JAMA ophthalmology最新文献

{"title":"Synchysis Scintillans After Long-Standing History of Retinal Detachment.","authors":"Zuyi Yang,Youxin Chen,Xinyu Zhao","doi":"10.1001/jamaophthalmol.2024.2945","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.2945","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"35 1","pages":"e242945"},"PeriodicalIF":8.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Risk of Depressive Disorder in Patients With Retinitis Pigmentosa","authors":"Hae Rang Kim, Nang Kyeong Lee, Youngsong Suh, Christopher Seungkyu Lee, Suk Ho Byeon, Sung Soo Kim, Seung Won Lee, Yong Joon Kim","doi":"10.1001/jamaophthalmol.2024.3641","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.3641","url":null,"abstract":"ImportanceThere is a lack of large-scale clinical studies exploring mental health among patients with retinitis pigmentosa (RP). Additionally, few studies have evaluated the associations of visual impairment with mental health in young patients.ObjectiveTo investigate the association between depressive disorder and RP.Design, Setting, and ParticipantsThis was a retrospective, nationwide, population-based cohort study using data obtained from the Health Insurance Review and Assessment service in Korea between 2008 and 2022. A total of 10 879 individuals who were newly diagnosed with RP between January 2011 and December 2021, as verified by both the RP registration code (National Registry of Rare and Intractable Disease in Korea code V209) and diagnostic code (<jats:italic>International Statistical Classification of Diseases, 10th Revision</jats:italic> code H35.51), were included. Data analysis was performed from October 2023 to January 2024.ExposureDiagnosis of RP.Main Outcomes and MeasuresParticipants were categorized into 3 groups based on age at diagnosis (<20, 20-39, and ≥40 years). The incidence of depressive disorder in RP was determined after excluding those diagnosed with depressive disorder prior to RP diagnosis. Age- and sex-adjusted standardized incidence ratios (SIRs) of depressive disorder in patients with RP compared with the general population were calculated. Subgroup analyses by sex and age group were conducted.ResultsA total of 10 879 patients (638 aged <20 years, 2233 aged 20-39 years, and 8008 aged ≥40 years; 5710 [52.5%] female) newly diagnosed with RP between 2011 and 2021 were included. The 10-year cumulative incidence of depressive disorder was 17.67% (95% CI, 16.57%-18.84%) in patients with RP. Subgroup analysis showed higher incidence of depressive disorder in female patients (hazard ratio [HR], 1.46; 95% CI, 1.29-1.65; <jats:italic>P</jats:italic> < .001) and those aged 40 years or older (HR, 1.93; 95% CI, 1.63-2.29; <jats:italic>P</jats:italic> < .001). The overall SIR of depressive disorder in patients with RP was 1.19 (95% CI, 1.12-1.27; <jats:italic>P</jats:italic> < .001), indicating a higher risk of depressive disorder compared with that in the general population. Both male and female patients with RP showed increased incidence rates of depressive disorder (17.53 [95% CI, 15.91-19.27] and 25.57 [95% CI, 23.58-27.67] per 1000 person-years, respectively) and increased SIRs of depressive disorder (1.21 [95% CI, 1.10-1.33] and 1.18 [95% CI, 1.09-1.28], respectively) (all <jats:italic>P</jats:italic> < .001) compared with the general population. Subgroup analysis by age group showed that the SIR peaked in patients in their 20s (1.50; 95% CI, 1.17-1.90; <jats:italic>P</jats:italic> = .006) and aged 60 years or older (1.25; 95% CI, 1.14-1.37; <jats:italic>P</jats:italic> < .001).Conclusions and RelevanceIndividuals diagnosed with RP had a higher","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"23 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142275594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aflibercept Biosimilar MYL-1701P vs Reference Aflibercept in Diabetic Macular Edema: The INSIGHT Randomized Clinical Trial.","authors":"Susan B Bressler,Abhijit Barve,Prasanna C Ganapathi,Katrin Beckmann,Rajendra S Apte,Dennis M Marcus,Kristine Baumane,Somesh Agarwal,Piotr Oleksy,David A Reichstein,Sunil S Patel,Jan Ernest,Rozsa Dégi,Vishali Gupta,Genichiro Kishino,Motohiro Kamei,Subramanian Loganathan,","doi":"10.1001/jamaophthalmol.2024.3458","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.3458","url":null,"abstract":"ImportanceBiosimilars may be lower-cost alternatives to originator biologic products, potentially offering expanded access or reduced economic burden, but have not been evaluated with aflibercept in diabetic macular edema (DME).ObjectiveTo compare efficacy and safety of MYL-1701P, an aflibercept biosimilar, with reference aflibercept (Eylea [Regeneron]) in DME.Design, Setting, and ParticipantsThis was a double-masked, randomized clinical trial that included participants at 77 centers across the US, Europe, Japan, and India. Included in the analysis were individuals 18 years and older with type 1 or type 2 diabetes with central DME and best-corrected visual acuity (BCVA) letter score of 73 to 38 in the study eye using an Early Treatment Diabetic Retinopathy Study (ETDRS) chart. Study data were analyzed from October to December 2021.InterventionsFormulations of MYL-1701P (0.5-mg vial) or reference aflibercept every 4 weeks for 5 consecutive intravitreal injections, followed by every 8 weeks through week 52.Main Outcomes and MeasuresThe primary outcome was the adjusted difference in least squares mean (SE) change from baseline BCVA letter score at week 8 with an equivalence margin of -3 to +3 letters. Secondary outcomes included change in central subfield thickness (CST), BCVA, number of injections over 52 weeks, incidence of adverse events (AEs), and antidrug antibodies (ADAs).ResultsA total of 355 participants (mean [SD] age, 62.2 [9.2] years; 216 male [60.8%]) were randomized to MYL-1701P (179 participants [50.4%]) and aflibercept (176 participants [49.6%]). At week 8, mean (SE) change in BCVA was 6.60 (0.55) letters vs 6.56 (0.55) letters in the MYL-1701P vs aflibercept groups. The adjusted mean difference of 0.04 letters (90% CI, -1.16 to 1.24 letters) met the primary outcome. At week 8, mean (SE) change in CST was -112 (7) μm vs -124 (7) μm in the MYL-1701P vs aflibercept groups (adjusted mean difference, 12 μm; 90% CI, -3 to 26 μm). The incidence of treatment-emergent AEs in the MYL-1701P and aflibercept arms were ocular (30.9% [55 of 178] vs 29.5% [52 of 176]), serious ocular (0.6% [1 of 178] vs 1.1% [2 of 176]), nonocular (65.2% [116 of 178] vs 65.3% [115 of 176]), and serious nonocular (16.9% [30 of 178] vs 11.9% [21 of 176]). The mean (SD) total number of injections was 8.4 (2.1) vs 8.7 (1.8) in the MYL-1701P vs aflibercept groups. The incidence of treatment-induced or treatment-boosted ADAs was 2.8% (5 of 177) vs 5.7% (10 of 176) in the MYL-1701P vs aflibercept arms.Conclusions and RelevanceMYL-1701P demonstrated clinical equivalence in regard to efficacy, with comparable safety and immunogenicity, to reference aflibercept. These findings support use of MLY-1701P as an alternative to reference aflibercept.Trial RegistrationClinicalTrials.gov Identifier: NCT03610646.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"13 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Race, Social Determinants of Health, and the Quality of Diabetic Eye Care.","authors":"Azraa S Chaudhury,Maryam Ige,Shikha Marwah,Xueqing Zhou,Chris A Andrews,Kunal Kanwar,Charlesnika T Evans,Abel N Kho,Joshua D Stein,Paul J Bryar,Dustin D French,","doi":"10.1001/jamaophthalmol.2024.3528","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.3528","url":null,"abstract":"ImportanceBesides race, little is known about how other social determinants of health (SDOH) affect quality of diabetic eye care.ObjectiveTo evaluate the association between multiple SDOH and monitoring for diabetic retinopathy (DR) in accordance with clinical practice guidelines (CPGs).Design, Setting, and ParticipantsThis cohort study was conducted in 11 US medical centers and included adult patients (18-75 years old) with diabetes. Patients received care from 2012 to 2023 and had 18 months or more of follow-up.ExposuresMultiple SDOH and associated factors, including ethnicity, urbanicity of residence, health insurance type, and diabetes type.Main Outcomes and MeasuresAdjusted odds ratio (aOR) of receiving 1 or more eye-care visits and 1 or more dilated fundus examinations in accordance with CPGs.ResultsThe study cohort included 37 397 adults with diabetes: 10 157 Black patients and 27 240 White patients. The mean (SD) age was 58 (11) years for Black patients and 59 (11) years for White patients. Of the Black patients, 6422 (63.2%) were female and 3735 (36.8%) male; of the White patients, 13 120 (48.1) were female and 14 120 (51.8) were male. Compared with those of the same race in urban communities, Black patients (aOR, 0.12; 95% CI, 0.04-0.31) and White patients (aOR, 0.75; 95% CI, 0.62-0.91) with diabetes living in rural communities had 88% and 25% lower odds of having eye-care visits, respectively. Sicker Black and White patients, defined by the Charlson Comorbidity Index, had 4% (aOR, 1.04; 95% CI, 1.02-1.06) and 5% (aOR, 1.05, CI 1.04-1.06) higher odds of having an eye-care visit, respectively. Black patients with preexisting DR had 15% lower odds of visits (aOR, 0.85, CI 0.73-0.99) compared with those without preexisting DR while White patients with preexisting DR had 16% higher odds of eye-care visits (aOR, 1.16; 95% CI, 1.05-1.28). White patients with Medicare (aOR, 0.85; 95% CI, 0.80-0.91) and Medicaid (aOR, 0.81; 95% CI, 0.68-0.96) had lower odds of eye-care visits vs patients with commercial health insurance. Hispanic White patients had 15% lower odds of eye-care visits (aOR, 0.85; 95% CI, 0.74-0.98) vs non-Hispanic White patients. White patients with type 1 diabetes had 17% lower odds of eye-care visits (aOR, 0.83; 95% CI, 0.76-0.90) vs those with type 2 diabetes. Among patients who had eye-care visits, those with preexisting DR (Black: aOR, 1.68; 95% CI, 1.11-2.53; White: aOR, 1.51; 95% CI, 1.16-1.96) were more likely to undergo dilated fundus examinations.Conclusions and RelevanceThis study found that certain SDOH affected monitoring for DR similarly for Black and White patients with diabetes while others affected them differently. Patients living in rural communities, Black patients with preexisting DR, and Hispanic White patients were not receiving eye care in accordance with CPGs, which may contribute to worse outcomes.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"21 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic Determinants in Diabetic Retinopathy Screening.","authors":"Asadolah Movahedan,Keith J Wroblewski","doi":"10.1001/jamaophthalmol.2024.3709","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.3709","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"106 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinopathy Associated With Hair Dye","authors":"Nicolas Chirpaz, Marion Bricout, Sandra Elbany, Olivier Loria, Antonin Rocher, Carole Burillon, Corinne Dot","doi":"10.1001/jamaophthalmol.2024.3453","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.3453","url":null,"abstract":"This case report describes a woman who presented with bilateral blurry vision a few days after dyeing her hair with hair dye containing aromatic amines.","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"105 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142174959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Evaluation of a Retrieval-Augmented Large Language Model Framework for Ophthalmology.","authors":"Ming-Jie Luo, Jianyu Pang, Shaowei Bi, Yunxi Lai, Jiaman Zhao, Yuanrui Shang, Tingxin Cui, Yahan Yang, Zhenzhe Lin, Lanqin Zhao, Xiaohang Wu, Duoru Lin, Jingjing Chen, Haotian Lin","doi":"10.1001/jamaophthalmol.2024.2513","DOIUrl":"10.1001/jamaophthalmol.2024.2513","url":null,"abstract":"<p><strong>Importance: </strong>Although augmenting large language models (LLMs) with knowledge bases may improve medical domain-specific performance, practical methods are needed for local implementation of LLMs that address privacy concerns and enhance accessibility for health care professionals.</p><p><strong>Objective: </strong>To develop an accurate, cost-effective local implementation of an LLM to mitigate privacy concerns and support their practical deployment in health care settings.</p><p><strong>Design, setting, and participants: </strong>ChatZOC (Sun Yat-Sen University Zhongshan Ophthalmology Center), a retrieval-augmented LLM framework, was developed by enhancing a baseline LLM with a comprehensive ophthalmic dataset and evaluation framework (CODE), which includes over 30 000 pieces of ophthalmic knowledge. This LLM was benchmarked against 10 representative LLMs, including GPT-4 and GPT-3.5 Turbo (OpenAI), across 300 clinical questions in ophthalmology. The evaluation, involving a panel of medical experts and biomedical researchers, focused on accuracy, utility, and safety. A double-masked approach was used to try to minimize bias assessment across all models. The study used a comprehensive knowledge base derived from ophthalmic clinical practice, without directly involving clinical patients.</p><p><strong>Exposures: </strong>LLM response to clinical questions.</p><p><strong>Main outcomes and measures: </strong>Accuracy, utility, and safety of LLMs in responding to clinical questions.</p><p><strong>Results: </strong>The baseline model achieved a human ranking score of 0.48. The retrieval-augmented LLM had a score of 0.60, a difference of 0.12 (95% CI, 0.02-0.22; P = .02) from baseline and not different from GPT-4 with a score of 0.61 (difference = 0.01; 95% CI, -0.11 to 0.13; P = .89). For scientific consensus, the retrieval-augmented LLM was 84.0% compared with the baseline model of 46.5% (difference = 37.5%; 95% CI, 29.0%-46.0%; P < .001) and not different from GPT-4 with a value of 79.2% (difference = 4.8%; 95% CI, -0.3% to 10.0%; P = .06).</p><p><strong>Conclusions and relevance: </strong>Results of this quality improvement study suggest that the integration of high-quality knowledge bases improved the LLM's performance in medical domains. This study highlights the transformative potential of augmented LLMs in clinical practice by providing reliable, safe, and practical clinical information. Further research is needed to explore the broader application of such frameworks in the real world.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"798-805"},"PeriodicalIF":7.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11258636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Bilateral Periorbital Edema in a Psychiatric Patient.","authors":"Kaela N Acuff, George A Villatoro, Sally L Baxter","doi":"10.1001/jamaophthalmol.2024.2815","DOIUrl":"10.1001/jamaophthalmol.2024.2815","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"880-881"},"PeriodicalIF":7.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endophthalmitis Rates and Types of Treatments After Intraocular Procedures.","authors":"Brian L VanderBeek, Yineng Chen, Maurizio Tomaiuolo, Jordan D Deaner, Zeba A Syed, Binod Acharya, Qiang Zhang, Joel S Schuman, Leslie Hyman","doi":"10.1001/jamaophthalmol.2024.2749","DOIUrl":"10.1001/jamaophthalmol.2024.2749","url":null,"abstract":"<p><strong>Importance: </strong>Long-term trend analyses of overall endophthalmitis rates and treatment patterns are scarce. It is also unknown if the deviation from the recommendations of the Endophthalmitis Vitrectomy Study toward decreased utilization of vitrectomy is associated with different vision outcomes.</p><p><strong>Objective: </strong>To determine whether the rate of endophthalmitis after intraocular procedures or the primary treatment (prompt vitrectomy vs tap and inject) for endophthalmitis has changed over the past 20 years.</p><p><strong>Design, setting, and participants: </strong>This cohort study examined data for cohorts created by querying for different intraocular procedures, including intravitreal injections and surgeries for cataract removal, glaucoma, retinal conditions, and corneal transplants from 2000 to 2022. The data source was a US administrative medical claims database comprising commercial and Medicare Advantage insurance plans. Any intraocular procedure with at least 6 months of data available before and 6 weeks after the procedure was eligible. Exclusion criteria consisted of any previous diagnosis of endophthalmitis or another intraocular procedure during the follow-up period.</p><p><strong>Main outcome measure: </strong>The main outcomes were rate of postprocedure endophthalmitis and relative rate of prompt vitrectomy (vs tap and inject) as the primary method of treatment.</p><p><strong>Results: </strong>Among 2 124 964 patients, the mean (SD) age was 71.4 (10.2) years; 1 230 320 were female and 894 414 male. Over 22 years, 5 827 809 intraocular procedures were analyzed with 4305 cases of endophthalmitis found for an overall endophthalmitis rate of 0.07%. The yearly rate of endophthalmitis varied but generally declined from a high of 7 cases per 3502 procedures (0.20%) in 2000 to a low of 163 cases per 332 159 procedures (0.05%) in 2022. The percentage of cases treated with prompt vitrectomy also varied but generally declined over time with a high of 17 of 35 (48.6%) in 2003 and a low of 60 of 515 (11.6%) in 2021. Multivariable analysis of the endophthalmitis incidence rate ratio (IRR) showed a per-year decrease of 2.7% (IRR, 0.97; 95% CI, 0.97-0.98; P < .001) over the study period. A similar analysis also showed that the incidence rate of prompt surgical treatment decreased by 3.8% per year throughout the study period (IRR, 0.96; 95% CI, 0.95-0.97; P < .001).</p><p><strong>Conclusions and relevance: </strong>This study found that the incidence of endophthalmitis following intraocular procedures appears to have decreased substantially over the past 20 years while prompt vitrectomy is being used less frequently as primary treatment than in the past.</p>","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":" ","pages":"827-834"},"PeriodicalIF":7.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-Time Visualization of a Transient Retinal Embolus.","authors":"Jakob Bjerager, Morten Jørgensen, Steffen Hamann","doi":"10.1001/jamaophthalmol.2024.2946","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2024.2946","url":null,"abstract":"","PeriodicalId":14518,"journal":{"name":"JAMA ophthalmology","volume":"142 9","pages":"e242946"},"PeriodicalIF":7.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}