rate ratio = 0.58 [95% CI 0.38-0.78]; P < 0.001). The mean outpatient visit rate was higher in the semaglutide 2.4 mg-treated group (36.6 vs. 31.6; P = 0.027), but outpatient costs were slightly lower ($13,366 vs. $15,654; aCR = 0.88; 95% CI 0.74-1.03; P = 0.11) with semaglutide 2.4 mg, indicating more frequent outpatient services, but at a lower intensity level. No difference was found in emergency department costs or visit rates.</p><p><strong>Implications: </strong>This real-world analysis of a large, US administrative claims database shows significantly lower medical costs and inpatient resource utilization among patients treated with semaglutide 2.4 mg with overweight or obesity and HF compared with those who did not receive semaglutide 2.4 mg. Improving outcomes with semaglutide 2.4 mg in these patients combined with lower costs and HCRU can help to manage the growing burden of HF to the US.</p>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Polymorphisms as Treatment Biomarkers for Gynecological Malignancies Treated With Carboplatin and Paclitaxel: A Systematic Review.","authors":"Nadine de Godoy Torso, Yasmim Gabriele Matos, Giovana Fernanda Santos Fidelis, Carolina Dagli-Hernandez, Marília Berlofa Visacri, Eder de Carvalho Pincinato, Jefman Efendi Marzuki, Baharuddin Baharuddin, Paulo Caleb J L Santos, Patricia Moriel","doi":"10.1016/j.clinthera.2025.07.012","DOIUrl":"https://doi.org/10.1016/j.clinthera.2025.07.012","url":null,"abstract":"<p><strong>Purpose: </strong>Gynecological tumors, which correspond to the group of neoplasms that affect the female reproductive system, have high incidence and mortality rates. This systematic review aimed to summarize the most recent advances in identifying pharmacogenetic variants associated with the clinical outcomes of carboplatin-paclitaxel chemotherapy in these patients.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across eight databases to identify studies published up to July 17, 2024. Two reviewers independently selected the studies and extracted the data; disagreements were resolved by two additional reviewers.</p><p><strong>Findings: </strong>Out of the 2375 records that were found, only 20 met the eligibility criteria. The main findings were: (1) The three most extensively investigated genes were ATP binding cassette subfamily C member 1 (ABCB1), cytochrome P450 2C8 (CYP2C8), and glutathione S-transferase P1 (GSTP1); (2) three variants, rs1128503 (ABCB1), rs10509681 and rs11572080 (CYPC28), appear to have a significant association with important adverse drug reactions (in particular, neutropenia, thrombocytopenia, and peripheral sensory neuropathy). Others, as is the case with rs1045642 (ABCB1) and rs1695 (GSTP1), have inconsistent results, and the extent to which these results can be extrapolated is still limited; and (c) most of the included studies concerned Asian or European patients.</p><p><strong>Implications: </strong>Therefore, future research should include more extensive analyses with more inclusive cohorts. As a limitation of the study, a meta-analysis was not possible due to the significant heterogeneity among the studies.</p>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Azithromycin on Lung Function in Children And Adolescents with Cystic Fibrosis: A Systematic Review And Meta-Analysis.","authors":"Kangping Wu, Suling Wu, Lina Wang","doi":"10.1016/j.clinthera.2025.07.008","DOIUrl":"https://doi.org/10.1016/j.clinthera.2025.07.008","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the effects of azithromycin on lung function in children with cystic fibrosis (CF) through a systematic review and meta-analysis of randomized controlled trials (RCTs). The study primarily focuses on its impact on FEV1 (forced expiratory volume in 1 second), FVC (forced vital capacity), and the progression of lung function decline.</p><p><strong>Methods: </strong>Electronic searches were conducted across PubMed,Cochrane Central, Embase, Web of Science, and China National Knowledge Infrastructure databases, including studies published up to November 1, 2024. Inclusion criteria required RCTs involving children with CF, azithromycin as the intervention, and placebo controls. Meta-analyses were performed using random-effects models, and heterogeneity was assessed using the I² statistic. Sensitivity analyses were conducted to ensure the robustness of results.</p><p><strong>Findings: </strong>Eight RCTs were included, covering a total of 625 participants. Meta-analysis revealed that azithromycin significantly improved FEV1 compared to the control group, with a standardized mean difference (SMD) of 0.58 (95% CI: 0.03-1.14), though substantial heterogeneity was observed (I² = 82.8%). However, no statistically significant improvement in FVC was detected (SMD: 0.62, 95% CI: -0.04 to 1.29, I² = 85.4%). Additionally, azithromycin reduced the relative risk of lung function decline (RR: 0.79, 95% CI: 0.62-1.00), with moderate heterogeneity (I² = 45.5%). Sensitivity analyses confirmed the stability of these results.</p><p><strong>Implications: </strong>Azithromycin shows potential in improving FEV1 and slowing lung function decline in children with cystic fibrosis, likely through its anti-inflammatory and immunomodulatory effects. Further large-scale studies are warranted to confirm its long-term efficacy, evaluate safety, and optimize treatment strategies, including potential combination therapies.</p>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor Regarding \"Efficacy and Safety of Simnotrelvir-Ritonavir Compared With Nirmatrelvir-Ritonavir in the Treatment of COVID-19: Real-World Evidence From a Retrospective Cohort Study During the Prevalence of the Omicron EG.5 Variant\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1016/j.clinthera.2025.07.017","DOIUrl":"https://doi.org/10.1016/j.clinthera.2025.07.017","url":null,"abstract":"","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Role of Cannabis in Managing Spasticity in Multiple Sclerosis: A Systematic Review and Meta-Analysis.","authors":"Yazan AlHabil, Liza Saadeddin, Hana Ishkirat, Mariam Alqam, Obada Hossoon, Seema Hameedi, Hamzeh Yacoub, Diana Yasin, Anita Bahbah, Majd Oweidat, Hanadi Mosa","doi":"10.1016/j.clinthera.2025.07.009","DOIUrl":"https://doi.org/10.1016/j.clinthera.2025.07.009","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is a complex, heterogeneous disease, and its management remains challenging due to varying symptoms and patient responses to treatments. While injectable therapies like glatiramer acetate and beta-interferon are common, they have limitations such as side effects and varying efficacy. Cannabis has garnered attention as a potential alternative treatment, particularly for symptoms like spasticity and pain.</p><p><strong>Objective: </strong>This study aims to evaluate the efficacy of cannabis-based therapies for managing MS-related spasticity.</p><p><strong>Methods: </strong>Nine clinical trials involving 2544 MS patients were included, with studies conducted between 2003 and 2021 across multiple countries. Cannabinoid therapies studied included whole-plant extracts, oils, and smoked cannabis containing delta-9-tetrahydrocannabinol and/or cannabidiol. Spasticity was assessed using standardized scales, including the Ashworth scale (AS), visual analog scale, and numeric rating scale (NRS). Effect sizes were pooled using random or fixed effects models, and heterogeneity and publication bias were evaluated using I², Tau², and funnel plots.</p><p><strong>Results: </strong>The overall meta-analysis revealed a standardized mean difference (MD) of 39.19 (95% CI: 34.32-44.05) in spasticity scores, indicating notable improvement post-treatment. Subgroup analyses showed a MD of 20.36 (95% CI: 20.35-20.37) for AS and 1.18 (95% CI: 1.16-1.21) for NRS. However, substantial heterogeneity (I² = 100% for overall and AS analyses; 91% for NRS) and asymmetry in funnel plots suggest possible publication bias and study variability. Short-term studies demonstrated modest changes (MD = 4.53, 95% CI: -0.06 to 9.12), while long-term studies yielded larger effects (MD = 75.81, 95% CI: 66.39-85.22). Adverse events were generally mild, including dizziness and dry mouth.</p><p><strong>Conclusion: </strong>Cannabis-based therapies are associated with clinically meaningful improvements in MS-related spasticity, particularly over longer durations. Despite the promising findings, high heterogeneity and suspected bias necessitate caution. Further high-quality randomized trials with standardized protocols and comprehensive safety assessments are warranted to validate efficacy and long-term outcomes.</p>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Plasma Septin9 Methylation Status With Therapeutic Response to Antitumor Agents in Colorectal Cancer Patients.","authors":"Han Shan, Qiong Du, Mengmeng Wang","doi":"10.1016/j.clinthera.2025.07.005","DOIUrl":"https://doi.org/10.1016/j.clinthera.2025.07.005","url":null,"abstract":"<p><strong>Purpose: </strong>Although the diagnostic potential of septin 9 methylation (mSEPT9) in colorectal cancer (CRC) has been well documented in numerous studies, its predictive role in determining therapeutic response to antitumor agents among patients with advanced CRC remains unexplored.</p><p><strong>Methods: </strong>This real-world, large-scale retrospective study analyzed 1098 CRC cases selected from a comprehensive database of 1490 patients who underwent mSEPT9 testing. We first investigated the association between mSEPT9 status and clinicopathological characteristics in the overall CRC cohort. Subsequently, in a subset of 479 stage IV CRC patients receiving systemic antitumor therapy, we evaluated the predictive value of mSEPT9 status by assessing treatment outcomes, including objective response rate (ORR) and progression-free survival (PFS).</p><p><strong>Findings: </strong>mSEPT9 positivity was significantly elevated in stage Ⅳ versus stage Ⅰ-Ⅲ patients and correlated with Eastern Cooperative Oncology Group (ECOG) score, but not with other clinicopathological features. mSEPT9-positive patients demonstrated significantly higher ORR to fluoropyrimidines, oxaliplatin, and bevacizumab compared with mSEPT9-negative patients, whereas no significant ORR differences were observed for irinotecan or cetuximab. Conversely, mSEPT9-positive patients showed shorter PFS with fluoropyrimidines, oxaliplatin, irinotecan, and cetuximab, but comparable PFS with bevacizumab between the 2 groups.</p><p><strong>Implications: </strong>mSEPT9 status significantly correlated with CRC stage and ECOG score, influencing antitumor agents efficacy in advanced CRC. Although mSEPT9-positive patients showed higher ORR to certain agents, they exhibited shorter PFS, suggesting more aggressive tumor biology. Bevacizumab appeared to partially counteract the adverse prognostic impact of mSEPT9 positivity. This first demonstration of mSEPT9's predictive value for advanced CRC treatment outcomes provides new insights for personalized therapy.</p>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to EU-Authorized Nonreimbursed Anticancer Medicines: An Explorative Survey Among Dutch Medical Oncologists.","authors":"H Colinda Post, Charlotte H C Bomhof, Maartje Schermer, Carla E M Hollak, Hanneke W M van Laarhoven, Tim Schutte, Eline M Bunnik","doi":"10.1016/j.clinthera.2025.07.003","DOIUrl":"https://doi.org/10.1016/j.clinthera.2025.07.003","url":null,"abstract":"<p><strong>Purpose: </strong>Timelines for market authorization and reimbursement for anticancer medicines differ across European countries. Therefore, medical oncologists may face periods when promising anticancer medicines are not reimbursed, prompting ethical concerns about equitable access, particularly in publicly funded healthcare systems, such as the Netherlands. This study explores Dutch medical oncologists' experiences and moral perspectives regarding access to EU-authorized nonreimbursed anticancer medicines and assesses practice variation.</p><p><strong>Methods: </strong>A survey targeted 378 Dutch medical oncologists from all hospitals to explore their experiences, perspectives, and perceived responsibilities, as well as hospital policies regarding nonreimbursed EU-authorized anticancer medicines and their opinions on out-of-pocket payments and information provision.</p><p><strong>Findings: </strong>Responses were provided by 132 medical oncologists (response rate of 34.9%), with 104 (78.8%) reporting that they sought access to nonreimbursed medicines in the past three years for one or more patients, primarily through manufacturer-funded \"free-of-charge\" programs (n = 77/104; 74,0%), clinical trials referral (n = 46/104; 44.2%) or clinical trials at their own hospital (n = 45/104; 43.3%), insurance leniency (n = 45/104; 43.3%), or the Dutch Drug Access Protocol (n = 42/104; 40.4%). While 48.5% felt responsible for seeking access to nonreimbursed medicines, 40.9% did not. Respondents mentioned different hospital policies on drug access. In the past three years, 69.5% (n = 91/131) of respondents had received patient inquiries about out-of-pocket (OOP) payment, but only 3.1% (n = 4/131) had actually prescribed OOP financed medicines. Fewer than half of the respondents (44.7%; n = 59/132) informed patients about nonreimbursed treatment options. Oncologists expressed strong concerns about financial toxicity, inequities in access, and threats to solidarity-based health care.</p><p><strong>Implications: </strong>The majority of Dutch medical oncologists encounter EU-authorized, nonreimbursed anticancer medicines and report substantial variation in related practices and ethical views. In the absence of a national access framework, availability often depends on individual physicians, leading to potential inequities. National regulation is recommended to ensure consistent and equitable access for all patients.</p>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Older Patients with Acute Pain: A Complex Milieu","authors":"Paul Beninger MD, MBA","doi":"10.1016/j.clinthera.2025.06.013","DOIUrl":"10.1016/j.clinthera.2025.06.013","url":null,"abstract":"","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"47 8","pages":"Pages 533-535"},"PeriodicalIF":3.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multilateral Qualitative Study of Perspectives on Enhancing Clinical Trial Diversity Among Historically Underrepresented Groups.","authors":"Matthew J DePuccio, Daniel Torrez, Elizabeth Hsu, Elizabeth B Lynch, Rachel S Bergmans, Robert J McCarthy","doi":"10.1016/j.clinthera.2025.06.006","DOIUrl":"10.1016/j.clinthera.2025.06.006","url":null,"abstract":"<p><strong>Purpose: </strong>Clinical trial enrollment among underrepresented patient populations remains a critical challenge in biomedical research. This study was conducted for a clinical trial designed to identify biomarkers that would help predict the transition from acute to chronic pain. Specifically, the purpose of this study was to understand the perspectives of multiple stakeholders to characterize the factors that contribute to underrepresented patients' decisions to participate in the trial and inform actionable strategies that can improve trial recruitment and retention.</p><p><strong>Methods: </strong>Forty-seven participants from a Midwestern US city participated in one-on-one interviews, including 26 patients, 11 healthcare providers and staff, and 10 community-based healthcare organization employees. Interviews were recorded, transcribed, and analyzed inductively by an experienced health services researcher, with results organized into key themes.</p><p><strong>Findings: </strong>Analysis revealed six major themes about what influences underrepresented patients' participation: Practical barriers to participation, historical context and past experiences impacting research apprehensiveness, communication gaps, and information needs, adapting protocols to address participation barriers, opportunities for building rapport and trust, and motivations and perceived benefits of participating. Common barriers included logistical challenges (eg, distance to medical center), distrust toward medical institutions, and poor communication about clinical trial opportunities, while efforts to intentionally build rapport and trust with patients and community members were identified as opportunities to improve recruitment.</p><p><strong>Implications: </strong>The results of this study demonstrated that the barriers and enablers to underrepresented patient participation in a clinical trial were diverse and included both systemic and individual factors. These findings were supported across participant groups, suggesting that the engagement of multiple perspectives in the design and implementation of clinical trials play a role in mitigating barriers to clinical trial participation and enhancing participant diversity.</p>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter Regarding Article “Epidemiology and Economic Burden of Diagnosed Congenital Cytomegalovirus Infection in the First 2 Years of Life among Commercially Insured and Medicaid-Insured Individuals in the United States”","authors":"John Diaz-Decaro PhD, MS,&nbsp;Philip O. Buck PhD, MPH","doi":"10.1016/j.clinthera.2025.06.004","DOIUrl":"10.1016/j.clinthera.2025.06.004","url":null,"abstract":"","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":"47 8","pages":"Pages 659-660"},"PeriodicalIF":3.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}