JAMA Network Open最新文献

{"title":"Error in Affiliations.","authors":"","doi":"10.1001/jamanetworkopen.2024.49923","DOIUrl":"10.1001/jamanetworkopen.2024.49923","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"7 11","pages":"e2449923"},"PeriodicalIF":10.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638985","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":"The Evolving Landscape of Hepatocellular Carcinoma Mortality in the US.","authors":"Emad Qayed","doi":"10.1001/jamanetworkopen.2024.45533","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2024.45533","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"7 11","pages":"e2445533"},"PeriodicalIF":10.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648047","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":"Prevalence of Cardiovascular-Kidney-Metabolic Syndrome Stages by Social Determinants of Health.","authors":"Ruixin Zhu, Ran Wang, Jingjing He, Langrun Wang, Huiyu Chen, Xiaokang Niu, You Sun, Yiran Guan, Yifan Gong, Liwei Zhang, Peng An, Keji Li, Fazheng Ren, Weili Xu, Jie Guo","doi":"10.1001/jamanetworkopen.2024.45309","DOIUrl":"10.1001/jamanetworkopen.2024.45309","url":null,"abstract":"<p><strong>Importance: </strong>Cardiovascular-kidney-metabolic (CKM) syndrome-a novel, multistage, multisystem disorder as defined by the American Heart Association-is highly prevalent in the US. However, the prevalence of CKM stages by social determinants of health (SDOH) remains unclear.</p><p><strong>Objective: </strong>To investigate whether the prevalence of CKM stages varies by SDOH in US adults.</p><p><strong>Design, setting, and participants: </strong>This cross-sectional study used data from the National Health and Nutrition Examination Survey (1999-2018) and included a nationally representative sample of adults aged 30 to 79 years through complex, multistage probability sampling. Data were analyzed from April 1 to June 15, 2024.</p><p><strong>Exposures: </strong>The exposures included 5 CKM stages (ie, stages 0-4) reflecting progressive pathophysiology, with advanced (stages 3 or 4) and nonadvanced (stages 0, 1, or 2) disease. CKM stages were defined based on risk factors for metabolic syndrome, cardiovascular disease, and chronic kidney disease.</p><p><strong>Main outcome and measures: </strong>The main outcome was the age-standardized prevalence of CKM stages and advanced CKM stages across SDOH, including education, marital status, family income, food security, health insurance, employment, home ownership, and health care access.</p><p><strong>Results: </strong>Among 29 722 participants (weighted mean [SE] age, 50.8 [0.1] years; weighted 50.7% male), the age-standardized prevalence of CKM stages 0 to 4 was 13.6% (95% CI, 13.0%-14.3%), 29.9% (95% CI, 29.1%-30.7%), 43.7% (95% CI, 42.9%-44.5%), 4.7% (95% CI, 4.4%-5.0%), and 8.1% (95% CI, 7.6%-8.5%), respectively. Significant differences were observed in the prevalence of CKM stages across all unfavorable SDOH of interest compared with their favorable counterparts, with unemployment (18.8% [95% CI, 17.7%-20.1%] vs 11.4% [95% CI, 11.0%-11.9%]), low family income (16.1% [95% CI, 15.4%-16.8%] vs 10.1% [95% CI, 9.5%-10.7%]), and food insecurity (18.3% [95% CI, 17.1%-19.6%] vs 11.7% [95% CI, 11.2%-12.2%]) associated with an increased likelihood of advanced CKM stages. Participants with 2 or more unfavorable SDOH were more likely to have advanced CKM stages (age-standardized prevalence, 15.8% [95% CI, 15.2%-16.5%] vs 10.5% [95% CI, 9.9%-11.1%] with <2 unfavorable SDOH). Living in a rented home (15.9% [95% CI, 14.7%-17.0%] vs 9.3% [95% CI, 8.7%-9.9%] owning the home) or not living with a partner (13.2% [95% CI, 12.3%-14.3%] vs 9.2% [95% CI, 8.5%-9.8%] living with a partner) increased the likelihood of advanced CKM stages in female but not male participants.</p><p><strong>Conclusions and relevance: </strong>In this cross-sectional study, disparities in the prevalence of CKM stages by SDOH, particularly family income, food security, and employment, with notable sex differences, were observed in US adults. These findings highlight the need to address inequities in CKM syndrome through targeted int","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"7 11","pages":"e2445309"},"PeriodicalIF":10.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648034","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":"Standardized Patient Communication and Low-Value Spinal Imaging: A Randomized Clinical Trial.","authors":"Joshua J Fenton, Camille Cipri, Melissa Gosdin, Daniel J Tancredi, Anthony Jerant, Carly Ann Robinson, Guibo Xing, Ilona Fridman, Gary Weinberg, Andrew Hudnut","doi":"10.1001/jamanetworkopen.2024.41826","DOIUrl":"10.1001/jamanetworkopen.2024.41826","url":null,"abstract":"<p><strong>Importance: </strong>Acute back pain is a common reason for primary care visits and often results in low-value spinal imaging.</p><p><strong>Objective: </strong>To evaluate the effect of a standardized patient-delivered intervention on rates of low-value spinal imaging among primary care patients with acute low back pain.</p><p><strong>Design, setting, and participants: </strong>In this randomized clinical trial, physicians or advanced practice clinicians were recruited from March 22 to August 5, 2021, from 10 adult primary care or urgent care clinics in Sacramento, California. The intervention period was from May 1, 2021, to March 30, 2022, with follow-up from October 28, 2021, to June 30, 2023. Analyses were performed from April 1 to June 25, 2024.</p><p><strong>Intervention: </strong>Clinicians were randomized 1:1 to intervention or control. Intervention clinicians received 3 simulated office visits, each with a standardized patient instructor (SPI) portraying a patient with acute uncomplicated back pain. At each visit, SPIs provided clinician feedback guided by a 3-step model: (1) set the stage for deferred imaging by building trust, (2) convey empathy, and (3) communicate optimism while advocating watchful waiting without imaging. Control clinicians received no intervention.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was lumbar spinal imaging completion within 90 days of acute low back pain visits, with study clinicians assessed up to 18 months of follow-up. Secondary outcomes were cervical spine imaging completion after acute neck pain visits, any imaging completion after an adult visit, patient experience ratings of clinicians (scale range, 0-100), and use of targeted communication skills during an audio-recorded standardized patient evaluation visit at median follow-up of 16.8 months (range, 14.1-18.0 months).</p><p><strong>Results: </strong>The analysis included 53 clinicians; mean (SD) age was 46.7 (1.0) years, and 35 (66.0%) reported female gender. A total of 25 were in the intervention group and 28 in the control group. After adjustment for prerandomization rates, patients with acute low back pain who saw intervention and control clinicians during follow-up had similar rates of lumbar imaging (194 of 1234 clinic visits [15.7%] vs 226 of 1306 clinic visits [17.3%]; adjusted ratio of postintervention vs preintervention odds ratios [AORR], 1.00; 95% CI, 0.72-1.40). Adjusted follow-up rates of imaging for acute neck pain (AORR, 1.16; 95% CI, 0.83-1.63) and overall imaging (AORR, 1.07; 95% CI, 0.97-1.19) were not significantly different among patients of intervention and control clinicians. Intervention and control clinicians had similar mean (SD) patient experience ratings during follow-up (88.6 [28.7] vs 88.8 [28.3]; adjusted mean difference-in-differences, -1.0; 95% CI, -3.0 to 0.9). During audio-recorded standardized patient visits, intervention clinicians had significantly better ratings than con","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"7 11","pages":"e2441826"},"PeriodicalIF":10.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11541634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583219","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":"Pharmaceutical Expenditure and Consumption of Recommended Drugs to Avoid in Italy.","authors":"Filomena Fortinguerra, Benedetta Bellini, Antonietta Colatrella, Francesco Trotta","doi":"10.1001/jamanetworkopen.2024.46237","DOIUrl":"10.1001/jamanetworkopen.2024.46237","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"7 11","pages":"e2446237"},"PeriodicalIF":10.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675835","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":"Neonatal Mortality Rates With and Without a Minimum Threshold.","authors":"Fu-Wen Liang, Yu-Shan Chang, Chia-Sui Chou, Mei-Jy Jeng, Ichiro Kawachi, Tsung-Hsueh Lu","doi":"10.1001/jamanetworkopen.2024.47487","DOIUrl":"10.1001/jamanetworkopen.2024.47487","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"7 11","pages":"e2447487"},"PeriodicalIF":10.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686921","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":"Disparities in Continuous Glucose Monitoring Among Patients Receiving Care in Federally Qualified Health Centers.","authors":"Amisha Wallia, Shivani Agarwal, Andrew L Owen, Emily L Lam, Ka'Derricka Davis, Stacy C Bailey, Sean E DeLacey, Allison P Pack, Juan Espinoza, Dana Bright, Alice Eggleston, Eve Walter, Matthew J O'Brien","doi":"10.1001/jamanetworkopen.2024.45316","DOIUrl":"10.1001/jamanetworkopen.2024.45316","url":null,"abstract":"<p><strong>Importance: </strong>While continuous glucose monitoring (CGM) has been found to improve diabetes care processes and outcomes, adoption remains low.</p><p><strong>Objective: </strong>To examine the association between CGM prescriptions and individual characteristics among patients with type 1 or 2 diabetes (T1D and T2D, respectively).</p><p><strong>Design, setting, and participants: </strong>Retrospective cross-sectional study using electronic health record data for patients with T1D or T1D from 275 clinic sites nationwide between January 2014 and February 2021. All participating clinics were federally qualified health centers (FQHCs), the largest US system of primary care for vulnerable populations. Data were analyzed from September 2022 to August 2024.</p><p><strong>Main outcomes and measures: </strong>Sociodemographic factors, clinical characteristics, and CGM prescription orders.</p><p><strong>Results: </strong>A total of 1168 patients with T1D (mean [SD] age, 41.8 [16.0] years; 600 [51.4%] male; 372 [31.9%] Black; 262 [22.4%] Hispanic, and 750 [64.2%] White patients) and 35 216 patients with T2D (mean [SD] age, 58.4 [13.1] years; 19 772 [56.1%] female; 12 030 [34.2%] Black; 12 979 [36.9%] Hispanic, and 20 413 [58.0] White patients) were included. Overall, CGM prescriptions were infrequent (129 [11.0%] for patients with T1D and 362 [1.0%] for those with T2D) but increased throughout the study period. Among patients with T1D, those who reported Hispanic ethnicity (odds ratio [OR], 0.30; 95% CI, 0.16-0.57), Black race (OR, 0.61; 95% CI, 0.38-0.99), or were uninsured (OR, 0.42; 95% CI, 0.23-0.74) had lower multivariable odds of receiving a CGM prescription than White or insured adults, respectively. Similar findings were observed among patients with T2D reporting Hispanic ethnicity (OR, 0.43; 95% CI, 0.32-0.57), Black race (OR, 0.76; 95% CI, 0.59-0.98), or being uninsured (OR, 0.42; 95% CI, 0.31-0.58), relative to their counterparts. Among patients with T2D, hemoglobin A1c values higher than 9.0% (OR, 3.17; 95% CI, 2.37-4.21) and a greater burden of diabetes complications were associated with higher odds of CGM prescription.</p><p><strong>Conclusions and relevance: </strong>In this cross-sectional study of electronic health record data, rates of CGM prescription orders were low among FQHC patients with T1D and T2D. Disparities in CGM orders were observed among patients reporting Hispanic ethnicity, Black race, and those who lacked health insurance. Future research is needed to understand the causes of infrequent CGM orders in FQHCs and drivers of observed disparities in this vulnerable patient population.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"7 11","pages":"e2445316"},"PeriodicalIF":10.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686972","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":"Artificial Intelligence Impact on Burnout in Radiologists-Alleviation or Exacerbation?","authors":"Farid Ghareh Mohammadi, Ronnie Sebro","doi":"10.1001/jamanetworkopen.2024.48720","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2024.48720","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"7 11","pages":"e2448720"},"PeriodicalIF":10.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687108","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":"American College of Surgeons Operative Standards and Breast Cancer Outcomes.","authors":"Crystal D Taylor, Ton Wang, Alison S Baskin, Brandy Sinco, Tasha M Hughes, Daniel J Boffa, Judy C Boughey, Lesly A Dossett","doi":"10.1001/jamanetworkopen.2024.46345","DOIUrl":"10.1001/jamanetworkopen.2024.46345","url":null,"abstract":"<p><strong>Importance: </strong>The American College of Surgeons (ACS) operative standards were established to detail critical elements of cancer surgery, reduce technical variation, and improve outcomes. Two of the 6 operative standards target adequate axillary surgery for breast cancer. The potential association of the operative standards with short-term oncologic outcomes, such as nodal yield and nodal positivity rates, is currently unknown.</p><p><strong>Objective: </strong>To evaluate the potential association of the ACS operative standards with short-term oncologic outcomes in breast cancer.</p><p><strong>Design, setting, and participants: </strong>A cohort study was performed using data on 1 201 317 women 18 years or older who underwent sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) for invasive breast cancer from January 1, 2012, to December 31, 2020. Patients were identified using the National Cancer Database (NCDB), a clinical oncology database encompassing approximately 70% of new cancer diagnoses, sourced from hospital registry data from 1317 facilities. Statistical analysis was performed from October 2023 to June 2024.</p><p><strong>Exposure: </strong>Sentinel lymph node biopsy or ALND.</p><p><strong>Main outcomes and measures: </strong>Reliability-adjusted facility-level lymph node yield and nodal positivity rate for each procedure were calculated using generalized linear mixed models, Poisson regression, and logistic regression with facility-level random intercepts.</p><p><strong>Results: </strong>The cohort included 1 201 317 women with a median age of 62 years (IQR, 53-70 years). Facility-level nodal yield ranged from 1 to 6 for SLNB and from 6 to 22 for ALND. Median facility-level nodal yield for SLNB was 2.6 (IQR, 2.3-3.0) and the nodal positivity rate for SLNB was 12.2% (IQR, 11.0%-13.7%), with rates ranging from 6% to 21%. A weak correlation between facility-level lymph node yield and nodal positivity was observed (Spearman correlation coefficient, 0.17). Median nodal upstaging rate (≥4 positive nodes) for ALND was 30.5% (IQR, 26.5%-35.0%), with rates ranging from 11% to 54%; median nodal yield was 12.2 (IQR, 10.9-13.6). A strong correlation between nodal yield and nodal upstaging rates was observed (Spearman correlation coefficient, 0.53).</p><p><strong>Conclusions and relevance: </strong>In this cohort study of women undergoing axillary surgery for invasive breast cancer, facility-level variation in lymph node yield was present for both SLNB and ALND, which could potentially be improved through the ACS operative standards. However, this variation had mixed associations with nodal positivity and upstaging rates, suggesting the association of the ACS operative standards with oncologic outcomes may be mixed.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"7 11","pages":"e2446345"},"PeriodicalIF":10.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675829","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":"Complication Rates After Ultrasonography-Guided Nerve Blocks Performed in the Emergency Department.","authors":"Andrew Goldsmith, Lachlan Driver, Nicole M Duggan, Matthew Riscinti, David Martin, Michael Heffler, Hamid Shokoohi, Andrea Dreyfuss, Jordan Sell, Calvin Brown, Christopher Fung, Leland Perice, Daniel Bennett, Natalie Truong, S Zan Jafry, Michael Macias, Joseph Brown, Arun Nagdev","doi":"10.1001/jamanetworkopen.2024.44742","DOIUrl":"10.1001/jamanetworkopen.2024.44742","url":null,"abstract":"<p><strong>Importance: </strong>Ultrasonography-guided nerve blocks (UGNBs) have become a core component of multimodal analgesia for acute pain management in the emergency department (ED). Despite their growing use, national adoption of UGNBs has been slow due to a lack of procedural safety in the ED.</p><p><strong>Objective: </strong>To assess the complication rates and patient pain scores of UGNBs performed in the ED.</p><p><strong>Design, setting, and participants: </strong>This cohort study included data from the National Ultrasound-Guided Nerve Block Registry, a retrospective multicenter observational registry encompassing procedures performed in 11 EDs in the US from January 1, 2022, to December 31, 2023, of adult patients who underwent a UGNB.</p><p><strong>Exposure: </strong>UGNB encounters.</p><p><strong>Main outcomes and measures: </strong>The primary outcome of this study was complication rates associated with ED-performed UGNBs recorded in the National Ultrasound-Guided Nerve Block Registry from January 1, 2022, to December 31, 2023. The secondary outcome was patient pain scores of ED-based UGNBs. Data for all adult patients who underwent an ED-based UGNB at each site were recorded. The volume of UGNB at each site, as well as procedural outcomes (including complications), were recorded. Data were analyzed using descriptive statistics of all variables.</p><p><strong>Results: </strong>In total, 2735 UGNB encounters among adult patients (median age, 62 years [IQR, 41-77 years]; 51.6% male) across 11 EDs nationwide were analyzed. Fascia iliaca blocks were the most commonly performed UGNBs (975 of 2742 blocks [35.6%]). Complications occurred at a rate of 0.4% (10 of 2735 blocks). One episode of local anesthetic systemic toxicity requiring an intralipid was reported. Overall, 1320 of 1864 patients (70.8%) experienced 51% to 100% pain relief following UGNBs. Operator training level varied, although 1953 of 2733 procedures (71.5%) were performed by resident physicians.</p><p><strong>Conclusions and relevance: </strong>The findings of this cohort study of 2735 UGNB encounters support the safety of UGNBs in ED settings and suggest an association with improvement in patient pain scores. Broader implementation of UGNBs in ED settings may have important implications as key elements of multimodal analgesia strategies to reduce opioid use and improve patient care.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"7 11","pages":"e2444742"},"PeriodicalIF":10.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620987","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}