Journal of atherosclerosis and thrombosis最新文献

{"title":"Non-high-density Lipoprotein Cholesterol for Secondary Prevention after Minor Stroke.","authors":"Yanan Wang, Zhixuan Jiang, Simiao Wu","doi":"10.5551/jat.ED272","DOIUrl":"10.5551/jat.ED272","url":null,"abstract":"","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"122-124"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral Small Vessel Disease is Associated with Prehospital Delay in Acute Ischemic Stroke.","authors":"Marina Masui, Takeo Sato, Motohiro Okumura, Takahiro Ishikawa, Kenichi Sakuta, Tatsushi Kokubu, Junichiro Takahashi, Tomomichi Kitagawa, Maki Tanabe, Asako Onda, Teppei Komatsu, Kenichiro Sakai, Tadashi Umehara, Hidetaka Mitsumura, Yasuyuki Iguchi","doi":"10.5551/jat.64968","DOIUrl":"10.5551/jat.64968","url":null,"abstract":"<p><strong>Aim: </strong>To determine whether the severity of cerebral small vessel disease (SVD) is associated with prehospital delay in acute ischemic stroke.</p><p><strong>Methods: </strong>Consecutive patients with ischemic stroke were included in this study. We evaluated the SVD burden using the total SVD score. Patients were divided into 2 groups: onset-to-door time within 4.5 hours (early arrival group) and onset-to-door time over 4.5 hours (delayed arrival group). First, we assessed whether the total SVD score was related to prehospital delay using a logistic regression analysis. Second, we assessed which item of the score was independently associated with delays. Finally, we determined whether the item had a linear association with the delay.</p><p><strong>Results: </strong>Of the 2,112 screened patients, 1,754 were enrolled in the study (1,253 males [71%]; median age, 69 years). There were 1,105 patients (63%) in the delayed arrival group. The total SVD score was independently associated with delay (OR 1.11, 95% CI 1.01-1.21, p=0.025). Among the 4 items of the score, only enlarged perivascular spaces (EPVS) in the basal ganglia was independently associated with delay (OR 1.37, 95% CI 1.05-1.80, p=0.022). A linear trend was observed between EPVS grade and delay with reference to EPVS grade 0-1 (EPVS grade 2: OR 1.22, 95% CI 0.92-1.62, p=0.170, EPVS grade 3: OR 1.69, 95% CI 1.20-2.38, p=0.002, EPVS grade 4: OR 2.17, 95% CI 1.37-3.44, p=0.001).</p><p><strong>Conclusions: </strong>Prehospital delay in acute ischemic stroke could be associated with the severity of SVD, particularly EPVS in the basal ganglia.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"198-209"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Medical Claims Database Study of Factors Associated with Medication Adherence and Treatment Persistence in Patients Receiving PCSK9 Monoclonal Antibodies.","authors":"Yuri Takahashi, Takeshi Morimoto, Kazuma Iekushi, Hidenori Arai","doi":"10.5551/jat.64848","DOIUrl":"10.5551/jat.64848","url":null,"abstract":"<p><strong>Aim: </strong>To investigate medication adherence and treatment persistence in patients receiving proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibodies (mAbs) in Japan.</p><p><strong>Methods: </strong>Using an anonymized claims database from January 2015 to December 2021, data on adult patients at high risk for atherosclerotic cardiovascular disease or with a history of coronary artery disease (CAD) who had at least 1 prescription for PCSK9-mAbs were retrieved.</p><p><strong>Results: </strong>In total, 276 patients were analyzed. The cumulative treatment persistence rate after 1 year was 67.0%. A multivariate analysis revealed that better adherence to oral low-density lipoprotein cholesterol (LDL-C)-lowering therapy in the year before starting PCSK9-mAbs (adjusted odds ratio [OR] 2.16) and a history of CAD for secondary prevention (adjusted OR 2.44) were associated with better adherence to PCSK9-mAbs in the first year. Better adherence to oral LDL-C-lowering therapy in the year before starting PCSK9-mAbs (adjusted OR 2.32) and a history of CAD for secondary prevention (adjusted OR 3.03) were also associated with a lower rate of discontinuation of PCSK9-mAbs. Age, sex, comorbidity, number of tablets taken daily (all medications), and number of hospital or clinic visits in the year prior to starting PCSK9-mAbs did not affect the persistence rate or adherence to PCSK9-mAbs in the multivariate analyses.</p><p><strong>Conclusion: </strong>Better adherence to oral LDL-C-lowering therapy and secondary prevention were identified as factors associated with better medication adherence and treatment persistence in patients receiving PCSK9-mAbs within the first year.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"163-175"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second Derivative of the Finger Photoplethysmogram Predicts the Risk of Developing Hypertension in Middle-Aged Men.","authors":"Toshiaki Otsuka, Yasuhiro Nishiyama, Katsuhito Kato, Eitaro Kodani, Tomoyuki Kawada","doi":"10.5551/jat.65123","DOIUrl":"10.5551/jat.65123","url":null,"abstract":"<p><strong>Aim: </strong>Increased arterial stiffness impairs the functional and structural properties of arteries, which in turn elevates blood pressure (BP). The aim of this study was to test whether indices obtained from the second derivative of the finger photoplethysmogram (SDPTG), a marker of arterial stiffness, predict future development of hypertension in middle-aged men.</p><p><strong>Methods: </strong>The SDPTG was measured in 902 men without hypertension (mean age 44±6 years) at an annual medical checkup. The development of hypertension was monitored for a maximum of 4 years. Two indices of arterial stiffness were calculated from the SDPTG waveforms: b/a, an index of large elastic arterial stiffness, and d/a, an index of systemic arterial stiffness, including the structural and functional properties of small and muscular arteries and peripheral circulation. A Cox proportional hazards model was used to examine whether the b/a and d/a ratios were independent predictors of future development of hypertension.</p><p><strong>Results: </strong>During the follow-up period, 124 individuals developed hypertension, defined as a systolic/diastolic BP ≥ 140/90 mm Hg or the use of antihypertensive medications. The hazard ratio for the development of hypertension significantly increased in the lowest quartile of the d/a ratio (2.84, 95% confidence interval: 1.58-5.13, p＜0.001) compared with the highest quartile, after adjusting for multiple potential confounders. In contrast, the b/a ratio did not show significant hazard ratios for the development of hypertension.</p><p><strong>Conclusions: </strong>The d/a ratio, calculated from the SDPTG waveforms, predicted the risk of future development of hypertension in this study population.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"188-197"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excess Triglycerides in Very Low-Density Lipoprotein (VLDL) Estimated from VLDL-Cholesterol could be a Useful Biomarker of Metabolic Dysfunction Associated Steatotic Liver Disease in Patients with Type 2 Diabetes.","authors":"Tsutomu Hirano","doi":"10.5551/jat.65164","DOIUrl":"10.5551/jat.65164","url":null,"abstract":"<p><strong>Aims: </strong>We report that small dense low-density lipoprotein cholesterol (sdLDL-C) levels are sensitive biomarkers of metabolic dysfunction-associated steatotic liver disease (MASLD). Since triglyceride (TG)-rich very low-density lipoprotein (VLDL) is a precursor of sdLDL and is overproduced by MASLD, the composition of VLDL may be more directly associated with MAFLD than sdLDL-C or plasma TG. To identify TG-rich VLDL, this author proposed \"Excess TG\" and examined its association with MASLD.</p><p><strong>Methods: </strong>Patients with type 2 diabetes (n=1295), excluding fasting hypertriglyceridemia (TG ≥ 400 mg/dL) and heavy drinkers were examined. Liver steatosis and visceral fat area (VFA) were evaluated using CT. VLDL-C was calculated as the total C minus direct LDL-C minus HDL-C. The average VLDL-TG level can be estimated using VLDL-C×5, according to the principle of the Friedewald equation for LDL-C. Thus, VLDL-TG was estimated as VLDL-C×5, and Excess TG was calculated as plasma TG minus VLDL-C×5.</p><p><strong>Results: </strong>Patients with MASLD were younger, more likely to be men and drinkers, and had higher VFA, TG, sdLDL-C, and excess TG, while VLDL-C was comparable. Excess TG was found to be the most sensitive lipid parameter for identifying MASLD, independent of sdLDL-C, TG, TG/VLDL-C, and VFA. The odds ratios for MASLD were 2.4-, 3.7-, and 3.9-fold higher for Excess TG ranges of 0-24, 25-49, and ≥ 50 mg/dL, respectively, relative to ＜0 mg, and a close relationship remained significant after adjustment for lipid- and adiposity-related parameters.</p><p><strong>Conclusions: </strong>Excess TG in VLDL was strongly associated with MASLD beyond TG and sdLDL-C levels, which may reflect the presence of TG-rich VLDL.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"253-264"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"All-Cause and Cause-Specific Mortality Associated with Long-Term Exposure to Fine Particulate Matter in Japan: The Ibaraki Prefectural Health Study.","authors":"Takehiro Michikawa, Yuji Nishiwaki, Keiko Asakura, Tomonori Okamura, Toru Takebayashi, Shuichi Hasegawa, Ai Milojevic, Mihoko Minami, Masataka Taguri, Ayano Takeuchi, Kayo Ueda, Toshimi Sairenchi, Kazumasa Yamagishi, Hiroyasu Iso, Fujiko Irie, Hiroshi Nitta","doi":"10.5551/jat.65424","DOIUrl":"https://doi.org/10.5551/jat.65424","url":null,"abstract":"<p><strong>Aims: </strong>Long-term exposure to fine particulate matter (PM_2.5) is causally associated with mortality and cardiovascular disease. However, in terms of cardiovascular cause-specific outcomes, there are fewer studies about stroke than about coronary heart disease, particularly in Asia. Furthermore, there remains uncertainty regarding the PM_2.5-respiratory disease association. We examined whether long-term exposure to PM_2.5 is associated with all-cause, cardiovascular and respiratory disease mortality in Japan.</p><p><strong>Methods: </strong>We used data of 46,974 participants (19,707 men; 27,267 women), who were enrolled in 2009 and followed up until 2019, in a community-based prospective cohort study (the second cohort of the Ibaraki Prefectural Health Study). We estimated PM_2.5 concentrations using the inverse distance weighing methods based on ambient air monitoring data, and assigned each participant to administrative area level concentrations. A Cox proportional hazard model was applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality.</p><p><strong>Results: </strong>During the average follow-up of 10 years, we confirmed 2,789 all-cause deaths. All outcomes including stroke mortality did not significantly increase as the PM_2.5 concentration increased. For non-malignant respiratory disease mortality, the multivariable adjusted HR per 1 µg/m³ increase in the PM_2.5 concentration was 1.09 (95% CI = 0.97-1.23).</p><p><strong>Conclusions: </strong>In this population exposed to PM_2.5 at concentrations of 8.3-13.1 µg/m³, there was no evidence that long-term exposure to PM_2.5 had adverse effects on mortality. Weak evidence of positive association observed for non-malignant respiratory disease mortality needs further studies in other populations.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Significant Effect of Pemafibrate on Carotid and Cerebral Atherosclerosis in Patients with Hypertriglyceridemia and Stroke.","authors":"Hidekatsu Yanai","doi":"10.5551/jat.ED277","DOIUrl":"https://doi.org/10.5551/jat.ED277","url":null,"abstract":"","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary Prevention of Stroke in Patients with Non-Valvular Atrial Fibrillation and Advanced Chronic Kidney Disease.","authors":"Yanzhao Ren, Menglong Miao, Ruopeng Tan, Guiwen Xu, Yang Liu, Xiaomeng Yin","doi":"10.5551/jat.65186","DOIUrl":"https://doi.org/10.5551/jat.65186","url":null,"abstract":"<p><strong>Aims: </strong>Evidence supporting the prescription of anticoagulant therapy for patients with atrial fibrillation (AF) with advanced chronic kidney disease (CKD) has been limited, and its clinical application in this context remains controversial.</p><p><strong>Methods: </strong>We identified AF patients with advanced CKD (G4-G5) and a history of stroke who were admitted to the First Affiliated Hospital of Dalian Medical University between January 1, 2011, and June 30, 2023. Patients were classified into warfarin, non-vitamin K antagonist oral anticoagulant (NOAC), antiplatelet therapy, and control (no antithrombotic therapy) groups. We evaluated the benefits and safety of different antithrombotic therapies by comparing the long-term clinical outcome measures, including the incidence of subsequent ischemic stroke events, bleeding, and all-cause death.</p><p><strong>Results: </strong>In total, 570 patients were included. In this cohort, 87 (15.3%) patients had no antithrombotic treatment, 252 (44.2%) received antiplatelet therapy, 105 (18.4%) received warfarin, and 126 (22.1%) received NOAC therapy. Compared with patients without treatment, we found that treatment with anticoagulant therapy significantly decreased the risk of ischemic stroke, but antiplatelet therapy did not. Treatment with anticoagulant therapy was associated with significantly lower mortality than no antithrombotic therapy or antiplatelet therapy , at least within the study period. Furthermore, compared with warfarin treatment, patients treated with NOAC therapy showed a significant decrease in the incidence of bleeding risks.</p><p><strong>Conclusion: </strong>Among AF patients with advanced CKD and prior stroke, receiving anticoagulants resulted in a reduced risk of recurrent ischemic stroke events than no antithrombotic treatment, and lower mortality than no antithrombotic treatment or antiplatelet therapy.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Middle Cerebral Artery Wall Shear Stress in Branch Atheromatous Disease: A Computational Fluid Dynamics Analysis.","authors":"Yorito Hattori, Shuta Imada, Ryo Usui, Akimasa Yamamoto, Masanori Nakamura, Masafumi Ihara","doi":"10.5551/jat.65439","DOIUrl":"https://doi.org/10.5551/jat.65439","url":null,"abstract":"<p><strong>Aim: </strong>Branch atheromatous disease (BAD), characterized by the occlusion of perforating branches near the orifice of a parent artery, often develops early neurological deterioration because the mechanisms underlying BAD remain unclear. Abnormal wall shear stress (WSS) is strongly associated with endothelial dysfunction and plaque growth or rupture. Therefore, we hypothesized that computational fluid dynamics (CFD) modeling could detect differences in WSS between BAD and small-vessel occlusion (SVO), both of which result from perforating artery occlusion/stenosis.</p><p><strong>Methods: </strong>This cross-sectional observational study included consecutive patients admitted to our institution within 7 days after symptom onset who met the following criteria: absence of stenosis/occlusion in the intracranial major arteries on brain magnetic resonance angiography (MRA) or extracranial carotid arteries on carotid ultrasonography. The WSS and blood flow velocity in the M1 segment of the middle cerebral artery were analyzed using CFD based on MRA.</p><p><strong>Results: </strong>The number of patients with a WSS ratio (ipsilesional/contralesional) of ＞1 was significantly higher in patients with BAD (n = 27) than in those with SVO (n = 27) [20 (74.1%) vs. 11 (40.7%), p = 0.013]. Higher WSS on ipsilesional M1 than on contralesional M1 was an independent risk factor for BAD (adjusted odds ratio 4.38, 95% confidence interval 1.29-14.82, p = 0.018). Blood flow velocity in the M1 segment was not associated with BAD.</p><p><strong>Conclusions: </strong>In patients with BAD, higher M1 segment WSS on CFD can be a risk factor for the development of vulnerable plaques in branch orifices. Moreover, the use of CFD may contribute to the diagnosis of BAD.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Space Prescription: Initiative to Improve Health and Well-being in Tokyo.","authors":"Gantsetseg Ganbaatar, Mizuki Ohashi, Mazuin Kamarul Zaman, Nazar Mohd Azahar, Kazue Yamawaki, Haruki Matsuo, Suon Pileap, Akira Nishiyama, Shigeru Inoue, Yuichiro Yano","doi":"10.5551/jat.RV22028","DOIUrl":"10.5551/jat.RV22028","url":null,"abstract":"<p><p>This review introduces \"space prescribing,\" an innovative healthcare approach that incorporates the physical environment's role in promoting health beyond traditional clinical settings. Recognizing that individuals spend a significant amount of time outside clinical environments, this approach explores the therapeutic potential of natural and built environments in improving well-being and managing diseases, particularly cardiovascular and mental health conditions.Traditional healthcare models focus on treatments in hospital and clinic settings. However, evidence suggests that environmental factors profoundly influence health outcomes. Space prescribing recommends specific environments that encourage healthier lifestyles and enhance wellbeing. This concept includes social prescribing, in which healthcare professionals direct patients to community-based, non-medical activities such as art classes and sports, acknowledging that well-being transcends biological factors.This review also highlights \"Cultural Ecosystem Services\" (CES) in health through stress reduction, social connections, and physical activity. For cardiovascular health, elements such as green spaces and urban design are vital for managing conditions, such as hypertension and heart disease. Similarly, the configuration of indoor and outdoor spaces plays a crucial role in mental health. Therapeutic landscapes, including community gardens and culturally enriched urban areas, support mental health recovery, foster community engagement and reduce isolation.In conclusion, space prescribing advocates an integrated approach that considers the physical and social environments as fundamental components of health promotion. This strategy aims to mitigate health disparities and enhance the quality of life, while making health-enhancing activities accessible in urban and rural settings. Through this holistic approach, space prescribing has the potential to transform public health by strategically utilizing environmental designs to support health outcomes.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"1-10"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}