International Urology and Nephrology最新文献

{"title":"Mortality trends of renal diseases due to hypertension in adults: an analysis of gender, race, place of death, and geographical disparities in the United States from 1999 to 2020.","authors":"Muhammad Shaheer Bin Faheem, Muhammad Bilal Masood, Aleeza Rehman, Shamikha Cheema, Hafiz Muhammad Kamran Ahmad Mughal, Farhan Ahmed, Muhammad Ahmad Abbasi, Syed Ibrahim Ali, Ibrahim Rashid","doi":"10.1007/s11255-025-04493-3","DOIUrl":"https://doi.org/10.1007/s11255-025-04493-3","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension-related renal diseases remain a significant healthcare concern, particularly in the United States, owing to the higher mortality rate across different demographic groups. This retrospective study aimed to analyze trends in mortality rates of hypertension-related kidney diseases stratified by age, race, gender, urbanization, state, and place of death.</p><p><strong>Methods: </strong>Database of Center of Disease Control and Prevention (CDC) WONDER was used to extract death certificates among adults in US population from 1999 to 2020 using ICD codes. Gender, race, location of death, urbanization, and geographic location per state were used to determine age-adjusted mortality rates (AAMR) per 1,000,000 at a significant level of p < 0.05. Annual percentage changes (APC) and average annual percentage changes (AAPC) were computed using the Joinpoint Regression Program.</p><p><strong>Results: </strong>From 1999 to 2020, about 590,139 were reported among adults with a variable trend having a spike of AAMR from 49.5 in 1999 to 140.2 in 2000 followed by another sudden rise in AAMR from 177.5 in 2010 to a peak of 257.4 (APC: 4.85) in 2012. Then there is notable decline to 46.8 (APC: 46.89) in 2015 and afterward, a steady rise to 77.1 (APC: 16.69) observed in 2020. Overall, males (144.9) had higher AAMRs than females (109.2) throughout the study period with females having more deaths. Among races, African Americans (246.2) had highest AAMR among all followed by Hispanics (124.8), American Alaskans (118.6), Whites (111.4), and lastly Asians (102.9). About half deaths were reported in medical facilities (49.44%) with least reported in hospice (3.29%). The highest AAMRs were observed in non-metropolitan regions (142.2) compared to the large metropolitan (114.1) having lowest AAMR with small metropolitan (129.9) in between. The state of Utah (66.5) was observed lowest AAMR in contrast with the state of North Dakota (191.2) having highest AAMR among all states.</p><p><strong>Conclusion: </strong>Hypertension-related renal diseases were responsible for 590,139 deaths. Males, African American, non-metropolitan areas, and the state of Dakota demonstrated the highest AAMR. Further research is needed to understand the root cause of these disparities.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health literacy, illness perception, and their association with medication adherence in end-stage renal disease.","authors":"Muhammad Amir Hamza, Shahan Ullah, Hina Ahsan, Wajeeha Ali, Mariam Masud, Ali Ahmed","doi":"10.1007/s11255-025-04472-8","DOIUrl":"https://doi.org/10.1007/s11255-025-04472-8","url":null,"abstract":"<p><strong>Background: </strong>Medication non-adherence is a prevalent and complicated problem among patients receiving hemodialysis. Strictly following the prescribed medication regimen is crucial for achieving successful dialysis in end-stage renal disease.</p><p><strong>Objective: </strong>This study aimed to investigate how health literacy and illness perception influence medication adherence in hemodialysis patients.</p><p><strong>Methods: </strong>An observational cross-sectional study was conducted from October 2023 to February 2024 at dialysis units of multisite hospitals across Rawalpindi and Islamabad, Pakistan. A pre-validated, reliable, and interview-based questionnaire was utilized, and a convenience sampling technique was employed to collect data from 390 patients. The Statistical Package for the Social Sciences version 23.0 was utilized for statistical analysis.</p><p><strong>Results: </strong>More than half of the dialysis patients were female, 52.8%, 31% were between the ages of 46-60, and 66.6% had minimal or no education. Of the patients studied, 45.1% exhibited inadequate health literacy, 46.7% held negative perceptions of their illness, and 41.8% demonstrated low levels of medication adherence. The study found a weak correlation: a negative correlation between health literacy and illness perception (r = - 0.080), a positive correlation between health literacy and medication adherence (r = 0.024), and a negative correlation between illness perception and medication adherence (r = -0.061), none of which were statistically significant.</p><p><strong>Conclusion: </strong>A considerable proportion of the patients demonstrate low medication adherence, inadequate health literacy, and negative perceptions of their illness, highlighting the urgent need for targeted interventions. Structured educational programs, motivational interviewing, individual or group support, and in-person or remote (web- or telephone-based) counseling can help address these issues. Additionally, healthcare professionals-led interventions by doctors, pharmacists, and nurses play a crucial role in raising awareness, enhancing medication adherence, and optimizing treatment outcomes.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between daily coffee intake and diabetic kidney disease: evidence from the 2007 to 2016 NHANES.","authors":"Kuohai Xiong, Tianshu Gao","doi":"10.1007/s11255-025-04480-8","DOIUrl":"https://doi.org/10.1007/s11255-025-04480-8","url":null,"abstract":"<p><strong>Purpose: </strong>Regular coffee intake is recognized as a protective factor against various chronic diseases, particularly diabetes. However, the correlation between coffee intake-both the act of drinking coffee and the amount consumed-and diabetic kidney disease (DKD) remains uncertain. The goal of this study is to measure the correlation between coffee intake and DKD.</p><p><strong>Methods: </strong>This cross-sectional study was based on data from the 2007 to 2016 National Health and Nutrition Examination Survey (NHANES). DKD was characterized by the coexistence of diabetes combined with impaired glomerular filtration rate (eGFR < 60 mL/min/1.73 m²) or ACR ≥ 30 mg/g. Weighted logistic regression and restricted cubic spline (RCS) analyses were adopted to evaluate the correlation between coffee intake and DKD. The subgroup analyses were implemented to assess the reliability of the results.</p><p><strong>Results: </strong>The study included 13,177 participants, representing a weighted population of 125,388,198 individuals. Among them, 8198 (64%) participants consumed coffee and 1430 (7.6%) were classified as having DKD. After controlling for covariates, multivariable logistic regression showed a negative correlation between moderate coffee intake and DKD (OR = 0.68; 95% CI: 0.55-0.83; P < 0.001). The RCS analysis suggested a U-shaped, non-linear correlation between coffee intake and DKD (P overall = 0.013; P nonlinear = 0.047). The subgroup analyses further supported the stability and reliability of these findings.</p><p><strong>Conclusion: </strong>The results indicate a U-shaped correlation between coffee intake and diabetic kidney disease.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of L-carnitine supplementation in improving cardiac function of hemodialysis patients: a systematic review and meta-analysis.","authors":"Rayyan Nabi, Hanzala Ahmed Farooqi, Sabahat Ul Ain Munir Abbasi, Najaf Ahmed Rajpar, Aqsa Munir, Hamza Bin Ahmed, Uzair Iqbal, Tabeer Zahid, Zahid Nabi","doi":"10.1007/s11255-025-04478-2","DOIUrl":"https://doi.org/10.1007/s11255-025-04478-2","url":null,"abstract":"<p><strong>Purpose: </strong>Heart failure is a significant complication among patients undergoing hemodialysis, often associated with left ventricular hypertrophy and dysfunction. L-carnitine, crucial for fatty acid metabolism, has shown promise in improving cardiac function. This systematic review and meta-analysis aim to evaluate the safety and efficacy of L-carnitine supplementation in improving cardiac function in hemodialysis patients.</p><p><strong>Methodology: </strong>A comprehensive search of PubMed, Cochrane, and EMBASE was conducted up to October 3, 2024, to identify relevant studies. The trials assessing the effects of L-carnitine on echocardiographic parameters such as left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), and diastolic function were included. A random-effects model was applied to pool data, and heterogeneity was assessed using the I² statistic.</p><p><strong>Results: </strong>A total of 23 studies were included in the systematic review, with 7 studies involving 426 participants being meta-analyzed. L-carnitine supplementation significantly improved LVEF (MD = 1.64, 95% CI 0.10-3.17, p = 0.04), with low heterogeneity (I² = 37%). However, no significant changes were observed for LVMI (MD = -3.19, p = 0.60) or diastolic markers (E/A ratio MD = -0.13, p = 0.47; E/e ratio MD = -0.35, p = 0.67).</p><p><strong>Conclusion: </strong>L-carnitine supplementation significantly improves cardiac function, particularly systolic function (LVEF) in hemodialysis patients. However, its effects on LVMI and markers of diastolic function are inconclusive. Future large-scale trials are warranted to further elucidate its role in cardiac function among this population.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty and surgical outcomes in genitourinary prosthetic procedures: an ACS-NSQIP comparative analysis of risk indices.","authors":"Umar Ghaffar, Behzad Abbasi, Nizar Hakam, Adrian Fernandez, Marvin N Carlisle, Robert Pearce, Hiren V Patel, Kevin D Li, Nikit Venishetty, Benjamin N Breyer","doi":"10.1007/s11255-025-04484-4","DOIUrl":"https://doi.org/10.1007/s11255-025-04484-4","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the association between frailty and surgical outcomes using frailty indices and to assess tool performance. Genitourinary prosthetics, including artificial urinary sphincter (AUS), urethral sling, and penile prosthesis, are standard therapeutic interventions but are susceptible to complications. These procedures are often performed on older, frail patients, necessitating a deeper understanding of the relationship between frailty and postoperative morbidity.</p><p><strong>Methods: </strong>We utilized data from the NSQIP database (2011-2020) to identify patients undergoing urologic prosthetic procedures, including artificial urinary sphincter, sling, and penile prosthesis. Frailty was assessed using the modified frailty index-5 (mFI-5), the Risk Analysis Index (RAI-A) and ASA Class. Primary outcomes focused on 30-day postoperative morbidity, with secondary outcomes including mortality, length of stay, discharge disposition, readmissions, and reoperations. Logistic and linear regression models were constructed, adjusting for relevant clinical variables, and ROC curve plotted to compare the predictive abilities of mFI-5, RAI-A, and ASA classification.</p><p><strong>Results: </strong>We identified 4,734 patients who underwent AUS, sling, or penile prosthesis surgeries. Frailty, as measured by RAI-A (OR 2.05, 95% CI 1.59-2.65, p < 0.001) and ASA Class (OR 1.55, 95% CI 1.19-2.01, p = 0.001), was significantly associated with postoperative morbidity, while mFI-5 was not. Cardiovascular complications and discharge to continued care were associated with all tools. ROC curve analysis showed that RAI-A had significantly greater predictive ability for postoperative morbidity than mFI-5 (p = 0.023).</p><p><strong>Conclusions: </strong>RAI-A and ASA are more effective than the mFI-5 in predicting postoperative morbidity, mortality, and other adverse outcomes in patients undergoing urologic prosthetic surgeries.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between elevated serum parathyroid hormone and QTc interval prolongation in chronic kidney disease patients.","authors":"Yanan Wang, Qing Li, Gang Xu, Yi Yang, Fan He","doi":"10.1007/s11255-025-04479-1","DOIUrl":"https://doi.org/10.1007/s11255-025-04479-1","url":null,"abstract":"<p><strong>Purpose: </strong>Heart rate-corrected (QTc) interval prolongation is frequently linked to fatal arrhythmias and sudden cardiac death in chronic kidney disease (CKD) patients. In this cross-sectional study, we assessed the prevalence of prolonged QTc intervals and identified clinical factors associated with them across different stages of kidney failure.</p><p><strong>Methods: </strong>723 patients with CKD stages 2-5 who had electrocardiogram records available were analyzed retrospectively. QTc intervals were calculated by correcting the QT intervals for all patients included in the study. QTc interval prolongation defined as a QTc interval ˃ 440 ms was assessed for its prevalence and its association with various clinical factors.</p><p><strong>Results: </strong>A total of 723 patients with CKD stages 2-5 were finally included in this study, among which 420 (58.1%) were male. The average age of the participants was 48.2 ± 14.6 years old. In patients with CKD stages 2-4, the prevalence of QTc interval prolongation was 26%, 24.1%, and 37.8%, respectively. Among patients with CKD stage 5, those not on dialysis had a prevalence of 63%, while those undergoing dialysis had a prevalence of 74.3%. Multivariate logistic regression analysis revealed that elevated levels of parathyroid hormone (PTH) were significantly associated with an increased risk of QTc intervals prolongation in CKD patients (aOR = 1.384, 95% CI 1.173-1.632; P < 0.001). This suggests that higher PTH levels may contribute to QTc interval prolongation in this population. The patients were then grouped by CKD stages. Elevated PTH levels were independently associated with an increased risk of QTc interval prolongation specifically in CKD stages 4 and 5 patients who were not on dialysis. After adjusting for potential confounders, this association remained significant (CKD stage 4: aOR = 2.571, 95% CI 1.030-6.416; P < 0.001; CKD stage 5, non-dialysis: aOR = 1.333, 95% CI 1.063-1.671; P < 0.001).</p><p><strong>Conclusion: </strong>In patients with CKD, the prevalence of QTc prolongation increases with advancing CKD stages. Specially, among patients with CKD stage 4 and stage 5 who were not on dialysis, elevated PTH levels were independently associated with an increased risk of QTc interval prolongation.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Integrating biomarker clustering for improved diagnosis of interstitial cystitis/bladder pain syndrome: a review.","authors":"Yu-Chen Chen, Hann-Chorng Kuo","doi":"10.1007/s11255-025-04492-4","DOIUrl":"https://doi.org/10.1007/s11255-025-04492-4","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"E -cigarettes and kidney health: current knowledge and future perspectives.","authors":"Susanne M Lang, Julia Hoffmann, Helmut Schiffl","doi":"10.1007/s11255-024-04278-0","DOIUrl":"10.1007/s11255-024-04278-0","url":null,"abstract":"<p><strong>Background: </strong>Chronic conventional cigarette smoking has been closely linked to incident chronic kidney disease (CKD) in the general population. It is associated with the acceleration of pre-existing CKD and failure of kidney allograft function. Cessation of conventional cigarette smoking is effective in reducing the increased risk of smoking induced kidney damage.</p><p><strong>Methods: </strong>This narrative review summarizes current knowledge and future study perspectives of the impact of e-cigarettes (e-cigs) use on kidney health.</p><p><strong>Results: </strong>The past decade has seen a dramatic increase in the use of electronic nicotine delivering systems, also called e-cigs. Compared to conventional cigarette smoking, little is known concerning the effects of e-cigs use on kidney health. A few cross-sectional studies suggest an association between vaping and kidney damage (albuminuria, reduction in estimated glomerular filtration rate) in adolescents and young adults. Furthermore, limited animal experiments indicate that e-cigs constituents/aerosols may lead to structural and functional kidney damage. The renal health effects of e-cigs remain largely uncertain and make it difficult to draw definitive conclusions about e-cigs use and kidney health. The relatively new popularity of e-cigs, the wide variability in device design and e-liquid formulations, and the lack of standardized methods to measure daily or life-long e-cigs exposure make it challenging to conduct comprehensive long-term studies.</p><p><strong>Conclusions: </strong>Nephrologists should actively address smoking habits in their patients and urge cessation of conventional cigarette smoking as well as e-cigs use to prevent CKD progression and improve overall health.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1199-1205"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and reproducibility are essential in imaging-based size assessment of renal masses: comment on-\"Renal mass imaging modalities: does body mass index (BMI) matter?\"","authors":"Jens Borgbjerg, Marte Leland-Try, Ole Graumann, Tommy Kjærgaard Nielsen, Stig Müller","doi":"10.1007/s11255-024-04237-9","DOIUrl":"10.1007/s11255-024-04237-9","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1351-1352"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a correlation between TMAO plasma levels and archaea in the gut of patients undergoing hemodialysis?","authors":"Julie Ann Kemp, Júnia Schultz, Fluvio Modolon, Marcelo Ribeiro-Alves, Alexandre S Rosado, Denise Mafra","doi":"10.1007/s11255-024-04273-5","DOIUrl":"10.1007/s11255-024-04273-5","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with chronic kidney disease (CKD) present high plasma levels of trimethylamine N-oxide (TMAO), a uremic toxin produced by gut microbiota associated with atherogenesis. Experimental studies have shown that certain methanogenic archaea members use trimethylamine (TMA), the TMAO precursor in the human gut, to produce methane, suggesting a potential strategy to reduce TMAO levels in patients with CKD. Hence, this study aimed to evaluate the association of Archaea in the gut microbiota and TMAO plasma levels in patients with CKD undergoing hemodialysis.</p><p><strong>Methods: </strong>Twenty-five patients were enrolled in the study (15 women, 53 (18) years, BMI, 25.8 (6.75) kg/m²). TMAO plasma levels were evaluated using the HPLC-EM/EM method. Fecal DNA was extracted using a commercial kit. Subsequently, we sequenced the V4 region of the 16S rRNA gene to characterize the microbial composition. NCT04600258 was retrospectively registered in September 2022.</p><p><strong>Results: </strong>According to the reference values in the European Uremic Toxins Work Group (EUTox) database, the patients exhibited high TMAO plasma levels, as expected. The most abundant Archaea members were assigned to the Euryarchaeota phylum, the Methanobacteriaceae family, and the genus Methanobrevibacter. A significant negative correlation between TMAO and Methanobrevibacter was observed.</p><p><strong>Conclusions: </strong>To our knowledge, this study represents the first investigation into the correlation between TMAO levels and the prevalence of Archaea in patients with CKD. Our findings support the archaebiotic hypothesis, suggesting that specific members of the archaea community could play a crucial role in reducing TMA production in the human gut, potentially decreasing TMAO synthesis in CKD patients.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1269-1275"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}