Journal of Assisted Reproduction and Genetics最新文献

{"title":"Prediction of the acupuncture effects on pregnancy outcomes with personalized, embryonic, endometrial characteristics in women undergoing frozen-thawed embryo transfer.","authors":"Li-Ying Liu, Yuan-Yuan Lai, Yong-Na Wu, Lei Huang, Rui Tian, Di Gan, Wen-Hui Hu, Si-Yi Yu, Jie Yang","doi":"10.1007/s10815-025-03704-1","DOIUrl":"https://doi.org/10.1007/s10815-025-03704-1","url":null,"abstract":"<p><strong>Objective: </strong>Acupuncture is acknowledged for its safety and effectiveness in the process of frozen embryo transfer (FET) to improve pregnancy outcomes. The study aimed to develop a clinical prediction model to predict the probability of clinical pregnancy after acupuncture treatment during FET and to identify the most predictive characteristics.</p><p><strong>Methods: </strong>Two clinical trials on acupuncture treatment during FET containing a total of 390 patients (315 in Trial 1 and 75 in Trial 2) were involved for data training. Eighty baseline clinical characteristics were collected from patients in Trial 1, and the support vector classification (SVC) model was created to predict the improvement of FET clinical pregnancy by acupuncture. Trial 1 was utilized as the internal validation set (divided into internal test and validation sets in a 7:3 ratio), whereas Trial 2 was used as the external validation set to assess the external generalizability of this clinical prediction model.</p><p><strong>Results: </strong>In Trial 1, the prediction model achieved an accuracy of 0.778, a precision of 0.821, a recall score of 0.807, an f1 score of 0.814, and an AUC of 0.772 in predicting the acupuncture response. The in-hospital cycle, vascularized flow index, and transferred embryo number were the essential predictive features identified by the SVC model. For Trial 2, an accuracy of 0.74, a precision of 0.625, a recall score of 0.625, an f1 score of 0.625, an AUC of 0.713 were shown in the LSVC model.</p><p><strong>Conclusion: </strong>The clinical prediction model constructed through this study may help physicians determine in advance how patients will respond to acupuncture before FET and provide accurate treatment plans for acupuncture.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct post-insemination dynamics between fresh and frozen-derived gametes using testicular sperm.","authors":"V Ferracuti, A Bayram, I Elkhatib, A Abdala, E Kalafat, F Ruiz, H Fatemi, D Nogueira","doi":"10.1007/s10815-025-03696-y","DOIUrl":"https://doi.org/10.1007/s10815-025-03696-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate differences in post-insemination events between fresh and frozen-derived gametes when testicular sperm extraction (TESE) is used.</p><p><strong>Method: </strong>A retrospective cohort study including 980 oocytes retrieved across 72 cycles from 30 couples, between January 2017 and September 2023. Gamete sources were fresh (fresh-TESE) or frozen-thawed-TESE (frozen-TESE) from the same patients with non-obstructive azoospermia (NOA), and fresh or vitrified (frozen) oocytes from the same female partner. Following insemination by TESE-sperm, embryos were cultured in a time-lapse (TL) incubator. Resulting blastocysts underwent trophectoderm (TE) biopsy for preimplantation genetic testing for aneuploidy (PGT-A) by next-generation sequencing (NGS). Fertilization, usable blastocysts, and euploidy rates were recorded, and morphokinetic key parameters were annotated.</p><p><strong>Results: </strong>Oocyte/sperm dyads using frozen-TESE showed an association with lower fertilization (OR 0.64, 95% CI 0.45-0.89, P = 0.008) and lower blastulation/MII (OR 0.53, 95% CI 0.37-0.77, P = 0.001), but similar blastulation/2PN (OR 0.69, 95% CI 0.45-1.07, P = 0.09). After accounting for female age, euploidy per tested blastocyst was similar whether fresh or frozen-TESE was used, but frozen oocyte use showed no association with these outcomes. The use of frozen dyads was associated with longer duration of 2PN after tPNa to tPNf: in frozen-TESE, 2.10 h longer (95% CI 0.55-3.64, P = 0.008) and in vitrified oocytes, 2.34 h longer (95% CI 0.31-4.36, P = 0.024). Slight morphokinetic differences between fresh and frozen-TESE were observed during subsequent developmental stages.</p><p><strong>Conclusions: </strong>Synchronizing fresh-TESE with oocyte retrieval, when possible, appears safer to maximize fertilization rates. Regardless of the gamete type, frozen-sourced sperm or oocyte impact 2PN-lag time, possibly indicating nuclear repair mechanisms post-freezing, requiring further investigation.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing patient perceptions and understandings of genetic testing after pregnancy loss.","authors":"Emily Hrach, Jenna Carlson, Robin E Grubs, Elizabeth Sheehan, Ruth B Lathi, Aleksandar Rajkovic, Svetlana A Yatsenko","doi":"10.1007/s10815-025-03705-0","DOIUrl":"https://doi.org/10.1007/s10815-025-03705-0","url":null,"abstract":"<p><strong>Purpose: </strong>The ACOG and ASRM practice guidelines recommend cytogenetic testing after two pregnancy losses. This study aimed to evaluate patients' understandings of the benefits and limitations of genetic testing, feelings, motivations, and hesitations regarding genetic testing, effect of genetic findings on family planning, and to discern the areas of potential clinical improvement.</p><p><strong>Methods: </strong>An anonymous online survey collected responses regarding frequency and outcomes of testing, family history, patients' perceptions regarding benefits and utility of genetic testing, and likelihood of utilizing various reproductive options. Results were compared between participants with a single miscarriage (SM) and recurrent pregnancy losses (RPL).</p><p><strong>Results: </strong>Out of 218 qualified respondents, 198 (90.8%) completed the entire survey. Overall, 92.1% of respondents were interested in genetic testing to find an explanation for miscarriage. Genetic testing on the miscarriage tissue was offered to 55.4% of respondents (63.7% with RPL and 46.0% with SM). Parental genetic testing was offered to 67.9% of patients and 54.5% of their partners with RPL and to 27.6% of individuals and 18.4% of their partners with SM. Genetic testing provided an explanation for the miscarriage for an approximately equal proportion of SM and RPL respondents. Knowing a genetic cause, respondents would be more likely to utilize preimplantation genetic screening or prenatal testing than egg/sperm donation or adoption.</p><p><strong>Conclusion: </strong>Genetic testing is highly desired by patients to aid in decision making about future pregnancies, but many are not offered testing despite meeting practice guidelines, indicating the need for more widespread implementation of practice guidelines.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of clinical outcome after intrauterine insemination with donor semen in single women, lesbian couples and heterosexual couples.","authors":"M Godinho, M Chaillot, S Bouée, A Reignier, T Fréour","doi":"10.1007/s10815-025-03706-z","DOIUrl":"https://doi.org/10.1007/s10815-025-03706-z","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to compare clinical pregnancy rate after IUI-D in heterosexual couples (HC), lesbian couples (LC), and single women (SW).</p><p><strong>Methods: </strong>This retrospective multicentric study was conducted in two university-based ART centers in France in all consecutive IUI-D cycles performed after stimulation with gonadotropins in 2021-2023. The primary outcome was clinical pregnancy rate (CPR). Cumulative clinical pregnancy rate was also calculated. Comparisons were made between groups taking HC as the control group and adjusting for age.</p><p><strong>Results: </strong>A total of 962 patients undergoing 2737 IUI-D cycles were included in the analysis, 234 HC women (24.3%), 478 LC women (49.7%), and 250 (30%) single women (SW). SW were significantly older than HC and LC. Clinical pregnancy rate (CPR) per cycle was significantly lower in LC and SW than in HC in univariate analysis. Age was negatively associated with clinical pregnancy. After adjusting for age, no statistically significant relationship was found between category and clinical pregnancy (p = 0.07). Cumulative clinical pregnancy rates (CCPR) and the average number of cycles required to achieve pregnancy were not significantly different between HC, LC and SW.</p><p><strong>Conclusions: </strong>This first study conducted in France after change in law allowing ART access for LC and SW confirms that CPR after IUI-D is not significantly associated with relationship status after adjusting for age.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphokinetic parameter S2 predicts early embryo developmental potential and associated metabolic pathways.","authors":"Xuehua Chen, Huanhua Chen, Guiting Huang, Ruoyun Lin, Hong Zhou, Xiaojing Fan, Zhulian Wu, Kongrong Xu, Jinhui Shu, Caizhu Wang","doi":"10.1007/s10815-025-03709-w","DOIUrl":"https://doi.org/10.1007/s10815-025-03709-w","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to determine the predictive value of the morphokinetic parameter S2 (the duration between cleavage from the 3-cell to 4-cell stage in the absence of direct cleavage) for early embryo developmental potential, establish its optimal cutoff value, and explore associated metabolic pathways.</p><p><strong>Methods: </strong>This prospective study analyzed 662 embryos from 65 patients (September 2023-October 2024) which were cultured in time-lapse incubators. S2's predictive value for blastocyst formation/quality was assessed, with a cutoff value calculated through receiver operating characteristic (ROC) analysis. Subsequently, metabolomic profiling of spent culture media (SCM) from 20 patients was stratified by S2 cutoff using liquid chromatography-tandem mass spectrometry (LC-MS).</p><p><strong>Results: </strong>Among 662 embryos cultured in time-lapse incubators, 474 were analyzed to evaluate the association between S2 and developmental potential. Significant differences in S2 values were observed between the blastocyst formation vs. non-formation groups and high- vs. low-quality blastocyst groups (both median 0.5 vs. 0.8, P < 0.05). Logistic regression analysis showed that S2 predicted available blastocyst formation with an area under the curve (AUC) of 0.622 (95%CI = 0.559-0.685, P < 0.001) and blastocyst quality with an AUC of 0.645 (95% CI = 0.569-0.722), with an optimal cutoff of 0.7 h. Based on this cutoff, the day 3 (D3) SCM from 20 patients was divided into two groups (S2 < 0.7 and S2 ≥ 0.7) for metabolomic analysis. The results revealed 98 differentially expressed metabolites (59 upregulated and 39 downregulated), enriched in protein digestion/ absorption, aminoacyl-tRNA biosynthesis, fatty acid metabolism, central carbon metabolism in cancer, and glutamatergic synapse.</p><p><strong>Conclusions: </strong>The S2 parameter (optimal cutoff = 0.70 h) shows moderate predictive capacity for embryo developmental potential (AUC = 0.64), with its regulation by specific metabolic pathways, supporting its inclusion in future multifactorial embryo evaluation models.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ovarian stimulation and retrieval outcomes in transgender males maintained on testosterone: a case series.","authors":"Roisin M Mortimer, Zachary W Walker, Rachel K Ashby, Elizabeth S Ginsburg, Serene S Srouji","doi":"10.1007/s10815-025-03699-9","DOIUrl":"https://doi.org/10.1007/s10815-025-03699-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to report on three cases of transgender men who continued testosterone therapy throughout controlled ovarian hyperstimulation for fertility preservation.</p><p><strong>Methods: </strong>This was a retrospective case series of three transgender men who presented for oocyte cryopreservation at a university-affiliated fertility clinic and continued gender-affirming testosterone therapy up until or during the controlled ovarian hyperstimulation protocol. The primary outcomes were the number of oocytes retrieved, the number of mature oocytes retrieved, and the total gonadotrophin dose required during stimulation.</p><p><strong>Results: </strong>The average age of patients in this series was 29.5 years, with an average BMI of 31 kg/m². Mean serum testosterone prior to starting stimulation was 359 ng/dL. The average AMH and AFC levels were 1.2 ng/ml and 12 follicles, respectively, and the mean number of mature oocytes vitrified was 16. One patient fertilized seven mature oocytes and has an ongoing pregnancy following a single blastocyst embryo transfer.</p><p><strong>Conclusions: </strong>This is the largest case series of patients who continued testosterone during ovarian stimulation, with the widest range of testosterone dosing reported, and the first report of a self-carried pregnancy after COS on testosterone. While there is no long-term data as yet, these early findings are reassuring for patients and indicate that proceeding with a stimulation cycle without a testosterone washout period, or continuing testosterone during the cycle, may be a reasonable option, thereby increasing the accessibility of fertility preservation for gender-diverse and transgender individuals who wish to continue testosterone.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel CYLC1 variants are associated with male infertility due to sperm head deformity.","authors":"Kexin Yu, Yu Wang, Xiaoya Zhu, Huan Wu, Yuying Jiao, Jingjing Zhang, Zongliu Duan, Yiru Zhou, Mingfei Xiang, Fengsong Wang, Xiaoyu Yang, Yunxia Cao, Fuxi Zhu","doi":"10.1007/s10815-025-03665-5","DOIUrl":"https://doi.org/10.1007/s10815-025-03665-5","url":null,"abstract":"<p><strong>Purpose: </strong>To identify novel CYLC1 variants in infertile men with sperm head deformity.</p><p><strong>Methods: </strong>Two infertile men underwent routine semen analysis, followed by whole-exome sequencing (WES) and Sanger sequencing to identify candidate pathogenic variants. Morphologic characteristics of sperm were analyzed by Hematoxylin-eosin (HE) staining, while Western blotting and immunofluorescence staining were used to evaluate variant effects on protein expression and localization. A Cylc1 knockout (KO) mouse model, generated by CRISPR/Cas9, was subsequently analyzed. Sperm from Cylc1-KO mice were examined using HE staining, immunofluorescence, scanning electron microscopy (SEM), and transmission electron microscopy (TEM) to evaluate morphological and ultrastructural features.</p><p><strong>Results: </strong>Two novel variants in CYLC1 (NM_021118.3: c.982A > G: p.K328E and c.971A > T: p.K324M) were identified in two infertile men with sperm head deformity. The CYLC1 variants had no significant effect on protein expression levels, but the localization of CYLC1 and the acrosome morphology of sperm from infertile men were altered. Notably, the localization of PLCZ1 was also altered in the sperm. Cylc1-KO mice displayed a similar subfertility phenotype, with ultrastructural analysis (SEM/TEM) demonstrating acrosome-nuclear detachment in sperm. Importantly, two infertile men achieved successful pregnancy outcomes through intracytoplasmic sperm injection (ICSI).</p><p><strong>Conclusions: </strong>Our results enrich the variant spectrum of CYLC1, offering additional support for an association between CYLC1 variants and male infertility.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring ovarian tissue cryopreservation as a means to an end: more than a reproductive lifespan extender.","authors":"David F Albertini","doi":"10.1007/s10815-025-03689-x","DOIUrl":"https://doi.org/10.1007/s10815-025-03689-x","url":null,"abstract":"","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential unmet fertility needs among men cancer survivors: exploratory evidence from the National Survey of Family Growth.","authors":"Katherine Tierney, Kelsey Sullivan","doi":"10.1007/s10815-025-03700-5","DOIUrl":"https://doi.org/10.1007/s10815-025-03700-5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate (1) sociodemographic variation in fertility care-seeking among men with a history of cancer at or before age 44, (2) whether sociodemographic inequalities among men with a history of cancer differ from men without a history of cancer, and (3) whether care-seeking differed among women and men with a history of cancer.</p><p><strong>Methods: </strong>This study uses five cycles of National Survey of Family Growth (NSFG), a nationally representative survey of women and men in the USA. Multivariable logistic regression with and without interaction terms were employed.</p><p><strong>Results: </strong>Among men young cancer survivors (YCS), non-Hispanic white men were less likely to ever-seek fertility care than YCS men of color (odds ratio = 0.28, p < 0.10). Additionally, among YCS men, those with less than bachelor's degree had lower odds of ever-seeking fertility care relative to those with a bachelor's or higher (OR = 0.25, p < 0.10). Analyses with interaction terms showed that the associations between ever-seeking care and race/ethnicity were significantly different among men YCS than men without a history of cancer (OR = 0.20, p < 0.05), while associations with educational attainment did not differ significantly between these groups. Finally, the results showed women YCS had higher odds of ever-seeking fertility care than men YCS (OR = 3.20, p < 0.01).</p><p><strong>Conclusions: </strong>Fertility care-seeking among men YCS differs by race/ethnicity from the associations observed among men without a history of cancer. Meanwhile, associations between care-seeking and education and sex were similar to associations observed in populations without a history of cancer. Thus, there may be unmet need for fertility-care among men YCS.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of chemical pollution and warming on male fertility: a narrative review by the Special Interest Group \"Environment and Fertility\" of the Italian Society of Fertility and Sterility and Reproductive Medicine (SIFES-MR).","authors":"Giuseppe Defeudis, Cristina de Angelis, Rossella Mazzilli, Federica Barbagallo, Claudia Leanza, Iva Sabovic, Rosita A Condorelli, Rocco Rago, Daniele Gianfrilli, Rosario Pivonello, Andrea Di Nisio, Paola Anserini, Carlo Foresta","doi":"10.1007/s10815-025-03678-0","DOIUrl":"https://doi.org/10.1007/s10815-025-03678-0","url":null,"abstract":"<p><p>Environmental changes are a growing global concern, and their impact on reproductive health remains incompletely understood. In this narrative review, conducted on behalf of the Italian Society of Fertility and Sterility and Reproductive Medicine (SIFES-MR), we examined the impact of the environment on male fertility, considering endocrine-disrupting chemicals (EDCs), air pollution, and global warming, with the aim of identifying strategies to improve reproductive outcomes. Scientific literature demonstrates that all these aspects may contribute to a decline in reproductive health, impairing sperm count, motility, and morphology as well as reducing testicular hormonal function. Future research should focus on the role of environmental factors in male hypogonadism, impaired spermatogenesis, genital abnormalities, and transgenerational effects.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}