European Journal of Clinical Nutrition最新文献

{"title":"Muscle quality index comparisons between Hispanics and non-Hispanic Caucasians using dual energy X-ray absorptiometry and handgrip strength.","authors":"Ayush Mehra, Ronald L Snarr, Kyung-Shin Park, Jessica L Krok-Schoen, Stefan A Czerwinski, Brett S Nickerson","doi":"10.1038/s41430-024-01484-y","DOIUrl":"https://doi.org/10.1038/s41430-024-01484-y","url":null,"abstract":"<p><strong>Background & aims: </strong>Muscle quality index (MQI) can be computed in various ways. Also, many studies have evaluated MQI in older adults and non-Hispanic populations. The aim of this study was to compare various muscle quality indexes between Hispanics and non-Hispanic Caucasians when stratifying grip strength and appendicular lean mass measurements.</p><p><strong>Methods: </strong>235 participants (aged 25.5 ± 9.5 for males and 26.4 ± 9.9 for females) completed a dual energy X-ray absorptiometry (DXA) scan to assess appendicular lean mass (ALM). Handgrip strength (HGS) was assessed using a handheld dynamometer. MQI was computed using four different models: 1). MQI_RA: ALM and HGS of right arm and hand, respectively; 2). MQI_LA: ALM and HGS of left arm and hand, respectively; 3). MQI_ARMS: ALM and HGS of both arms and hands, respectively; and 4). MQI_TOTAL: ALM of upper and lower-limbs and HGS of left and right hand.</p><p><strong>Results: </strong>Hispanic males and females exhibited lower HGS compared to Caucasians with effect sizes ranging from trivial (d = 0.17) to moderate (d = 0.80). Females demonstrated higher MQI values compared to males for MQI_ARMS (d = 0.70), MQI_RA (d = 0.75), and MQI_LA (d = 0.57). However, MQI_TOTAL yielded a small practical effect (d = 0.33) in favor of males (3.2 ± 0.5 kg/kg vs. 3.1 ± 0.5 kg/kg). After factoring by sex and ethnicity, Hispanic males and females, compared to non-Hispanic Caucasians males and females, showed trivial-to-small practical differences (d values ranging from 0.03 to 0.39).</p><p><strong>Conclusions: </strong>These results demonstrate MQI models vary across sex, particularly when utilizing models that account for upper extremity strength and ALM (i.e., MQI_ARMS, MQI_RA, and MQI_LA). Lastly, to establish consistency in future research, the present study recommends using MQI models that account for ALM of upper- and lower-limbs (i.e., MQI_TOTAL). However, research measuring muscular strength via one upper-limb (e.g., left hand) might consider measuring ALM of the corresponding arm (e.g., left arm) when computing muscle quality (e.g., MQI_LA).</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906262","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":"Selective industry adoption of a voluntary front-of-pack nutrition label results in low and skewed uptake: 10-year results for the Health Star Rating.","authors":"Mariel Keaney, Damian Maganja, Eden Barrett, Simone Pettigrew, Alexandra Jones","doi":"10.1038/s41430-024-01480-2","DOIUrl":"https://doi.org/10.1038/s41430-024-01480-2","url":null,"abstract":"<p><p>Front-of-pack nutrition labelling (FOPNL) on packaged foods is recommended by the World Health Organization to promote healthier diets. Our aim was to assess uptake of Australia's FOPNL, the Health Star Rating (HSR), overall and by HSR score received (0.5 (less healthy) to 5.0 (more healthy) in 0.5 increments) after ten years of voluntary implementation. In a sample of 21,197 products, we found HSR uptake of 37% overall in 2023. Uptake was unevenly distributed, with 24% of products with an HSR ≤ 3 displaying the label, compared to 53% of products scoring ≥3.5 (p < 0.001). Low HSR uptake on poorly rated products demonstrates that most food manufacturers will only display FOPNL where marketing value exists in a voluntary system. Poor and uneven HSR uptake limits consumers' ability to meaningfully use the label to compare and choose healthier products. Government action is urgently required to make the HSR system mandatory.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893134","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":"Do we neglect nutrition in childhood interstitial lung disease?","authors":"Nagehan Emiralioglu, Nural Kiper","doi":"10.1038/s41430-024-01485-x","DOIUrl":"https://doi.org/10.1038/s41430-024-01485-x","url":null,"abstract":"<p><p>Growth failure and inadequate weight gain are common problems in childhood interstitial lung diseases (chILD) and these children usually need high calories. It is important to manage both pulmonary functions and nutrition as part of their overall treatment plan and early interventions will help children to improve their quality of life and slow the progression of chronic lung disease. Nutritional evaluation on routine clinical follow-up is important, although there are not any specific guidelines for chILD. Nutritional education, high balanced energy, protein, and fat diet will assist to improve weight gain and maintenance of adequate nutrition status in children with ILD.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897152","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 acute effects of variations in the flour composition of crackers on the glycemic index and glycemic responses in healthy adults.","authors":"Emilia Papakonstantinou, Vasilis Alsab, Foteini Lympaki, Sofia Chanioti, Marianna Giannoglou, George Katsaros","doi":"10.1038/s41430-024-01482-0","DOIUrl":"https://doi.org/10.1038/s41430-024-01482-0","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study assessed the glycemic index (GI) and glycemic load (GL) of three crackers formulated with different flours: a control cracker (CC) made with conventional flour, one with 30% whole wheat flour substitution (WWC), and another with 30% sunflower seed flour substitution (SFC). This study aimed to explore the impact of these substitutions, which vary in protein and fiber content, on the glycemic responses compared to a reference glucose drink.</p><p><strong>Subjects/methods: </strong>In a randomized controlled, crossover design, 11 healthy participants (mean age 23.5 ± 1 years; 7 women; BMI 23 ± 1 kg/m²), consumed cracker meals (CC, WWC, and SFC) each providing 50 g of available carbohydrates, and a 50 g glucose reference in separate sessions.</p><p><strong>Results: </strong>The SFC crackers provided low GI and GL values (GI: 53 on the glucose scale, GL: 6 per serving), whereas the WWC and CC crackers provided high GI (GI: 77 and 90 on the glucose scale, respectively) and medium GL values (11 and 12 per serving, respectively). Compared with the glucose reference and CC crackers, only SFC induced lower postprandial glucose concentrations, lower glucose excursions, and lower peak glucose values. All crackers were rated as enjoyable and associated with increased satiety.</p><p><strong>Conclusions: </strong>SFC moderated postprandial glycemic responses compared to CC and the reference (D-glucose), but not WWC. These effects may be attributed to the soluble fibers and protein content of the SFC. These findings suggest potential benefits for body weight management and glycemic control, warranting further investigation of the role of flour substitutions in healthy snack options.</p><p><strong>Clinical trial registration: </strong>This trial has been registered at Clinicaltrials.gov (NCT05702372).</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893135","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":"Association between coffee consumption and metabolic syndrome in Korean adults.","authors":"Sooyeun Choi, Youjin Je","doi":"10.1038/s41430-024-01478-w","DOIUrl":"https://doi.org/10.1038/s41430-024-01478-w","url":null,"abstract":"<p><strong>Background/objectives: </strong>Studies examining the association between coffee consumption and metabolic syndrome (MetS), considering different coffee types, have reported inconsistent results. We investigated the relationship between coffee consumption and MetS, taking into account coffee types, using data from the Korea National Health and Nutrition Examination Survey conducted from 2016 to 2021 among 14,631 adults aged 19-64 years.</p><p><strong>Subjects/methods: </strong>We used a 24-h dietary recall method to assess diet, including the type and quantity of coffee consumed. Coffee was categorized into black coffee and coffee with sugar and/or cream (non-drinkers, ≤1, 2-3, and >3 cups/day). Multivariable logistic regression models were utilized to investigate the relationship between coffee consumption and MetS, defined by the harmonized criteria.</p><p><strong>Results: </strong>After adjusting for potential covariates, for women, 2-3 cups/day of black coffee were inversely associated with MetS (OR = 0.66; 95% CI = 0.46-0.96). Three or fewer cups per day of black coffee were inversely associated with low high-density lipoprotein cholesterol (HDL-C) and elevated triglycerides in women. Coffee consumption was not significantly associated with MetS in men. Consumption of coffee with sugar and/or cream or more than three cups per day of coffee was not significantly associated with MetS overall.</p><p><strong>Conclusion: </strong>Our findings suggest that moderate of 2-3 cups/day of black coffee consumption is inversely associated with MetS in women, possibly due to its favorable impact on HDL-C and triglycerides. Further prospective studies examining the consumption of different coffee types in relation to MetS are warranted to offer definitive evidence.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878535","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":"Older adult women with chronic anorexia nervosa: heterogeneous adaptation to undernutrition over time.","authors":"Natacha Germain, Aurélia Gay, Gwénaelle Belleton, Amira Hammour, Célia Boivin, Thierry Thomas, Catherine Massoubre, Bruno Estour, Bogdan Galusca","doi":"10.1038/s41430-024-01479-9","DOIUrl":"https://doi.org/10.1038/s41430-024-01479-9","url":null,"abstract":"<p><strong>Introduction: </strong>Anorexia nervosa (AN) in older adult women is primarily described through reviews or case reports focusing on psychiatric traits, with no comprehensive studies evaluating their complete nutritional and hormonal profiles. This study aimed to describe a group of women with anorexia nervosa aged above 35 years old (AN35), and compare them with young women with anorexia nervosa (ANY) and normal-weight control participants.</p><p><strong>Method: </strong>Anthropometric, metabolic, nutritional, and psychiatric parameters were collected and compared among three groups of women: 50 AN35, 37 ANY, and 38 controls.</p><p><strong>Results: </strong>AN35 exhibited a mean disease duration of 271 ± 19 months, with 94% chronic forms and 58% restrictive types. Despite having similar BMI as ANY, AN35 displayed more altered parameters, including higher liver enzymes (p = 0.007), free T₃ (p = 0.0046) and leptin (p < 0.0001); and lower albumin (p = 0.0029), and white cells (p < 0.0001). AN35 showed significant heterogeneity in hormonal adaptation, such as free T_3. Half of the patients aged above 51 years revealed high gonadotropin levels despite being undernourished. Additionally, AN35 groups presented with 50% of bones fractures, decreased T-scores under -2.5 (p < 0.0001 for femoral), and altered micro architectural HRPQT parameters compared to ANY.</p><p><strong>Conclusion: </strong>Anorexia nervosa in older adult women is predominantly chronic. Nutritional parameters changes with age suggests a significant heterogeneity and possible adaptation of energy balance and bodyweight set point for others. Complications may be severe, altering the quality of life, and sometimes potentially lethal. These findings highlight the potential adaptation of energy balance with age, and should assist clinicians in clinical practice.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855245","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":"Dairy consumption and vitamin D concentration in adolescents with challenge-confirmed cow’s milk allergy during infancy","authors":"Sonja Piippo, Helena Hauta-alus, Mirva Viljanen, Erkki Savilahti, Mikael Kuitunen","doi":"10.1038/s41430-024-01477-x","DOIUrl":"https://doi.org/10.1038/s41430-024-01477-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background/Objectives</h3><p>Milk is an important source of dietary calcium and, if fortified, vitamin D. Cow’s milk allergy (CMA) is treated with a milk elimination diet. Although most children become tolerant by age 3 years, some continue dairy avoidance. It remains unclear whether adolescents with a history of CMA adopt similar milk consumption as their peers. We assessed dairy consumption and concentration of serum 25-hydroxyvitamin D (25(OH)D) in adolescents with either confirmed CMA or a negative CMA challenge in infancy (CMA-refuted group) and age-matched controls.</p><h3 data-test=\"abstract-sub-heading\">Subjects/Methods</h3><p>This study is based on a previously reported randomized controlled trial from 1999 to 2002 on the treatment effect of probiotics on atopic eczema in participants aged &lt;12 months (<i>n</i> = 230) with data on CMA status. We followed up these participants, aged 15–18 years, in 2017 (<i>n</i> = 104). A 20-item food frequency questionnaire assessed dairy consumption. An automated immunoassay measured 25(OH)D concentration.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Median dairy product consumption did not differ between adolescents with CMA (449 g/d, <i>n</i> = 40), the CMA-refuted group (566 g/d, <i>n</i> = 36), and controls (235 g/d, <i>n</i> = 51) (<i>P</i> = 0.117). Median 25(OH)D concentrations were 76.0, 79.3, and 80.8 nmol/l, respectively (<i>P</i> = 0.844). Among participants, 93% were vitamin D sufficient (25(OH)D ≥ 50 nmol/l), with no differences between groups (<i>P</i> = 0.914).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Among adolescents with a history of CMA during infancy, our study found no reintroduction failure of milk and no difference in vitamin D insufficiency rate compared with peers. Current management of CMA seems to adequately minimize later nutritional disadvantages associated with a cow’s milk elimination diet.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141770495","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":"Nutritional ultrasound: above body mass index, two cases presentation.","authors":"Santiago Gómez-Jordan, Juan Camilo Castellanos-de la Hoz, Sandra Saumett, Alejandra Molano, Eduardo Zúñiga-Rodríguez","doi":"10.1038/s41430-024-01459-z","DOIUrl":"10.1038/s41430-024-01459-z","url":null,"abstract":"<p><p>Malnutrition is a prevalent condition in chronic diseases, significantly impacting morbidity and mortality. Point-of-care ultrasound (POCUS) is increasingly utilized in clinical practice as a rapid and accessible tool for evaluating muscle mass. Here, we present two cases of females with chronic diseases who presented with acute exacerbations of their conditions accompanied by fluid overload. Suspected of experiencing nutritional alterations, they underwent ultrasound evaluation to confirm muscle mass loss. These cases highlight the potential of ultrasound in guiding effective muscle mass assessment, particularly in pathologies prone to fluid overload, such as chronic kidney disease and heart failure.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765850","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":"Artificial intelligence chatbots for the nutrition management of diabetes and the metabolic syndrome.","authors":"Farah Naja, Mandy Taktouk, Dana Matbouli, Sharfa Khaleel, Ayah Maher, Berna Uzun, Maryam Alameddine, Lara Nasreddine","doi":"10.1038/s41430-024-01476-y","DOIUrl":"10.1038/s41430-024-01476-y","url":null,"abstract":"<p><strong>Background: </strong>Recently, there has been a growing interest in exploring AI-driven chatbots, such as ChatGPT, as a resource for disease management and education.</p><p><strong>Objective: </strong>The study aims to evaluate ChatGPT's accuracy and quality/clarity in providing nutritional management for Type 2 Diabetes (T2DM), the Metabolic syndrome (MetS) and its components, in accordance with the Academy of Nutrition and Dietetics' guidelines.</p><p><strong>Methods: </strong>Three nutrition management-related domains were considered: (1) Dietary management, (2) Nutrition care process (NCP) and (3) Menu planning (1500 kcal). A total of 63 prompts were used. Two experienced dietitians evaluated the chatbot output's concordance with the guidelines.</p><p><strong>Results: </strong>Both dietitians provided similar assessments for most conditions examined in the study. Gaps in the ChatGPT-derived outputs were identified and included weight loss recommendations, energy deficit, anthropometric assessment, specific nutrients of concern and the adoption of specific dietary interventions. Gaps in physical activity recommendations were also observed, highlighting ChatGPT's limitations in providing holistic lifestyle interventions. Within the NCP, the generated output provided incomplete examples of diagnostic documentation statements and had significant gaps in the monitoring and evaluation step. In the 1500 kcal one-day menus, the amounts of carbohydrates, fat, vitamin D and calcium were discordant with dietary recommendations. Regarding clarity, dietitians rated the output as either good or excellent.</p><p><strong>Conclusion: </strong>Although ChatGPT is an increasingly available resource for practitioners, users are encouraged to consider the gaps identified in this study in the dietary management of T2DM and the MetS.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765752","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":"Prediction of insulin resistance and elevated liver transaminases using serum uric acid and derived markers in children and adolescents.","authors":"Youngha Choi, Hyejin Yang, Soyoung Jeon, Kyoung Won Cho, Seo Jung Kim, Sujin Kim, Myeongseob Lee, Junghwan Suh, Hyun Wook Chae, Ho-Seong Kim, Kyungchul Song","doi":"10.1038/s41430-024-01475-z","DOIUrl":"10.1038/s41430-024-01475-z","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship of serum uric acid (Uacid) and derived parameters as predictors of insulin resistance (IR) and elevated liver transaminases in children and adolescents METHODS: Data of 1648 participants aged 10-18 years was analyzed using nationwide survey. Logistic regression analysis was performed with IR and elevated liver transaminases as dependent variables, and odds ratios (ORs) and 95% confidence intervals (CIs) for tertiles 2 and 3 of each parameter in comparison to tertile 1, which served as the reference. Receiver operating characteristic (ROC) curves were generated to assess predictability of the parameters for IR and elevated liver transaminases.</p><p><strong>Results: </strong>Hyperuricemia, IR, and elevated liver transaminases were significantly associated with each other. All Uacid and derived markers showed continuous increase in ORs and 95% CIs for IR and elevated liver transaminases across the tertiles of several biochemical and metabolic variables of interest (all p < 0.001), and were also significantly predictive in ROC curve. Overall, Uacid combined with obesity indices showed higher ORs and area under the curve (AUC) compared to Uacid alone. Uacid-body mass index (BMI) standard deviation score presented the largest AUC for IR. For elevated liver transaminases, Uacid-BMI and Uacid-waist-to-height ratio showed the largest AUC.</p><p><strong>Conclusions: </strong>Uacid combined with obesity indices are robust markers for prediction of IR and elevated liver transaminases in children and adolescents. Uacid and derived markers have potential as simple markers which do not require fasting for screening of IR and elevated liver transaminases in children and adolescents.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765851","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}