Diabetic Medicine最新文献

{"title":"Psychological and self care outcomes for children and adolescents living with type 1 diabetes and their caregivers attending diabetes camp: A mixed methods study.","authors":"Rita Sigley, Anna L Boggiss, Benjamin Albert, Dug Yeo Han, Craig Jefferies","doi":"10.1111/dme.70038","DOIUrl":"https://doi.org/10.1111/dme.70038","url":null,"abstract":"<p><strong>Aim: </strong>Diabetes camps for children and adolescents living with Type 1 Diabetes (T1D) offer an important opportunity to foster self-efficacy and 'common humanity', a sense that they are not alone in their challenges. The current study primarily aimed to assess whether psychological wellbeing, diabetes self care behaviours and HbA1c improved amongst campers and their caregivers, and whether these would be sustained at 3- and 6-months.</p><p><strong>Methods: </strong>Children and adolescents aged 7-13 years who attended the 2023 diabetes camp in Auckland, Aotearoa New Zealand and one of their caregivers were invited to participate. Campers and caregivers were assessed at camp enrolment and then at 1-week, 3-months and 6-months post-camp. Guided by the Theoretical Framework of Acceptability, optional qualitative interviews were also used to explore campers' experiences of camp.</p><p><strong>Results: </strong>Of the 31 children and adolescents who attended the 2023 camp, 27 (87%) participated in the study with a caregiver. Campers showed reduced feelings of isolation (p = 0.036) and overidentification (p = 0.036) 6 months. Caregivers demonstrated overall improvements in self-efficacy (p = 0.034), caregiver distress and burden (p = 0.006) and caregiver quality of life (p = 0.039). Qualitative findings confirmed high acceptability, with participants reporting positive camp experiences.</p><p><strong>Conclusions: </strong>Diabetes camps can improve caregivers' self-efficacy, diabetes distress and quality of life, and reduce feelings of isolation and overidentification among campers. Future work is needed to promote cultural inclusivity within camps and improve their accessibility, to be able to optimise the wellbeing of all children and adolescents living with T1D and their families.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70038"},"PeriodicalIF":3.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost effectiveness of early metformin in addition to usual care in the reduction of gestational diabetes mellitus effects (EMERGE)-A randomised placebo-controlled clinical trial.","authors":"Paddy Gillespie, Ronan Mahon, Christine Newman, Alberto Alvarez-Iglesias, John Ferguson, Andrew Smyth, Paula O'Shea, Declan Devane, Aoife Egan, Martin O'Donnell, Fidelma Dunne","doi":"10.1111/dme.70036","DOIUrl":"https://doi.org/10.1111/dme.70036","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the cost-effectiveness of early initiation of metformin and usual care for gestational diabetes mellitus (GDM).</p><p><strong>Methods: </strong>Economic evaluation from a healthcare perspective, based on the EMERGE randomised controlled trial. In total, 535 women with GDM were randomised to placebo in addition to usual care or metformin in addition to usual care. Economic outcomes included incremental healthcare costs and quality adjusted life years (QALYs) and expected cost-effectiveness at cost-effectiveness threshold values of €20,000, €45,000 and €100,000 per QALY gained. Uncertainty was explored using parametric, non-parametric, deterministic and probabilistic methods and heterogeneity using subgroup analysis.</p><p><strong>Results: </strong>On average, relative to the placebo arm, the early metformin arm was associated with non-statistically significant mean increases of €193.07 (95% CI: -€789.88, €1176.01; p = 0.700) and 0.002 QALYs (95% CI: -0.009, 0.013; p = 0.771). In terms of expected cost-effectiveness at threshold values of €20,000, €45,000 and €100,000 per QALY gained, the probability of the early metformin arm being more cost-effective was estimated at 0.423, 0.452 and 0.524. Exploratory subgroup analyses provided more favourable but not definitive evidence in favour of the early metformin arm for cohorts with previous GDM and previous caesarean section.</p><p><strong>Conclusions: </strong>We do not find definitive evidence that early initiation of metformin in addition to usual care for GDM was more cost-effective than usual care alone. The clinical and economic evidence may be considered equivocal, but worthy of further examination.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70036"},"PeriodicalIF":3.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of ultrasound-diagnosed lipohypertrophy subtypes on insulin regimen adjustments in patients with T1DM.","authors":"Jian Yu, Hong Wang, Meijing Zhou, Min Zhu, Jing Hang, Tao Yang, Yun Shi, Jingjing Xu","doi":"10.1111/dme.70034","DOIUrl":"https://doi.org/10.1111/dme.70034","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the effects of different subtypes of lipohypertrophy (LH) on insulin total daily dose (TDD) requirements in patients with type 1 diabetes mellitus (T1DM), and to propose subtype-specific insulin dosage adjustment strategies after avoiding injection at sites of LH.</p><p><strong>Methods: </strong>This prospective observational study enrolled hospitalised T1DM patients with a disease duration ≥1 year. Point-of-care ultrasound was performed immediately after their admission to determine the presence and the specific type of LH. An insulin pump was installed away from the LH sites of each patient. Continuous subcutaneous insulin was infused to control their blood glucose, and the insulin dose was titrated gradually until their blood glucose stabilised to the target.</p><p><strong>Results: </strong>A total of 288 patients were included. According to ultrasound screening, 104 patients (36.11%) were LH free (LH-0) and 184 patients (63.89%) were found to have LH (LH+), of which 114 had nodular hyperechoic LH (LH-1), 62 had diffuse hyperechoic LH (LH-2) and 8 had hypoechoic LH (LH-3). Paired-sample t-test showed that all LH+ groups had a decrease in TDD and TDD/body weight after avoiding injections at the lesion sites (all p < 0.05). Compared with the LH-0 group, the TDD and TDD/body weight of the LH-2 and LH-3 groups were significantly reduced (all p < 0.05), whereas there was no significant change in the LH-1 group. Among the TDD reduced in the LH-2 and LH-3 groups, the bolus insulin dosage reduced accounted for the vast majority, with 88.05% (8.55/9.71 international unit [IU]/day) and 74.78% (18.12/24.23 IU/day), respectively.</p><p><strong>Conclusions: </strong>TDD reductions vary among patients with different subtypes of LH. Nodular hyperechoic LH may not require immediate dose adjustments. Patients with diffuse hyperechoic and hypoechoic LH necessitate bolus-focused dose reductions.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70034"},"PeriodicalIF":3.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimisation of care among patients with diabetes mellitus and acute coronary syndrome through a specialised cardiodiabetes service-A registry study.","authors":"Muhammad Usman Shah, Alun Roebuck, Bala Srinivasan, Paul Edward Squires, Claire Elizabeth Hills, Maxime Inghels, Kelvin Lee","doi":"10.1111/dme.70030","DOIUrl":"https://doi.org/10.1111/dme.70030","url":null,"abstract":"<p><strong>Aims: </strong>Diabetes mellitus remains a prevalent condition worldwide and a significant risk factor for atherosclerotic cardiovascular disease. Recent evidence suggests the use of glucose-lowering therapies with cardiovascular benefit in optimising the cardiometabolic profile of patients with type 2 diabetes mellitus. However, uptake remains low. This study was carried out to assess the impact of a novel cardiodiabetes service for the management of patients with diabetes mellitus presenting with acute coronary syndromes.</p><p><strong>Methods: </strong>A retrospective, observational, registry-based analysis was performed among patients presenting with an acute coronary syndrome and diabetes mellitus to a regional heart centre before and after the implementation of a cardiodiabetes service. Intergroup comparison was made for the proportion of patients having a valid glycated haemoglobin during admission, initiation of guideline-recommended glucose and lipid-lowering therapies.</p><p><strong>Results: </strong>At median follow-up of 29.7 months, a valid HbA1c measurement at baseline was lower in the pre-intervention compared to the post-intervention group (556/711 [78.2%] vs. 302/362 [83.4%], p = 0.043) while more patients in the post-intervention group were prescribed sodium-glucose co-transporter inhibitors (297/362 [82.0%] vs. 359/711 [50.5%]). All-cause mortality (5.2 vs. 12.3 [events/100 patient-years], relative ratio [RR] 0.42, 95% confidence interval [CI] 0.28-0.61, and p < 0.001), first events of acute kidney injury (AKI) (10.0 vs. 13.0, RR 0.77, CI 0.57-1.03, p = 0.090) and all events of AKI (16.6 vs. 22.1, RR 0.75, CI 0.60-0.94, p = 0.015) were significantly lower in the post-intervention group.</p><p><strong>Conclusion: </strong>The introduction of a joint-speciality cardiodiabetes service improved the care and survival of patients with acute coronary syndrome and diabetes mellitus.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70030"},"PeriodicalIF":3.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding behaviour change maintenance after attending a self-management education and support programme for type 2 diabetes: A longitudinal qualitative study.","authors":"Márcia Carvalho, Eimear Morrissey, Pauline Dunne, Amanda Drury, Molly Byrne, Jenny McSharry","doi":"10.1111/dme.70032","DOIUrl":"https://doi.org/10.1111/dme.70032","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to explore behaviour change maintenance experiences of adults with type 2 diabetes over 15 months following attendance at a diabetes self-management education and support (DSMES) programme and their needs for post-programme support.</p><p><strong>Methods: </strong>A longitudinal qualitative study using four interviews and experience sampling (written notes and photographs) was conducted. Data were analysed through a deductive analysis based on an existing framework combined with an inductive thematic analysis approach.</p><p><strong>Results: </strong>Twenty-one adults (67% women, aged 39-74) participated; seventeen completed all interviews. Analysis resulted in the refined Supporting Understanding and Strategies for Type 2 Diabetes Maintenance Self-Management (SUSTAIN) framework and three themes capturing key trends and changes over time: (1) integrating the changes amidst the constant ebb and flow of life; (2) consolidating the changes: moving towards independent maintenance; and (3) building bridges to self-maintenance: the role of support post-programme.</p><p><strong>Conclusions: </strong>People may experience difficulties in maintaining behavioural changes post-DSMES programmes. Programmes should address the role of emotions, psychological and physical resources and environmental and social influences in behaviour change maintenance and promote the development of skills for longer-term management, including self-regulation, behavioural autonomy, intrinsic motivation and habit formation. As some people may also benefit from longer-term, ongoing support, digitally delivered with occasional sessions involving peers and educators beyond 12 months should be considered. Suggestions for ongoing support include progress monitoring, expert guidance, educational updates, troubleshooting opportunities and encouragement and motivational support.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70032"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved self-management of type 1 diabetes in young women: Experiences of Guided Self-Determination-Young: A qualitative interview study.","authors":"Josephine Haas, Martina Persson, Eva Hagström Toft, Johanna Bäck-Nirs, Marie Lindström, Anna Lindholm Olinder, Anna Lena Brorsson","doi":"10.1111/dme.70029","DOIUrl":"https://doi.org/10.1111/dme.70029","url":null,"abstract":"<p><strong>Aims: </strong>Young women with type 1 diabetes (T1D) have higher risks of diabetes complications and report higher diabetes distress and lower quality of life than men with T1D. Their experiences of self-management and need for support have received little attention, and targeted interventions are lacking. The aim of this qualitative interview study was to explore the experiences of young women with T1D after participating in an intervention with the person-centred reflection and problem-solving model Guided Self-Determination-Young (GSD-Y), with a focus on self-management and support in daily diabetes care.</p><p><strong>Methods: </strong>A qualitative interview study was performed in a paediatric and an adult diabetes outpatient clinic in Sweden. After participating in an intervention with GSD-Y, 12 women (15-20 years) with T1D were selected and interviewed individually. The interviews were analysed using inductive qualitative content analysis.</p><p><strong>Results: </strong>The analysis revealed an overarching theme: 'A person-centred approach facilitated deeper reflection on both an individual and a relational level', and two main categories: 'The process initiated within the individual', and 'The process initiated together with the health care provider'. The women experienced increased knowledge of, and increased ability to manage diabetes. They also experienced a new type of relationship with the health care provider, including exchange of in-depth information beyond glucose levels, which appeared to increase their ability to receive support.</p><p><strong>Conclusions: </strong>The GSD-Y model provided tools to explore and clarify the individual needs of young women with T1D, which supported diabetes self-management. Person-centred care was enabled when the women became engaged as active partners in diabetes health care.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70029"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight gain as a complication of intensification of glucose control with automated insulin delivery systems.","authors":"Julia Kelly, Devin Steenkamp, Elizabeth Brouillard, Howard Wolpert","doi":"10.1111/dme.70031","DOIUrl":"https://doi.org/10.1111/dme.70031","url":null,"abstract":"","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70031"},"PeriodicalIF":3.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'The seagull theory: Where people fly in, gather information… fly out and nothing ever comes about': A qualitative exploration of barriers and enablers to research participation among adults with type 2 diabetes living in Australian rural communities.","authors":"Joanne Jordan, Jo-Anne Manski-Nankervis, Meaghan Read, Timothy Skinner, Jane Speight, Elizabeth Holmes-Truscott","doi":"10.1111/dme.70027","DOIUrl":"https://doi.org/10.1111/dme.70027","url":null,"abstract":"<p><strong>Aim: </strong>Rural communities are under-represented in diabetes research, with implications for the generalisability, implementation and reach of research outcomes. Increased efforts to conduct diabetes research in, or inclusive of, rural communities are predicated on effective participant recruitment. This study explores the motivations for, barriers to and enablers of research participation among adults with type 2 diabetes (T2D) in Australian rural communities.</p><p><strong>Method: </strong>A phenomenological qualitative study was conducted involving adults (18+ years) living with T2D in rural communities, using multi-modal recruitment approaches and purposeful sampling across Australian states and gender. Audio-recorded, semi-structured interviews explored participants' perceptions of research participation. An abductive coding approach was undertaken to identify salient themes.</p><p><strong>Results: </strong>Twenty-one participants were recruited across all six Australian states, median (range) age of 63 (41-78) years and 65% were women. Barriers to research participation include diabetes stigma, lack of community awareness of T2D, few research opportunities, geographical distances of rural communities from research sites and individual time and resource constraints. Enablers strongly focused on increased engagement and involvement of rural communities in research and offering education or access to diabetes care as part of research activities. Motivations for research participation included opportunities to help or advocate for rural and T2D communities and highlight under-resourcing of rural healthcare services.</p><p><strong>Conclusion: </strong>Study findings inform practical strategies that may improve recruitment mechanisms for T2D research in rural communities, for example, community-driven recruitment methods. Evaluation of the effectiveness of such strategies in research practice will be needed.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70027"},"PeriodicalIF":3.2,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing discordance between HbA_1c and glucose management indicator.","authors":"Erna Lenters-Westra, Marion Fokkert, Eric S Kilpatrick, Erwin Schleicher, Scott Pilla, Emma English, Peter van Dijk","doi":"10.1111/dme.70023","DOIUrl":"https://doi.org/10.1111/dme.70023","url":null,"abstract":"<p><strong>Aims: </strong>The assessment of haemoglobin A1c (HbA_1c) continues to play an essential role in diabetes care; however, major advances in new technologies widen the armament available to clinicians to further refine treatment for their patients. Whilst HbA_1c remains a critical glycaemic marker, advances in technologies such as Continuous Glucose Monitoring (CGM) now offer real-time glucose monitoring, allowing a more instant assessment of glycaemic control. Discrepancies between laboratory-measured HbA_1c and Glucose Management Indicator (GMI) values are a significant clinical issue. In this article, we present a checklist of potential sources of error for both GMI and HbA_1c values and provide suggestions to mitigate these sources in order to continue to improve diabetes care.</p><p><strong>Methods: </strong>We identified key literature pertaining to GMI measurement, HbA_1c measurement, and potential factors of discordance between the two. Using these sources, we explore the potential factors leading to discordance and how to mitigate these when found.</p><p><strong>Results: </strong>We have constructed a quick reference checklist covering the main sources of discordance between HbA_1c and GMI, with accompanying narrative text for more detailed discussion. Discordance can arise due to various factors, including CGM accuracy, sensor calibration, red blood cell turnover and other physiological conditions.</p><p><strong>Conclusions: </strong>GMI will likely continue to be used in the upcoming years by both persons with diabetes and their health care providers, and so it is important for users of CGM devices to be equipped with the knowledge to understand the potential causes of discordance between GMI and HbA_1c values.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70023"},"PeriodicalIF":3.2,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient relevant outcomes for type 1 diabetes management: A qualitative evidence synthesis.","authors":"Jessica Hanae Zafra-Tanaka, Adela Del Valle, Nathaly Aya Pastrana, J Jaime Miranda, David Beran","doi":"10.1111/dme.70016","DOIUrl":"https://doi.org/10.1111/dme.70016","url":null,"abstract":"<p><strong>Aims: </strong>Identify and define relevant outcomes for people living with T1DM and their caregivers, and explore the differences across contexts and life stages. This exercise will inform the development of a Core Outcome Set (COS), an essential list of outcomes that should be measured for T1DM.</p><p><strong>Methods: </strong>A systematic review of qualitative studies published between 2010 and 2024 using PubMed (Medline), EMBASE, PsychINFO, and CINHAL was conducted. Studies that explored the perspectives and opinions of people living with T1DM or their caregivers around care and the healthcare system were included. Qualitative evidence synthesis was used to identify relevant outcomes for people living with T1DM and their caregivers. People living with T1DM and patient representatives were consulted to provide feedback on the results.</p><p><strong>Results: </strong>119 studies were included; 85/119 (71.4%) conducted in high-income countries. Through the qualitative evidence synthesis, we found three levels of outcomes: (1) individual level (diabetes burden, psychological distress, self-efficacy, hypoglycemia burden, and diabetes burnout), (2) caregivers and family level (caregiver burden, social support, support provided by diabetes management team, and financial impact), and (3) systemic level (access to healthcare, administrative burden, structural support).</p><p><strong>Conclusions: </strong>We found that outcomes can be categorized into three different levels (individual, caregivers/family, and systemic). COS usually considers individual level outcomes, but it was found that outcomes beyond the individual, such as those at the caregiver/family and healthcare levels, also matter for people living with T1DM. To meet the needs, all these levels should be measured.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e70016"},"PeriodicalIF":3.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}