Journal of Burn Care & Research最新文献

{"title":"MiR-223-3p promotes angiogenesis in burn wound healing by targeting FOXO1.","authors":"Rong Zhao, Yi Deng, Yan Han, Menghe Wang, Yiyun Huang","doi":"10.1093/jbcr/iraf083","DOIUrl":"https://doi.org/10.1093/jbcr/iraf083","url":null,"abstract":"<p><p>Deep second-degree burns represent a prevalent form of trauma encountered in clinical settings. The intricacies of the wound healing process are profoundly linked to the prognosis of affected patients. This study aims to explore the expression of miR-223-3p in deep second-degree burns and its role in wound healing. A total of 95 patients with deep second-degree burn were enrolled in this study and 50 healthy individuals were included in this study. Real-time quantitative PCR was employed to assess the expression levels of miR-223-3p. The TargetScan database was utilized to predict the target genes of miR-223-3p, and the luciferase reporter gene assay was employed to validate the predicted results. Pearson correlation analysis was conducted to examine the connection. The results indicate that the level of miR-223-3p was markedly increased in patients with deep second-degree burns and markedly decreased on the 28th day of wound healing. FOXO1 was the target gene of miR-223-3p. The level of miR-223-3p at the time of burn and after recovery is significantly negatively related to the expression of FOXO1 in patients with deep second-degree burn. Overexpression of miR-223-3p significantly inhibits the viability of HUVECs, while FOXO1 can partially reverse this inhibitory effect. In conclusion, the level of miR-223-3p is associated with the progression of deep second-degree burns, and it may participate in the wound healing process of burn injuries by targeting FOXO1.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early versus Late Tracheostomy in Critically Injured Burn Survivors: A National, Multi-Database Analysis.","authors":"Jennifer K Shah, Eloise W Stanton, Daniel Najafali, Rahim Nazerali, Clifford C Sheckter","doi":"10.1093/jbcr/iraf086","DOIUrl":"https://doi.org/10.1093/jbcr/iraf086","url":null,"abstract":"<p><p>Tracheostomy is indicated in critically ill patients when prolonged mechanical ventilation is anticipated. We leveraged national data to evaluate tracheostomy timing in burn patients, hypothesizing that early tracheostomy would be associated with reduced length of stay (LOS) and ventilator-associated pneumonia (VAP). Surviving burn encounters undergoing tracheostomy in three national databases-Nationwide Inpatient Sample (NIS), 2016-2021, National Trauma Data Bank (NTDB), 2007-2014, and Burn Care Quality Platform (BCQP), 2015-2022-were stratified by tracheostomy timing relative to admission: early: ≤ 10 days versus late: > 10 days. Early tracheostomy encounters were propensity-score-matched with late tracheostomy encounters on age, sex, and total body surface area (TBSA) of burns to evaluate the impact of tracheostomy timing on LOS, ICU LOS, ventilator days, VAP, discharge to inpatient rehabilitation, and discharge to long term acute care (LTAC). 9,173 burn encounters underwent tracheostomy (6,255 in NIS, 1,332 in NTDB, and 1,586 in BCQP) of which 51.1% were early. Within matched cohorts, early tracheostomy was associated with shorter LOS, reported as Average Treatment Effect, in days [95% CI]: NIS: -22.9 [-32.8- -13.1], p<0.01; NTDB: -12.7 [-18.7- -6.8], p<0.01; BCQP: -7.0 [-12.5- -1.5], p<0.01. Early tracheostomy was associated with shorter ICU LOS and fewer ventilator days in NTDB and BCQP (p<0.04). Early tracheostomy was not associated with discharge to inpatient rehabilitation or VAP. Early tracheostomy decreased discharge to LTAC in NTDB and BCQP (p≤0.02). Our multi-database analysis supports early tracheostomy in critically injured burn patients requiring prolonged mechanical ventilation.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Analysis of Regional Blocks During Enzymatic Debridement of Burns.","authors":"Zoey Chasen, Justin Suarez, Alexander Kurjatko","doi":"10.1093/jbcr/iraf084","DOIUrl":"https://doi.org/10.1093/jbcr/iraf084","url":null,"abstract":"<p><p>Anacaulase is a mixture of enzymes used for the breakdown of eschar in patients with deep partial- or full-thickness burns up to 20% of the body's surface area. European consensus guidelines recommend regional anesthesia of an isolated extremity undergoing enzymatic debridement, but no North American consensus has been reached. Our practice has shifted from a multimodal pain strategy to utilize regional blocks prior to application of anacaulase. The purpose of this study was to determine whether the introduction of regional blocks improved pain control in patients receiving anacaulase therapy. This is a single-center retrospective comparative study evaluating all patients who received anacaulase from July 2016 to July 2024. Continuous data was evaluated via Wilcoxon rank sum test and categorical data was evaluated via chi-square test of independence. In the prespecified period, 47 patients received anacaulase and were included for analysis. Of the 47 patients, 24 (51.1%) underwent regional block. There were no significant differences in baseline characteristics except lower baseline opioid requirements in the regional block group. Pain scores during anacaulase application were significantly lower in patients that received regional blocks (4.5 vs 7, p=0.003). There was no difference in change in opioid requirements or requirement of adjunct medications except for dexmedetomidine requirements (0% vs 78.3%, p <0.001). Our data suggest that regional blocks were associated with lower pain scores in burn patients receiving anacaulase therapy but did not result in a change in opioid requirements from baseline. Regional blocks may be an effective strategy in this population to reduce pain from enzymatic debridement, but prospective studies would be warranted.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Heparin and Enoxaparin Anticoagulant Prophylaxis on Improving Acute Mortality in Burn Patients.","authors":"Manav M Patel, Shawn E Lim, Victoria A Cuello, Joshua E Lewis, Amina El Ayadi, Michael J Erickson, Steven E Wolf, Juquan Song","doi":"10.1093/jbcr/iraf080","DOIUrl":"https://doi.org/10.1093/jbcr/iraf080","url":null,"abstract":"<p><p>Burn patients have a higher chance of developing thromboembolic complications leading to worsened mortality rates so prophylactic anticoagulation is important. Anticoagulants such as enoxaparin, a low molecular weight heparin (LMWH), and unfractionated heparin (UFH) have been frequently used as chemical prophylactic treatments of thromboembolisms. Enoxaparin has been shown to have lower mortality and higher efficacy in surgical patients and coronary artery disease patients. The aim of the study is to assess mortality and compare the safety of enoxaparin and heparin in acute burn patients. A retrospective cohort study of 26572 burn patients was conducted using the TriNetX database. Patients were divided into two cohorts: those receiving only unfractionated heparin (Cohort 1) and those receiving only enoxaparin (Cohort 2) prophylaxis within 24 hours after burn injury. Cohorts were matched with 1:1 propensity score matching to correct for differences in age, gender, ethnicity, race, burn severity, inhalation injury, diabetes mellitus, acute myocardial infarction, stroke, and central line venous catheter placement. Outcomes assessed included mortality and deep vein thrombosis (DVT) within a month (30 days). After matching, the enoxaparin(n=7484) cohort showed significantly lower 30-day mortality (1.3%) compared to the UFH (n=7484) cohort (3.6%) (RR = 2.70, 95% CI: 2.15-3.40, p < 0.05). Kaplan-Meier analysis demonstrated a higher survival probability in the enoxaparin group (98.6% vs. 96.4%, p < 0.05). DVT risk was slightly higher with UFH but not statistically significant (RR = 1.18, 95% CI: 0.54-2.54, p = 0.68). Prophylactic anticoagulation with enoxaparin is associated with a significant lower 30-day mortality risk compared to unfractionated heparin.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing and consumer testing fire and burn and cold injury prevention education with people who are unhoused: EQUIP Toolkit.","authors":"Caitlin M Orton, Maiya I Pacleb, Tony M Machacha, Carly Marincasiu, Megan Moore, Barclay T Stewart","doi":"10.1093/jbcr/iraf082","DOIUrl":"https://doi.org/10.1093/jbcr/iraf082","url":null,"abstract":"<p><p>Fifteen percent of people receiving care for major burn injuries in urban burn centers across North America were homeless pre-injury. The number and risk of such injuries are increasing due to greater numbers of people experiencing homelessness (PEH) and frequency of extreme climate events. Prevention education, along with passive and active fire and cold weather protections are critical for preventing these injuries. To increase acceptability, understandability, and actionability, prevention education needs to be in plain language, contextualized, and consumer-tested. We aimed to test newly developed fire and burn and cold injury prevention education materials with PEH and gain insights for preferred prevention strategies to address and mitigate related risks and hazards. Forty cognitive interviews with PEH were conducted. The Model System Knowledge Translation Center's consumer-testing toolkit was used to evaluate understandability and actionability of the education materials. Transcripts were analyzed using a harm reduction framework and deductive and inductive thematic coding. Themes were: 1) engage - being approachable and accessible, 2) use context-specific design to enhance relatability - reflect the lived experiences of PEH and their environments, 3) reduce harm - focus on mitigating rather than eliminating hazards, 4) empower - incorporate prevention guidance, guided by PEH in combination with conventional prevention strategies, and 5) integrate - disseminate prevention education and PEH preferred safety equipment within services and locations utilized by PEH. The process of consumer-testing with PEH generated acceptable fire, burn and cold injury prevention and mitigation strategies. These strategies were used to develop actionable prevention education materials.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burn violence against women in Australia: The tip of the iceberg from Australian burn centres.","authors":"Yvonne Singer, Lincoln M Tracy, Claudia Malic, Lisa Martin, Belinda Gabbe, Heather Douglas","doi":"10.1093/jbcr/iraf081","DOIUrl":"https://doi.org/10.1093/jbcr/iraf081","url":null,"abstract":"<p><p>Violence against women is pervasive. An estimated 25% of Australian women (≥ 15 years) have experienced intimate partner violence. Recent cases of homicidal burn violence perpetrated against Australian women have shocked the nation. However, little evidence exists about the burden of burn violence against Australian women. This study describes and compares the frequency, sociodemographic profile, injuries, and outcomes of women admitted to Australian burn centres with burns from suspected violence with women with unintentional burns. Data were extracted from the Burns Registry of Australia and New Zealand for women (≥ 18 years) admitted to Australian burn centres between 2009 and 2022, with burns from suspected violence or unintentional burns. Socio-demographic profiles, injury, and in-hospital outcomes were compared. To further explore group differences, 155 women from each group were propensity score matched (one-to-one basis), with subsequent group comparisons made. Of 6262 women meeting inclusion criteria, few reported burns from suspected violence (2.5% versus 97.5%). Women with burns from suspected violence were younger (median 36 vs 43 years), greater proportions sustained flame burns (38.1% vs 25.3%) involving petrol (80.0% vs 38.0%), their injuries more likely involved their head (42.3% vs 16.4%), and a greater proportion died (4.5% versus 1.5%). Perpetrators were most often intimate partners. Our study contributes to emerging international literature demonstrating the confronting nature and consequences of burn violence against women. Building capacity amongst burn centre teams to identify and respond to suspected burn violence will better protect Australian women and aligns with national plans to end violence against women.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Study of Microcolumn Skin Grafting in Full-thickness Burns.","authors":"Martin R Buta, Matthew Supple, Sean Hickey, Jonathan S Friedstat, John T Schulz, Edward A Bittner, Joshua Tam, Jeremy Goverman","doi":"10.1093/jbcr/iraf075","DOIUrl":"https://doi.org/10.1093/jbcr/iraf075","url":null,"abstract":"<p><p>This pilot study evaluated the feasibility of treating third-degree, full-thickness burn wounds with both split-thickness skin grafts (STSGs) and micro skin tissue columns (MSTC). Donor sites for both grafting techniques were also assessed. Patients aged ≥18 years with ≤60% total body surface area (TBSA) third-degree, full-thickness burns were enrolled. One 2.5 x 2.5 cm2 wound area was treated in each subject, with the remaining portion of the wound used as an internal control. The target wound was treated with MSTCs + STSG while the control site was treated with STSG. Patients were followed for up to nine months after wound closure. Primary endpoints included re-epithelialization rate (RER), scarring (Vancouver Scar Scale, Patient and Observer Scar Assessment Scale), and donor site pain (visual analogue scale). Ten patients were enrolled. Overall, MSTC donor sites were less painful, epithelialized faster, and resulted in improved POSAS and VSS scores than STSG donor sites. For all endpoints, there were no differences in the recipient wounds grafted with or without MSTCs. Intraoperative MSTC grafting is feasible and results in minimal donor site morbidity. This pilot study was unable to demonstrate enhanced wound healing or reduced scar formation when MSTCs were applied simultaneously with STSGs to burn wounds. Larger clinical studies are needed to assess the utility of MSTCs in conjunction with STSGs.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive Fungal Infection Increases Mortality Risk After Burn Injury.","authors":"Allison B Frederick, Savannah H Skidmore, Aaron P Lesher, Steven A Kahn, Rohit Mittal","doi":"10.1093/jbcr/iraf047","DOIUrl":"https://doi.org/10.1093/jbcr/iraf047","url":null,"abstract":"<p><p>While invasive fungal infections (IFIs) can be deadly for any hospitalized patient, a high-risk subset are those with burn injuries due to their immunocompromised state, and an increasing number of non-Candida infections have been on the rise. This novel study captures data from across the United States using a multi-institutional dataset derived from electronic health record data and is the largest study to date evaluating mortality associated with fungal infections in burn injury. Inclusion criteria identified all patients with burn injury from 2002 to 2024; IFI was defined as a diagnosis of fungal mycosis with systemic antifungal treatment which was compared to a control cohort of burn patients without mycoses or antifungal treatment. The cohorts were then propensity-matched for gender, age, and percent total body surface area (%TBSA). The unmatched fungal infection cohort contained 3325 patients while the control cohort contained 50 5421. After propensity matching, the 1-year mortality rate for all burn patients with fungal infection was 18.5% compared to 1.9% in controls (risk ratio: 9.8, 95% confidence interval, 7.2-13.2; P < .0001). Additionally, when stratified by %TBSA there was a stepwise increase in mortality: 21.6% for <10% TBSA (P < .0001), 29.0% for 10%-49% TBSA (P < .0001), and 33.1% for >50% TBSA (P = .2). The 3 most common and deadly infections among all burn patients were Aspergillus, invasive Candida, and unspecified mycoses. In all burns, fungal infection was associated with a nearly 10-fold increase in mortality. An incremental increase is noted when stratified by %TBSA and even <10% TBSA burns have an over 20% risk of mortality.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous chemical burns: Water irrigation first aid improves short term outcomes.","authors":"Hayley Chai, Lisa Martin, Rachel Kornhaber, Leila Cuttle, Mark Fear, Fiona Wood","doi":"10.1093/jbcr/iraf079","DOIUrl":"https://doi.org/10.1093/jbcr/iraf079","url":null,"abstract":"<p><p>First aid recommendations for chemical burns include copious water irrigation for 30 minutes to 2 hours after removal of the substance from skin. The aim of this retrospective analysis was to assess the efficacy of water irrigation on short-term outcomes for chemical burn injuries. Data from the Australian and New Zealand Burn registry (2009-2020) were analysed to categorize the application of running water for first aid for presence, timing of application post-injury and duration. The timing of first aid application was classified into whether the application was prehospital or in-hospital. Multivariate regression analyses then evaluated how water irrigation affected hospital stay, ICU admission, and the necessity for acute surgery for wound closure. Among 1,549 chemical burn patients, for those who received in-hospital first aid their stay was reduced by about 18% compared to those who did not. Patients receiving pre-hospital or in-hospital first aid had 37% and 31% lower odds, respectively, of needing acute care surgery for wound closure compared to those who did not. There was no evidence that first aid provision influenced the need for intensive care admission. Water irrigation is associated with shorter hospital stays and reduced acute care surgery for wound closure following chemical burns, without impacting intensive care admission rates.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized, Controlled Trial Comparing PermeaDerm to Mepilex Ag for the Treatment of Adult and Pediatric Partial-Thickness Burns.","authors":"David G Greenhalgh, David M Hill, Ram Velamuri, Ian Driscoll, Angela Gibson, Kevin Foster, David Smith, Aleisha Chamberlain, Katie Bush, Miao Yu","doi":"10.1093/jbcr/iraf013","DOIUrl":"https://doi.org/10.1093/jbcr/iraf013","url":null,"abstract":"<p><p>A next-generation transparent biosynthetic wound matrix (PermeaDerm) was developed for the treatment of burn injuries. Improvements include slits in an outer 2D silicone epidermal analog allowing for customizable moisture control, and an updated biocoating of the nylon knitted fabric to optimize wound adherence. The purpose of this randomized, single-blinded, multicenter trial was to compare PermeaDerm to a commonly used silver-containing foam dressing (Mepilex Ag) for the treatment of partial-thickness burns. Patients with partial-thickness burns <30% TBSA treated within 72 hours were included. Primary outcomes included incidence of 100% re-epithelialization at 14 days and time to conversion to alternative therapy. Secondary outcomes included incidence of healing at 7 and 21 days, pain, number of product changes, and adverse events. Sixty-seven patients (42 pediatric, 25 adult) were analyzed, 32 with Mepilex Ag and 35 with PermeaDerm. Though not statistically significant, more patients achieved healing with PermeaDerm at day 14 (P = 0.36), particularly those with superficial partial-thickness injuries (OR 5.87, P = 0.203, 95% CI = 0.385, 89.580). This trend continued to day 21 (P = 0.25). At day 7, nonsignificant increased incidence of healing of Mepilex Ag-treated wounds was observed (P = 0.25), in addition, PermeaDerm was associated with lower needs for product changes (OR 0.15, P = 0.034, 95% CI = 0.027, 0.872); both observations likely attributable to the adherent nature of PermeaDerm. No significant differences in time to conversion to alternate therapies were noted. Overall pain scores, aesthetics, and adverse events, including infection, were similar between groups. PermeaDerm is a safe and effective treatment for partial-thickness burns. PermeaDerm offers the clinical advantages of being transparent to continuously monitor the wound and adherent, reducing the need for a product change and allowing for bathing after 72 hours.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}