International journal of epidemiology最新文献

{"title":"Improving retrospective data on recent household deaths: a multi-arm randomized trial in Guinea-Bissau.","authors":"Orsola Torrisi, Ane B Fisker, Didier A A Fernandes, Stéphane Helleringer","doi":"10.1093/ije/dyaf009","DOIUrl":"10.1093/ije/dyaf009","url":null,"abstract":"<p><strong>Background: </strong>In countries with limited civil registration and vital statistics systems, assessing the impact of health crises requires precise retrospective mortality data. We tested whether calendar methods improve survey or census data on dates of recent household deaths registered in a Health and Demographic Surveillance System (HDSS).</p><p><strong>Methods: </strong>Between April and June 2023, we randomized 578 households with HDSS-registered deaths in Guinea-Bissau to interviews by using (i) a standard questionnaire with close-ended questions about dates of deaths, or similar questionnaires supplemented with (ii) a physical calendar of local events printed on paper or (iii) a digital calendar implemented on tablets. We evaluated the accuracy of reported dates through record linkages to HDSS data.</p><p><strong>Results: </strong>No deaths were reported in 11.8% of the 508 participating households. In other households (n = 448), informants reported 574 deaths since January 2020. Relative to the standard questionnaire, neither the physical calendar nor the digital calendar improved the proportion of deaths reported in the same month and year as recorded by using surveillance data. The physical and digital calendars reduced the share of missing data on dates of deaths (6.1% and 3.2%, respectively, versus 13.1% with the standard questionnaire). Reported dates of deaths obtained by using the digital calendar were more weakly correlated with surveillance data than those collected in other arms. Using the digital calendar also added 1.15 minutes to the data collection.</p><p><strong>Conclusion: </strong>Digital calendars do not improve the reporting of dates of deaths in surveys or censuses. Further trials of the use of a physical calendar in retrospective interviews about recent household deaths are warranted.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"54 2","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term effect of pharmacological treatment on academic achievement of Norwegian children diagnosed with ADHD: a target trial emulation.","authors":"Tomás Varnet Pérez, Kristin Romvig Øvergaard, Arnoldo Frigessi, Guido Biele","doi":"10.1093/ije/dyaf010","DOIUrl":"10.1093/ije/dyaf010","url":null,"abstract":"<p><strong>Background: </strong>Attention-deficit/hyperactivity disorder (ADHD) is one of the most commonly diagnosed mental disorders in children. For many patients, treatment involves long-term medication in order to reduce symptoms, regulate behaviour, and, hopefully, improve school performance and achievement. However, there is little to no evidence to support a long-term effect on the latter complex outcomes.</p><p><strong>Methods: </strong>We utilize a target trial framework to emulate a pretest-posttest control group design and estimate the intention-to-treat effect of ADHD medication on national test scores in children diagnosed with ADHD born between 2000 and 2007 in Norway. The data were obtained through linkage of Norwegian registries (NorPD, Norwegian Prescription Database; NPR, Norwegian Patient Registry; KUHR, Database for Control and Payment of Health Reimbursement; SSB, Statistics Norway; MBRN, Medical Birth Registry of Norway).</p><p><strong>Results: </strong>The resulting analytic sample size consisted of 8548 children diagnosed with ADHD, with about 9% missingness in their grade eight national test scores. We find that initiating ADHD medication had a slight positive average effect on national test scores for all three domains: English, numeracy, and reading [standardized mean differences: 0.037 (95% compatibility interval (CI95), -0.003; 0.076), 0.063 (CI95, 0.016; 0.111), 0.071 (CI95, 0.030; 0.111), respectively].</p><p><strong>Conclusion: </strong>We conclude that the estimated long-term average effect of ADHD medication on learning, as measured by the Norwegian national tests, is not clinically relevant. Study strengths include the use of real-world data on ecologically valid and relevant outcomes and the robustness of results across model specifications. Limitations include possibility of unobserved confounding and lack of prescription data.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"54 2","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of chronic obstructive pulmonary disease after a tuberculosis episode in a large, population-based cohort from Eastern China.","authors":"Jianbing Wang, Luhua Yu, Zongming Yang, Peng Shen, Yexiang Sun, Liming Shui, Mengling Tang, Mingjuan Jin, Bin Chen, Yang Ge, Hongbo Lin, Ye Shen, Kun Chen, Leonardo Martinez","doi":"10.1093/ije/dyae174","DOIUrl":"10.1093/ije/dyae174","url":null,"abstract":"<p><strong>Background: </strong>Although smoking is considered the primary cause of chronic obstructive pulmonary disease (COPD), there is a growing realization that there may be important secondary risk factors. Tuberculosis may lead to lung impairment; however, whether residual lung damage results in clinically significant, long-term outcomes, independent of smoking, has not been well studied. We aimed to investigate the association between tuberculosis and the subsequent development of COPD using a large, population-based cohort study.</p><p><strong>Methods: </strong>We conducted a longitudinal cohort study within the Chinese Electronic Health Records Research in Yinzhou study between 2009 and 2021. We followed participants free of COPD at the beginning of the study, and investigated whether previous or current tuberculosis was an important risk factor. Tuberculosis was recorded based on the Chinese National Disease Reporting system which includes all diagnosed cases at the city, provincial and national levels. We assessed the relationship between tuberculosis and COPD using multivariable survival models, adjusting for demographic and lifestyle characteristics, education level, comorbidities and use of medications.</p><p><strong>Results: </strong>Among 477 046 participants, 198 882 were eligible for inclusion in our analysis. In a multivariable model, pulmonary tuberculosis and all tuberculosis were associated with a 2.57-fold [95% confidence interval (CI), 2.31-2.87)] and 1.67-fold (95% CI, 1.48-1.90) increased COPD risk, respectively. Stronger associations of pulmonary tuberculosis and all tuberculosis with COPD were seen in participants who were elderly, or with lower body mass index or education level (Pinteraction<0.001). People with tuberculosis were at an increased risk of COPD if they were current smokers [adjusted hazard ratio (aHR), 1.40; 95% CI, 1.02-1.93] or non-smokers (aHR, 1.72; 95% CI, 1.50-1.98).</p><p><strong>Conclusions: </strong>Persons who developed tuberculosis were at much greater risk of developing COPD, even accounting for smoking and other potential confounders.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"54 2","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four targets: an enhanced framework for guiding causal inference from observational data","authors":"Haidong Lu, Fan Li, Catherine R Lesko, David S Fink, Kara E Rudolph, Michael O Harhay, Christopher T Rentsch, David A Fiellin, Gregg S Gonsalves","doi":"10.1093/ije/dyaf003","DOIUrl":"https://doi.org/10.1093/ije/dyaf003","url":null,"abstract":"Observational studies play an increasingly important role in estimating causal effects of a treatment or an exposure, especially with the growing availability of routinely collected real-world data. To facilitate drawing causal inference from observational data, we introduce a conceptual framework centered around “four targets”—target estimand, target population, target trial, and target validity. We illustrate the utility of our proposed “four targets” framework with the example of buprenorphine dosing for treating opioid use disorder, explaining the rationale and process for employing the framework to guide causal thinking from observational data. The “four targets” framework is beneficial for those new to epidemiologic research, enabling them to grasp fundamental concepts and acquire the skills necessary for drawing reliable causal inferences from observational data.","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"48 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Illustrating the structures of bias from immortal time using directed acyclic graphs","authors":"Guoyi Yang, Stephen Burgess, Catherine Mary Schooling","doi":"10.1093/ije/dyae176","DOIUrl":"https://doi.org/10.1093/ije/dyae176","url":null,"abstract":"Background Immortal time is a period of follow-up during which death or the study outcome cannot occur by design. Bias from immortal time has been increasingly recognized in epidemiological studies. However, the fundamental causes and structures of bias from immortal time have not been explained systematically. Methods We use an example ‘Does winning a Nobel Prize prolong lifespan?’ for illustration. We illustrate how immortal time arises and present structures of bias from immortal time using directed acyclic graphs that specify time-varying variables. We further explore the structures of bias with the exclusion of immortal time and with the presence of competing risks. We discuss how these structures are shared by different study designs in pharmacoepidemiology and provide solutions, where possible, to address the bias. Results The fundamental cause of immortal time is misalignment of exposure allocation and eligibility. Specifically, immortal time arises from using post-eligibility information to define exposure or using post-exposure information to define eligibility. The structures of bias from immortal time are confounding by survival until exposure allocation or selection bias from selecting on survival until eligibility. Excluding immortal time from follow-up does not fully address this confounding or selection bias, and the presence of competing risks can worsen the bias. Bias from immortal time may be avoided by aligning baseline, exposure allocation and eligibility, and by excluding individuals with prior exposure. Conclusions Understanding bias from immortal time in terms of confounding or selection bias helps researchers identify and thereby avoid or ameliorate this bias.","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"28 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142935931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in traffic-related air pollution exposures and associations with adverse birth outcomes over 20 years in Texas","authors":"Perry Hystad, Elaine L Hill, Andrew Larkin, David Schrank, Max Harleman, Evan Volkin, Erin J Campbell, John Molitor, Lena Harris, Beate R Ritz, Mary D Willis","doi":"10.1093/ije/dyae178","DOIUrl":"https://doi.org/10.1093/ije/dyae178","url":null,"abstract":"Background Billions of dollars have been spent implementing regulations to reduce traffic-related air pollution (TRAP) from exhaust pipe emissions. However, few health studies have evaluated the change in TRAP emissions and associations with infant health outcomes. We hypothesize that the magnitude of association between vehicle exposure measures and adverse birth outcomes has decreased over time, parallelling regulatory improvements in exhaust pipe emissions. Methods Using birth records in Texas from 1996 to 2016, we calculated residential exposure measures related to TRAP: nitrogen dioxide (NO2, a marker of the TRAP mixture), vehicle miles travelled within 500 m of homes (VMT500), a measure of traffic volume, and highway proximity. Using an accountability study framework, our analysis examined term birthweight, term low birthweight (TLBW) (&amp;lt;2500 g), preterm birth (PTB) (&amp;lt;37 weeks) and very preterm birth (VPTB) (&amp;lt;32 weeks). We implemented linear and logistic regression models to examine overall and time-stratified associations, including trends by race/ethnicity and socioeconomic groups. Results Among exposures for 6 158 518 births, NO2 exposures decreased 59% over time but VMT500 remained relatively stable. TRAP-related exposure measures were persistently associated with harmful birth outcomes [e.g. OR1996-2016 of 1.07 (95% CI: 1.04, 1.08) for TLBW comparing the highest vs lowest NO2 quintile]. The magnitude of associations decreased for total VMT500 and TLBW (-60%, OR1996: 1.08 to OR2016: 1.03 for the highest vs lowest quintile) and PTB (-65%) and VTPT (-61%), but not for term birthweight. Conclusions We observed evidence of small improvements in birth outcomes associated with reductions in exhaust pipe emissions over a 20-year period in Texas.","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"7 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between breastfeeding and breast cancer risk through mammographic breast density in a cohort of Korean women.","authors":"Soyeoun Kim, Thi Xuan Mai Tran, Mi Kyung Kim, Min Sung Chung, Eun Hye Lee, Woojoo Lee, Boyoung Park","doi":"10.1093/ije/dyae165","DOIUrl":"https://doi.org/10.1093/ije/dyae165","url":null,"abstract":"<p><strong>Background: </strong>Mammographic breast density has been suggested to play a role as a mediator between the risk factors for breast cancer (BC) and BC risk. We investigated the extent to which never breastfeeding is a risk factor for BC and how this risk is further mediated by increased mammographic breast density.</p><p><strong>Methods: </strong>This retrospective cohort study included 4 136 723 women aged ≥40 years who underwent mammographic screening between 2009 and 2010 and were followed up until 31 December 2020. Breastfeeding information was obtained by using a self-administered questionnaire. Mammographic breast density was extracted from national BC screening results, which were assessed by trained radiologists and categorized into dense and fatty breasts. We estimated the hazard ratios (HRs) and the proportion of the associations between breastfeeding and BC risk mediated by breast density.</p><p><strong>Results: </strong>The HR of never breastfeeding on BC risk was 1.34 (95% CI, 1.32-1.37) when adjusted for only parity, body mass index and smoking status, which were selected as covariates through a directed acyclic graph and 1.21 (95% CI, 1.19-1.23) when breast density was additionally adjusted. The proportion of the association between never breastfeeding and BC risk mediated by breast density in total, pre- and post-menopausal women was 35.48%, 17.86% and 24.0%, respectively (all P < 0.001). The HR of never breastfeeding on BC risk was 1.10 (95% CI, 1.08-1.12) when adjusted for nine known breast cancer risk factors and 1.09 (95% CI, 1.07-1.12) when breast density was additionally adjusted. The proportion of the association between never breastfeeding and BC risk mediated by breast density in the total, pre- and post-menopausal women was 7.50%, 3.71% and 12.21%, respectively (all P < 0.001).</p><p><strong>Conclusions: </strong>Our findings suggest that the association between never breastfeeding and BC risk may be mediated by breast density. However, the HR and proportion of medications varied according to the adjusted covariates, highlighting that variables for adjustment should be selected based on directed acyclic graphs.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"54 1","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meeting clean air targets could reduce the burden of hypertension among women of reproductive age in India.","authors":"Taruna Singh, Ekta Chaudhary, Ambuj Roy, Santu Ghosh, Sagnik Dey","doi":"10.1093/ije/dyaf007","DOIUrl":"https://doi.org/10.1093/ije/dyaf007","url":null,"abstract":"<p><strong>Background: </strong>Air pollution is one of the leading risk factors for hypertension globally. However, limited epidemiological evidence exists in developing countries, specifically with indigenous health data and for fine particulate matter (PM2.5) composition. Here, we addressed this knowledge gap in India.</p><p><strong>Methods: </strong>Using a logistic regression model, we estimated the association between hypertension (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg) prevalence among women of reproductive age (WRA, 15-49 years) from the fifth round of the National Family Health Survey and long-term exposure to PM2.5 and its composition, after adjusting for confounders. We also explored the moderating effects of socioeconomic indicators through a multiplicative interaction with PM2.5.</p><p><strong>Results: </strong>Hypertension prevalence increased by 5.2% (95% uncertainty interval: 4.8%-5.7%) for every 10 μg/m3 increase in ambient PM2.5 exposure. Significant moderating effects were observed among smokers against nonsmokers and for various sociodemographic parameters. Among PM2.5 species, every interquartile range increase in black carbon (BC) and sulphate exposure was significantly associated with higher odds of hypertension than for organic carbon and dust. We estimated that achieving the National Clean Air Program target and World Health Organization air quality guidelines can potentially reduce hypertension prevalence by 2.42% and 4.21%, respectively.</p><p><strong>Conclusion: </strong>Our results demonstrate that increasing ambient PM2.5 exposure is associated with a higher prevalence of hypertension among WRA in India. The risk is not uniform across various PM2.5 species and is higher with BC and sulphate. Achieving clean air targets can substantially reduce the hypertension burden in this population.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"54 1","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between COVID-19 cases and monthly mortality from all causes, cancer, cardiovascular diseases and diabetes in 16 countries, 2020-21.","authors":"Margherita Pizzato, Claudia Santucci, Nazrul Islam, Carlo La Vecchia, Gianfranco Alicandro","doi":"10.1093/ije/dyaf006","DOIUrl":"https://doi.org/10.1093/ije/dyaf006","url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic, mortality from some chronic diseases increased. In this study, we evaluated monthly excess mortality from all causes, cancer, cardiovascular diseases (CVD) and diabetes during the months of 2020 and 2021, examining its relationship with COVID-19 cases.</p><p><strong>Methods: </strong>Monthly cause-specific mortality data were downloaded from public repositories of national statistics offices or directly requested from them, and population data were obtained from the United Nations archives. Excess deaths were estimated as the difference between observed and expected deaths. Monthly expected deaths for 2020 and 2021 were calculated using a quasi-Poisson regression model trained on 2010-19 data (or a shorter timespan if the full decade of data was not available). To quantify the correlation between COVID-19 cases and monthly excess mortality, we used the Spearman's correlation coefficient (rs).</p><p><strong>Results: </strong>The study included 16 countries that provided monthly national data on causes of death (Argentina, Austria, Brazil, Switzerland, Chile, the Czech Republic, Germany, Georgia, Hungary, Italy, Lithuania, Latvia, Mexico, Serbia, Slovakia and the USA). A positive correlation was found between COVID-19 cases and monthly excess mortality from all causes in all countries (rs ranging from 0.61 to 0.91), from CVD in 11 countries (rs ranging from 0.45 to 0.85) and for diabetes in 13 countries (rs ranging from 0.42 to 0.79). Excess mortality above 5% was estimated from all causes in 14 countries for both 2020 and 2021, from CVD in seven countries for 2020 and in nine countries for 2021, and from diabetes in 11 countries for 2020 and in 12 countries for 2021. No excess above 5% was estimated for cancer mortality in any of the countries considered.</p><p><strong>Conclusions: </strong>Excess mortality from CVD and diabetes persisted in several countries throughout 2021. These increases coincide with COVID-19 peaks, supporting a short-term impact of the COVID-19 pandemic on mortality from these causes.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"54 1","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cohort Profile: The Chronic Hepatitis B Infection and Liver Disease (HEPCARE) study in Jiangsu, China.","authors":"Jie Jiang, Ci Song, Liguo Zhu, Jiao Qian, Chu He, Hua Wang, Haitao Yang, Fengcai Zhu, Minfang Yao, Tao Zhu, Minquan Cao, Hongxia Ma, Zhibin Hu, Hongbing Shen, Xiangjun Zhai","doi":"10.1093/ije/dyaf005","DOIUrl":"https://doi.org/10.1093/ije/dyaf005","url":null,"abstract":"","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":"54 1","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}