International Journal of Obesity最新文献

{"title":"The effect of Ramadan fasting on anthropometric and body composition of healthy adults within different time points: A systematic review and meta-analysis.","authors":"Fatqiatul Wulandari, Anisa Jannatin Naim, Ulfah Mahardika Pramono Putri, Anita Nyarkoa Walker, Qing Feng","doi":"10.1038/s41366-025-01785-7","DOIUrl":"https://doi.org/10.1038/s41366-025-01785-7","url":null,"abstract":"<p><p>To date, the effect of Ramadan fasting (RF) on anthropometric and body compositions remains inconsistent. This review aimed to investigate the impact of RF on anthropometric and body composition of healthy adults within different time points during and after RF. Qualified studies from MEDLINE, Web of Science, Embase, CINAHL Complete, ProQuest, and Scopus were included. We involved prospective observational studies with pre- and post-test design. The anthropometric and body composition parameters consist of weight, BMI, waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), absolute fat mass (FM), fat percentage (FP), fat-free mass (FFM), and total body water (TBW). Fifty-four studies involving 2857 subjects were identified and conducted in 21 countries between 1987 and 2024. RF exerts a significant reduction in weight and BMI, starting within the second and third week of RF, peaking in the first week after RF, and gradually returning to the pre-Ramadan value in the weeks afterward. Meanwhile, WC, HC, and WHR were significantly alleviated within the last week of RF and the first week post-RF for HC. In body composition, RF elicits a significant but small reduction of absolute FM and FP within the third and fourth week of RF, while FFM and TBW were not affected. During Ramadan, anthropometric and body composition changes are transient and elicit only a short-term effect. Such leverages need to be maintained to achieve a long-term benefit of RF on the anthropometric and body composition of healthy adults.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969718","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":"Maternal obesity and ancestry distance in influencing birth outcomes.","authors":"Randy Le, Richard J Biedrzycki, Fasil Tekola-Ayele","doi":"10.1038/s41366-025-01783-9","DOIUrl":"https://doi.org/10.1038/s41366-025-01783-9","url":null,"abstract":"<p><strong>Background: </strong>Maternal pre-pregnancy obesity has been associated with birth outcomes, but the influence of genetic distance (GD) on this relationship is unclear. Therefore, the objective of this study was to assess the interplay of GD and maternal obesity on birthweight, placental weight, and large for gestational age (LGA).</p><p><strong>Methods: </strong>We used data from the NICHD Fetal Growth Studies-Singletons cohort, a prospective cohort study of multi-ancestral pregnant women. GD was estimated using data from 1810 women across four ancestral reference populations. We categorized GD into five quintiles, with quintile one and quintile five representing the closest and farthest distances, respectively. Linear regression models were used to test association between GD and birth outcomes and to estimate the association of interaction of GD and maternal obesity with birth outcomes.</p><p><strong>Results: </strong>Farther maternal GD from an African reference was significantly associated with higher birthweight and higher odds of LGA, with associations persisting after adjusting for socioeconomic status (SES). The interaction between the third Amerindigenous GD quintile and obesity was significantly associated with a 198 g larger placental weight (95% CI = 51-345, p = 0.009) compared to the first Amerindigenous GD quintile. We also found the interaction between East Asian fourth GD quintile and obesity to be significantly associated with 86.0% lower odds of infants being born LGA (OR = 0.14 g, 95% CI = 0.02-74, p = 0.031) compared to the first quintile. These associations persisted after SES adjustment.</p><p><strong>Conclusions: </strong>Interplays between maternal GD from Amerindigenous and East Asian references and pre-pregnancy obesity influence placental weight and risk of LGA. The results underline that consideration of maternal obesity in the context of GD from multiple ancestries and SES may facilitate interventions that will minimize adverse pregnancy outcomes.</p><p><strong>Clinical trial registration: </strong>The study has been registered at ClinicalTrials.gov (Trial registration: NCT00912132).</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989246","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":"Individual participant data meta-analysis of eating behaviour traits as effect modifiers in acceptance and commitment therapy-based weight management interventions.","authors":"Laura Kudlek, Patricia Eustachio Colombo, Julia Mueller, Stephen J Sharp, Clare E Boothby, Simon J Griffin, Meghan Butryn, Christina Chwyl, Evan Forman, Charlotte Hagerman, Misty Hawkins, Adrienne Juarascio, Bärbel Knäuper, Marjukka Kolehmainen, Michael E Levin, Jason Lillis, Edurne Maiz, Stephanie Manasse, Lara Palmeira, Kirsi H Pietiläinen, Nancy E Sherwood, Amy L Ahern","doi":"10.1038/s41366-025-01759-9","DOIUrl":"https://doi.org/10.1038/s41366-025-01759-9","url":null,"abstract":"<p><strong>Background: </strong>Obesity care may benefit from precision approaches, matching patients to treatment types based on their individual characteristics, including eating behaviour traits (EBTs) like emotional eating, uncontrolled eating, external eating, internal disinhibition and restraint. Initial evidence suggests that Acceptance and Commitment Therapy (ACT)-based interventions might address dysregulated EBTs more effectively than standard behavioural treatments. However, it is unclear if ACT is more effective for certain EBT levels.</p><p><strong>Methods and analysis: </strong>This pre-registered (CRD42022359691) one-stage Individual Participant Data (IPD) meta-analysis explored the moderating effects of baseline EBTs on weight outcomes in trials of ACT-based interventions for adults with a BMI ≥ 25 kg/m². Unlike traditional meta-analyses, IPD meta-analyses re-analyse existing data to answer novel research questions. We identified 16 eligible trials through a systematic search of eight databases until June 20, 2022. We obtained, checked, and harmonised data from 15 trials (N = 2535). We used mixed regression models to investigate both continuous and categorical interaction effects.</p><p><strong>Results: </strong>We found no evidence of interactions between ACT vs. control and baseline EBTs as continuous variables on percentage weight change. However, we found evidence to suggest an added difference in weight change of -4.47% (95%CI -1.15, -7.73) from baseline to 12-months after intervention end in participants with medium levels of internal disinhibition compared to those with high levels. Sensitivity analyses similarly indicated a greater intervention benefit for participants with medium, rather than high, emotional eating levels (in trials that reduced experiential avoidance and in trials using the three-factor eating questionnaire) and internal disinhibition (in analyses of participants with at least 60% attendance). Given the exploratory nature of analyses, results should be interpreted with caution.</p><p><strong>Conclusion: </strong>Findings suggest potential non-linear interaction effects of ACT with internal disinhibition but require replication in confirmatory trials. These results may help guide further research on precision approaches based on EBTs.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017882","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":"Expanding lifestyle intervention beyond \"Diet and Exercise\" in the GLP-1RA era.","authors":"Robert Hsu, Anne-Kathrin Eiselt, Tejaswi Kompala","doi":"10.1038/s41366-025-01767-9","DOIUrl":"https://doi.org/10.1038/s41366-025-01767-9","url":null,"abstract":"","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965415","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":"Lessons learned from the lived experiences of people living with obesity during the first COVID-19 lockdown in the United Kingdom.","authors":"Friedrich C Jassil, Stuart W Flint, Adrian Brown","doi":"10.1038/s41366-025-01763-z","DOIUrl":"https://doi.org/10.1038/s41366-025-01763-z","url":null,"abstract":"<p><strong>Background: </strong>Quantitative studies have shown that people living with obesity experienced deteriorations in mental health and health-related behaviours during the first UK's Coronavirus Disease-2019 (COVID-19) lockdown. However, there is a lack of qualitative research exploring their lived experiences during this period.</p><p><strong>Methods: </strong>Thematic analysis of large-scale free-text survey data was conducted to understand the challenges faced by adults with obesity during the first UK's COVID-19 lockdown.</p><p><strong>Results: </strong>Among 543 participants, 467 (86%) responded to the free text questions. The majority were female (87.8%), with a mean age of 51.6 (SD 9.9) years. Of these, 65.3% has a body mass index ≥40 kg/m², and 57.7% were not enroled in weight management services. Five overarching themes and 10 sub-themes were identified with the five key themes being (1) increased fear and anxiety, (2) the impact of obesity being classified as 'high risk', (3) disruption in weight management services, (4) the impact on health-related behaviours, and (5) the adverse impact on mental health. Participants expressed fear of contracting COVID-19 and concerns about weight gain. UK Government messages linking obesity with severe COVID-19 complications exacerbated feelings of shame and stigma. The reduced provision of weight management services caused further health concerns, highlighting the need for digital health technologies for continued support. Participants reported changes in shopping, diet, physical activity, and sleep patterns, leading to deteriorated mental health.</p><p><strong>Conclusion: </strong>People living with obesity experienced distinct challenges during the first COVID-19 lockdown, affecting their ability to practice and maintain health-related behaviours.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996881","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":"The effect of aldafermin expressing-Escherichia coli Nissle 1917 along with dietary change on visceral adipose tissue in MASLD mouse model.","authors":"Valeria Iannone, Maija Vaittinen, Carlos Gómez-Gallego, Santtu Mikkonen, Johnson Lok, Giuseppe D'Auria, Ruben Vazquez-Uribe, Ida Tikkanen, Morten Otto Alexander Sommer, Hani El-Nezami, Marjukka Kolehmainen","doi":"10.1038/s41366-025-01774-w","DOIUrl":"https://doi.org/10.1038/s41366-025-01774-w","url":null,"abstract":"<p><strong>Background: </strong>Visceral adipose tissue (VAT) accumulation in obesity has been implicated as a key factor in the development of metabolic dysfunction-associated steatotic liver disease (MASLD). Apart from lifestyle change interventions, there is no effective therapy against MASLD. In this study, the effect of a novel microbial therapy along with dietary change on VAT and VAT-liver crosstalk was evaluated in a MASLD mouse model.</p><p><strong>Methods: </strong>MASLD was induced by feeding eighteen C57BL/6J male mice with the American Lifestyle-Induced Obesity diet for fourteen weeks. Subsequently, during the following seven weeks, all mice were switched to standard diet and the intervention group received single gelatine cubes containing 10⁹ CFU each of aldafermin-expressing Escherichia coli Nissle (EcNA, n = 6); while the control groups received either 10⁹ CFU/gelatine cube of non-modified Escherichia coli Nissle (EcN, n = 6) or gelatin cube with no treatment (CTRL, n = 6). The effect of EcNA on epididymal visceral adipose tissue (eVAT) morphology was evaluated by histology and the gene expression profile in eVAT and liver by RNA-sequencing analysis.</p><p><strong>Results: </strong>After seven weeks of intervention, EcNA, when compared to CTRL group, induced smaller adipocytes (p-value = 0.0217 for diameter, p-value = 0.0386 for area). Gene Set Enrichment Analysis in eVAT showed significant upregulation of fatty acid metabolism (FDR-adjusted p-value = 0.001), oxidative phosphorylation (FDR-adjusted p-value < 2.2e-16), peroxisome (FDR-adjusted p-value = 0.0185), and thermogenesis (FDR-adjusted p-value = 0.0199) pathways when EcNA was compared to EcN group. In addition, the impact of EcNA in eVAT-liver gene expression crosstalk was underlined by the upregulation of Bcl6 and Cnst expression in both tissues when EcNA was compared to CTRL and EcN groups.</p><p><strong>Conclusions: </strong>These results support the beneficial effects of EcNA, along with dietary change intervention, in obesity-associated MASLD. This microbial therapy could potentially boost the improvements induced by dietary change in eVAT metabolism and its crosstalk with the liver.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983498","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":"The association of age of onset of obesity with experienced weight stigma in adulthood.","authors":"Deepali K Ernest, Matthew Cali, Chellse Gazda, Jackson M Francis, Luyu Xie, Jeffrey N Schellinger, M Sunil Mathew, Aparajita Chandrasekhar, Jane Guo, Gloria L Vega, Sarah E Messiah, Jaime P Almandoz","doi":"10.1038/s41366-025-01769-7","DOIUrl":"https://doi.org/10.1038/s41366-025-01769-7","url":null,"abstract":"<p><strong>Background: </strong>Experienced weight stigma (EWS) is linked to adverse physical and mental health outcomes, including maladaptive health behaviors and attenuated weight loss in people with obesity. Limited research is available regarding the association between the age of onset and severity of obesity and lifetime experience of EWS among adults with obesity.</p><p><strong>Methods: </strong>Cross-sectional survey data (n = 686) from a single-site academic obesity medicine program was analyzed, including demographics, anthropometric measures, and the Stigmatizing Situations Inventory (SSI-B). The median SSI-B score was used to dichotomize the EWS outcome variable. Crude associations were assessed by chi-square and logistic regression analyses. Multivariable logistic regression determined age-adjusted odds ratios (aOR) of EWS with body mass index (BMI) at age 18 years and peak BMI.</p><p><strong>Results: </strong>Participants had a mean age of 55.8 years (SD = 12.7), and the majority were female and white. EWS was correlated with BMI at age 18 years (r = 0.38; p = 0.001) and peak BMI (r = 0.48; p = 0.001) before and after adjustment. Those with severe obesity (BMI ≥ 40) by 18 years had 2.79 times higher odds (aOR = 2.79; 95% CI: 1.38, 5.62; p < 0.01) of severe EWS vs. those who developed severe obesity after 18 years; 2.17 higher odds [aOR = 2.17; 95% CI: 1.08, 4.35; p = 0.009] of severe EWS versus those with BMI < 40 at 18 years; 2.98 times higher odds [aOR = 2.98; 95% CI: 1.44, 6.15; p = 0.001] of severe EWS vs. those with BMI < 30 at 18 years; and 4.06 times higher odds [aOR = 4.06; 95% CI: 1.39, 6.73; p = 0.001] of severe EWS vs. those with BMI < 25 at 18 years.</p><p><strong>Conclusion: </strong>Those with severe obesity before the age of 18 years were nearly 3 times more likely to report severe EWS than people who developed severe obesity later in life. Healthcare providers should consider screening for EWS in people with early onset of severe obesity, to identify those who may benefit from weight stigma interventions and support.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000856","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":"Lifestyle instability: an overlooked cause of population obesity?","authors":"Arthur B Daw, Chiara N Hinchcliffe, Lewis J James, James A King","doi":"10.1038/s41366-025-01787-5","DOIUrl":"https://doi.org/10.1038/s41366-025-01787-5","url":null,"abstract":"","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017248","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":"BMI, waist circumference, and waist-to-hip trajectories and all-cause, CVD, and cancer mortality by sex in people without diabetes.","authors":"Zailing Xing, Douglas D Schocken, Janice C Zgibor, Amy C Alman","doi":"10.1038/s41366-025-01778-6","DOIUrl":"https://doi.org/10.1038/s41366-025-01778-6","url":null,"abstract":"<p><strong>Objectives: </strong>We examined the associations of BMI, waist circumference, and waist-to-hip ratio trajectories with mortality in people without diabetes.</p><p><strong>Methods: </strong>We analyzed 7601 people without diabetes from the Atherosclerosis Risk in Communities Study. We used latent class analysis to identify trajectory patterns for BMI, waist circumference, and waist-to-hip. We employed propensity score matching to enhance the balance of covariates and used Cox proportional hazards regression models to examine the associations.</p><p><strong>Results: </strong>In females, the high trajectory of BMI was associated with higher cancer mortality risks than the low group, with the hazard ratio and 95% confidence interval of 1.76 (1.14-2.73). The high waist circumference trajectory was related to increased all-cause, CVD, and cancer mortality risks in males. The moderate and high waist-to-hip ratio trajectories were associated with elevated all-cause and CVD mortality risks in females, and the high trajectory was associated with high all-cause mortality risks in males. The mean lifespan of deceased females did not significantly differ across the trajectories. However, the mean lifespan of males in the waist circumference high group (73.0 years) was shorter than the low group (75.3 years).</p><p><strong>Conclusions: </strong>Sex differences were observed in the long-term impact of high BMI, waist circumference, and waist-to-hip ratio on mortality risks and lifespan in people without diabetes.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009691","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":"The association between the duration and degree of adiposity and appetitive trait trajectory profiles from childhood into early adolescence - results from the Generation XXI cohort.","authors":"Rita Pereira, Joana Araújo, Alexandra Costa, Milton Severo, Andreia Oliveira","doi":"10.1038/s41366-025-01765-x","DOIUrl":"10.1038/s41366-025-01765-x","url":null,"abstract":"<p><strong>Background: </strong>Body weight in childhood may predict appetitive traits. However, studies on the accumulated effect of adiposity and approaches using the clustering of different appetitive traits are lacking.</p><p><strong>Objective: </strong>To test associations between a cumulative measure of adiposity [from 4 to 13 years old (y)] and appetitive trait trajectory profiles (from 7 to 13 y), as well as to explore whether body mass index (BMI) at specific ages is associated with these profiles, independently of the cumulative BMI.</p><p><strong>Methods: </strong>Participants are from the Generation XXI birth cohort (Porto, Portugal) with weight and height measured at 4, 7, 10 and 13 y and complete data in variables of interest (final sample of n = 3339). Age- and sex-specific adjusted BMI standard deviation scores were calculated. The duration and degree of BMI were summarized through the BMI area under the curve (BMI_AUC), as an indicator of accumulated adiposity. Appetitive traits were assessed at 7, 10 and 13 y, using the validated Children's Eating Behaviour Questionnaire. Six previously identified profiles of appetite (groups of individuals with similar patterns of trajectories) were considered: 'moderate appetite' (reference profile), 'small appetite but increasing', 'small to moderate appetite', 'avid appetite', 'increasing appetite' and 'smallest appetite'. Multinomial logistic regressions tested associations between BMI_AUC and profiles.</p><p><strong>Results: </strong>The median monthly exposure to BMI_AUC was 17.4 kg/m². Except for 'increasing appetite', BMI_AUC was associated with all profiles: positively with the 'avid appetite' (OR = 1.47, 95% CI: 1.40-1.55) and negatively with the remaining ones, particularly with 'smallest appetite' (OR = 0.78, 95% CI: 0.73-0.83). Having overweight/obesity at 7 y increased 113% the odds of having an 'avid appetite' profile (OR = 2.13 95% CI: 1.42-3.21).</p><p><strong>Conclusion: </strong>Children with the highest cumulative adiposity between 4 and 13 y were more likely to present an 'avid appetite' during childhood. Additionally, having excessive weight at age 7 may indicate a higher appetite in subsequent years.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803188","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}