JAMA otolaryngology-- head & neck surgery最新文献

{"title":"Social Determinants of Health and Language and Academic Outcomes in Pediatric Cochlear Implantation: A Systematic Review and Meta-Analysis.","authors":"Lauren Mueller, Dean Adkins, Allison Kao, Marie-Ange Munyemana, Dorina Kallogjeri, Judith E Lieu","doi":"10.1001/jamaoto.2024.3564","DOIUrl":"10.1001/jamaoto.2024.3564","url":null,"abstract":"<p><strong>Importance: </strong>Cochlear implants can restore sound and enable speech and language development for children with severe to profound sensorineural hearing loss. Long-term outcomes of pediatric cochlear implant recipients are variable. Although the association between social determinants of health (SDH) and pediatric cochlear implant outcomes has been explored, the strength of this association has not been quantitatively synthesized in the literature.</p><p><strong>Objective: </strong>To determine the association of SDH with language and academic outcomes in pediatric cochlear implant recipients.</p><p><strong>Data sources: </strong>In August 2023, the following databases were searched: Embase.com, Ovid MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, Cumulated Index to Nursing and Allied Health Literature Plus, APA PsycINFO, and ClinicalTrials.gov. Following duplicate exclusion of 8687 results, 5326 records were finalized.</p><p><strong>Study selection: </strong>Abstract screening, full-text review, and risk of bias assessment was performed by 1 to 2 reviewers. Articles were included if an effect size for an SDH variable that was associated with measures of language, communication, reading, academics, and quality of life was reported.</p><p><strong>Main outcomes and measures: </strong>A random-effects meta-analysis was performed, with standardized regression coefficients measuring the relative direction and magnitude of a variable association with the outcome of interest.</p><p><strong>Results: </strong>Of 5326 articles, 40 articles that included a total of 3809 children were included in the systematic review; 20 articles that included a total of 1905 children were included in the meta-analysis. Parental involvement, education level, and low socioeconomic status were moderately to strongly associated with language outcomes (β = 0.30; 95% CI, 0.13-0.48; β = 0.45; 95% CI, 0.29-0.62; β = -0.47; 95% CI, -0.83 to -0.10, respectively). Known determinants of language outcomes, such as the age of cochlear implantation and duration of cochlear implant use, demonstrated moderate to no associations with language outcomes (β = -0.30; 95% CI, -0.43 to -0.17; β = 0.19; 95% CI, -0.26 to 0.63, respectively).</p><p><strong>Conclusions and relevance: </strong>The results of this systematic review and meta-analysis suggest that SDH are associated with childhood language development and academic achievement. In addition to efforts to expedite cochlear implant placement in eligible children, optimal outcomes may be achieved with interventions centered on the child's home, primary medical care, and school environment.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"29-38"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620858","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":"Erratum: Error in Figure 1.","authors":"","doi":"10.1001/jamaoto.2024.4232","DOIUrl":"10.1001/jamaoto.2024.4232","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1001/jamaoto.2024.2270.].</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"88"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604461","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":"JAMA Otolaryngology-Head & Neck Surgery.","authors":"","doi":"10.1001/jamaoto.2024.3425","DOIUrl":"https://doi.org/10.1001/jamaoto.2024.3425","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":"151 1","pages":"4"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949055","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":"Vitamin D Deficiency and Pediatric Obstructive Sleep Apnea Severity.","authors":"Andrew E Bluher, Timothy Kearney, Turaj Vazifedan, Cristina M Baldassari","doi":"10.1001/jamaoto.2024.3737","DOIUrl":"10.1001/jamaoto.2024.3737","url":null,"abstract":"<p><strong>Importance: </strong>Prior research has demonstrated an association between vitamin D deficiency and obstructive sleep apnea (OSA) in adults; however, its association with pediatric OSA is emerging.</p><p><strong>Objective: </strong>To evaluate the association of vitamin D levels with obstructive Apnea-Hypopnea Index (AHI) in children with OSA.</p><p><strong>Design, settings, and participants: </strong>This was a cross-sectional study of children aged 2 to 16 years with severe obstructive OSA (AHI ≥20 on polysomnogram) who were undergoing adenotonsillectomy at a tertiary care pediatric otolaryngology clinic from 2017 to 2022. Age, sex, race, body mass index, history of asthma, and season were considered in the analyses. Data were analyzed from September 3, 2021, to October 8, 2021.</p><p><strong>Main outcomes and measures: </strong>Serum 25-hydroxyvitamin D (25[OH]D) levels were measured and assessed for correlation with polysomnography metrics. Fasting blood samples were collected and vitamin D deficiency was defined as 25(OH)D level less than 20 ng/mL.</p><p><strong>Results: </strong>The consecutive sample included 72 patients (mean [SD] age, 6.7 [3.9] years; 34 [47.2%] females and 38 [52.8%] males). The mean (SD) AHI was 42.8 (25.5), and 35 participants (49.0%) had obesity. Vitamin D deficiency was present in 27 participants (37.5%). In univariate analysis, vitamin D deficiency was associated with younger age (difference, -5.0; 95% CI, -7.2 to -2.8), Black race (odds ratio [OR], 4.3; 95% CI, 1.4 to 14.3), female sex (OR, 4.8; 95% CI, 1.7 to 12.5), and higher obstructive AHI (difference, 13.8; 95% CI, 1.2 to 26.4). In multivariable analysis, vitamin D deficiency remained significantly associated with AHI. A 1.0-unit decrease in serum 25(OH)D levels was associated with an AHI increase of 0.7 (95% CI, 0.04 to 1.40).</p><p><strong>Conclusions: </strong>The findings of this cross-sectional study indicate that vitamin D deficiency was common in children undergoing adenotonsillectomy for severe OSA and is significantly associated with increased OSA severity. Future research is needed on vitamin D supplementation and its association with any improvements in pediatric OSA treatment outcomes.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"72-77"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545496","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":"Head and Neck Cancer Mortality in the Appalachian Region.","authors":"Todd Burus, Pamela C Hull, Krystle A Lang Kuhs","doi":"10.1001/jamaoto.2024.4514","DOIUrl":"https://doi.org/10.1001/jamaoto.2024.4514","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894756","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":"Shedding Light on How to Use Intraoperative Measurement of Parathyroid Hormone-Sunny Miami.","authors":"Martin Almquist","doi":"10.1001/jamaoto.2024.4454","DOIUrl":"https://doi.org/10.1001/jamaoto.2024.4454","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894758","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":"The End of Medicare Telehealth Coverage for Audiology.","authors":"Peter R Dixon, Elizabeth Camposeo, Theodore R McRackan","doi":"10.1001/jamaoto.2024.4572","DOIUrl":"https://doi.org/10.1001/jamaoto.2024.4572","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893713","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":"Intraoperative Parathyroid Hormone Monitoring Criteria in Primary Hyperparathyroidism: A Network Meta-Analysis of Diagnostic Test Accuracy.","authors":"Phillip Staibano, Michael Au, Han Zhang, Sheila Yu, Winnie Liu, Jesse D Pasternak, Xing Xing, Carolyn D Seib, Lisa Orloff, Nhu-Tram Nguyen, Michael K Gupta, Eric Monteiro, Sameer Parpia, Tyler McKechnie, Alex Thabane, J E M Ted Young, Mohit Bhandari","doi":"10.1001/jamaoto.2024.4453","DOIUrl":"10.1001/jamaoto.2024.4453","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Intraoperative parathyroid hormone (IOPTH) monitoring is recommended by the American Association of Endocrine Surgeons for use during parathyroidectomy for patients with primary hyperparathyroidism (PHPT), but there is no clinician consensus regarding the IOPTH monitoring criteria that optimize diagnostic accuracy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate and rank the diagnostic properties of IOPTH monitoring criteria used during surgery for patients with PHPT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;A bayesian diagnostic test accuracy network meta-analysis (DTA-NMA) was performed, in which peer-reviewed citations from January 1, 1990, to July 22, 2023, were searched for in MEDLINE, Embase, Web of Science, CENTRAL, and CINAHL.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study selection: &lt;/strong&gt;All full-text study designs that evaluated any IOPTH monitoring criteria as a diagnostic test were included in this meta-analysis. Any studies evaluating adult patients diagnosed with PHPT undergoing parathyroidectomy were also included. The reference standard used in this study was normalization of calcium and/or parathyroid hormone levels within 1 year of surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data extraction and synthesis: &lt;/strong&gt;This DTA-NMA was reported in accordance with the applicable Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. Two reviewers evaluated all abstracts and full-text articles using a piloted extraction form. A third author resolved any conflicts. There are no published Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) resources for DTA-NMA. The following conventional monitoring criteria were included: Halle, Miami, Rome, Vienna, and PTH normalization, and the following modified criteria were included: Miami and PTH normalization, modified Miami, and modified Vienna. A bayesian hierarchical DTA-NMA model with corresponding 95% credible intervals (CrIs) was used to describe the pooled diagnostic characteristics of the evaluated IOPTH monitoring criteria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Main outcomes included pooled diagnostic test properties, including sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 72 studies, which included 19 072 patients, met the inclusion criteria. Sixty-nine studies (95.8%) investigated classic PHPT. In PHPT, the Miami criteria were investigated most often and had the best diagnostic properties (diagnostic odds ratio, 60.00 [95% CrI, 32.00-145.00]) when compared to other conventional criteria. Moreover, the modified Miami criteria, which measures a postexcision IOPTH level 15 minutes or more postexcision of all hyperfunctioning parathyroid tissue, were the overall best criteria (diagnostic odds ratio, 79.71 [95% CrI, 22.46-816.67]). There was a low risk of study bias and no publication bias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevan","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894757","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":"Optimizing Osteotomy Geometries in Posterolateral Mandibulectomies.","authors":"Hugh Andrew Jinwook Kim, Michael J De Biasio, Vito Forte, Ralph W Gilbert, Jonathan C Irish, David P Goldstein, John R de Almeida, Matthew M Hanasono, Peirong Yu, Douglas B Chepeha, Thomas Looi, Christopher M K L Yao","doi":"10.1001/jamaoto.2024.3246","DOIUrl":"10.1001/jamaoto.2024.3246","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Reconstructive stability after mandibulectomy with osseous autogenous transplant is influenced by masticatory forces and the resulting stress on the titanium plate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To determine an optimal geometry of mandibular osteotomy that minimizes undesirable loading of the reconstruction plate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;In this combined in silico and in vitro basic science study, segmented computed tomography images of an adult male human mandible downloaded from the Visible Human Project were analyzed. Data were collected from July to November 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposures: &lt;/strong&gt;Four posterolateral mandibular resections and bony transplants were modeled following (1) vertical, (2) angled, (3) step, and (4) sagittal osteotomies. Using SOLIDWORKS software, mastication was simulated under (1) incisal, (2) ipsilateral molar, and (3) contralateral molar loading. Mandible models were then 3-dimensionally printed, osteotomized, and plated. Masticatory loads were simulated using pulleys, and strains were measured using strain gauges.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;On the reconstruction plate, von Mises stresses were measured in silico, and strains were measured using strain gauges in vitro. Stress and strain are reactions of a material to loading that can result in irreversible deformation or fracture.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In silico, maximum plate stress was highest with the vertical osteotomy, followed by the angled osteotomy (median difference vs vertical: ipsilateral molar loading, 126 MPa; 95% CI, 18-172; incisal loading, -24 MPa; 95% CI, -89 to 31; contralateral molar loading, 91 MPa; 95% CI, 23-189), step osteotomy (median difference vs angled: ipsilateral molar loading, 168 MPa; 95% CI, 112-235; incisal loading, 80 MPa; 95% CI, 15-140; contralateral molar loading, -17; 95% CI, -115 to 83), and sagittal osteotomy (median difference vs step: ipsilateral molar loading, 122 MPa; 95% CI, 102-154; incisal loading, 197 MPa; 95% CI, 166-230; contralateral molar loading, 161 MPa; 95% CI, 21-232). An angled osteotomy had the lowest stress at 30° of angulation (median difference vs contralateral molar loading at 40° of angulation: 111 MPa; 95% CI, 4-186). In vitro, the vertical osteotomy had the highest maximum strain, followed by the angled osteotomy (mean difference vs vertical: incisal loading, 0.021 mV/V; 95% CI, 0.014-0.027; contralateral molar loading, 0 mV/V; 95% CI, -0.004 to 0.005), step osteotomy (mean difference vs angled: incisal loading, 0.015 mV/V; 95% CI, 0.003-0.028; contralateral molar loading, 0.021 mV/V; 95% CI, 0.016-0.027), and sagittal osteotomy (mean difference vs step: incisal loading, 0.006 mV/V; 95% CI, -0.006 to 0.018; contralateral molar loading, 0.020 mV/V; 95% CI, 0.015-0.026).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this study, the traditional vertical osteotomy resulted in less favorable plat","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1113-1120"},"PeriodicalIF":6.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545493","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":"Detection, Patterns, and Outcomes of Recurrent HPV-Positive Oropharyngeal Squamous Cell Carcinoma.","authors":"Rema Shah, Sarah G Wilkins, Conrad W Safranek, Hemali P Shah, Catherine Brophy, Saral Mehra","doi":"10.1001/jamaoto.2024.3237","DOIUrl":"10.1001/jamaoto.2024.3237","url":null,"abstract":"<p><strong>Importance: </strong>Recurrent human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) is a relatively rare but serious disease with little empirical data. Previous works have studied patterns of recurrence in HPV-positive OPSCC, but only one has studied truly recurrent disease as opposed to persistent disease, and no work systematically analyzed posttreatment surveillance imaging strategies and how recurrences were detected.</p><p><strong>Objective: </strong>To refine the understanding of HPV-positive OPSCC recurrence and inform optimal imaging surveillance strategies.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study involved electronic medical record review at a tertiary care hospital. Patients treated for OPSCC from 2012 to 2019 were extracted, and patients diagnosed with HPV-positive OPSCC were identified. Data were analyzed from December 2022 to May 2023.</p><p><strong>Main outcome measures: </strong>Percentage of patients with a true recurrence, location of recurrence, time of recurrence detection, and method of recurrence detection. Recurrence was demonstrated with a scan after an imaging-established disease-free state 3 to 6 months posttreatment.</p><p><strong>Results: </strong>Of the 367 patients with HPV-positive OPSCC (mean [SD] age, 60.6 [9.2] years; 310 [84.5%] male), 37 (10.1%) experienced true disease recurrence. Median (IQR) follow-up time of the cohort was 3.6 years (8.5-88 months), defined as time from diagnosis to death or last contact. Within the true recurrence cohort, 21 patients (56.8%) experienced local, regional, or local and regional recurrence (LRR); 15 (40.5%) experienced distant metastasis (DM); and 1 (2.7%) experienced both LRR and DM. The mean (SD) time for detecting LRR was 2.46 (1.94) years and was considerably longer compared to the 1.89 (0.87) years for detecting DM (difference, 0.57 [95% CI, -0.29 to 1.02] years). The majority of patients identified their recurrence through symptom changes (31 [81.1%]) rather than through surveillance imaging (3 [8.1%]).</p><p><strong>Conclusion and relevance: </strong>In this cohort study, 10.1% of patients experienced true HPV-positive OPSCC disease recurrence, with most incidences of DM occurring in the lung and brain. Disease recurrence was identified primarily through symptomatic change, suggesting that further research may be needed to understand the optimal surveillance strategies after definitive treatment.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1105-1112"},"PeriodicalIF":6.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465672","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}