Journal of Clinical Apheresis最新文献

{"title":"Gender Composition of Invited Speakers and Session Chairs at American Society for Apheresis Annual Meetings Between 2019 and 2024","authors":"Jeremy W. Jacobs,&nbsp;Elizabeth S. Allen,&nbsp;Laura D. Stephens,&nbsp;Brian D. Adkins,&nbsp;Jennifer S. Woo,&nbsp;Allison P. Wheeler,&nbsp;Deva Sharma,&nbsp;Yvette M. Miller,&nbsp;Garrett S. Booth","doi":"10.1002/jca.70015","DOIUrl":"https://doi.org/10.1002/jca.70015","url":null,"abstract":"<p>Disparities persist throughout medicine, including among conference speakership invitations. The National Institutes of Health have highlighted the importance of diversity at academic conferences. We assessed the gender composition of speakers at the American Society for Apheresis (ASFA) annual meeting. We assessed all session chairs and speakers at the annual ASFA meeting from 2019 to 2024. Two authors independently assessed individuals' genders. The primary outcome was the gender composition of all session chairs and speakers by position. Subset analyzes were performed to assess the gender composition of unique individuals (i.e., examining the total number of unique men and women, independent of the number of sessions at which they spoke) and by professional degree. 820 positions (665 speaker positions and 155 chair positions) were identified; women comprised significantly more positions than men [64.3%, 528/820 (95% CI 61.1%–67.6%) vs. 35.6% 292/820 (32.4%–38.9%); <i>p</i> &lt; 0.0001]. 52.7% (432/820) of all session positions were held by physicians, with no significant difference in the gender composition [women 47.5%, 205/432 (42.8%–52.2%) vs. men 52.6%, 227/432 (47.8%–57.2%); <i>p</i> = 0.31]. When limited to unique physician individuals, women were significantly outnumbered by men [40.1%, 71/177 (33.2%–47.5%) vs. 59.9%, 106/177 (52.5%–66.8%); <i>p</i> = 0.01]. This analysis demonstrated mixed findings, with more women across all positions overall but significantly more men when limited to unique physicians. Diversity in conference positions begets a broader array of perspectives, knowledge, and expertise, and can aid in realizing greater diversity in related areas. Thus, academic conference diversity should be prioritized and thoughtfully pursued.</p>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jca.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Efgartigimod on Utilization of Therapeutic Plasma Exchange Procedures for Myasthenia Gravis in One Tertiary Medical Center","authors":"Ashley J. Crosby,&nbsp;Mariama Evans,&nbsp;Danielle L. V. Maracaja,&nbsp;Yara A. Park,&nbsp;James F. Howard Jr,&nbsp;Matthew S. Karafin","doi":"10.1002/jca.70010","DOIUrl":"https://doi.org/10.1002/jca.70010","url":null,"abstract":"<div>\u0000 \u0000 <p>Myasthenia gravis (MG) is an autoimmune disorder caused by autoantibodies against proteins of the neuromuscular junction, such as the acetylcholine receptor (AChR). While therapeutic plasma exchange (TPE) has been a standard chronic therapy for patients with poorly controlled MG, new medications have recently been approved by the FDA for such patients. We report the impact of a new therapy, efgartigimod, on the number of therapeutic plasma exchanges performed on patients with generalized MG in our apheresis unit. A retrospective chart review was performed for patients with MG between 2018–2019 (pre-efgartigimod) and 2022–2023 (post-efgartigimod). We evaluated any changes between the two periods, including the total number of MG patients, the proportion of TPEs that were performed for MG, and the proportion of inpatient TPEs for MG. A statistically significant reduction (<i>p</i> &lt; 0.0001) was observed in the proportion of total TPE procedures for MG between the two time periods. In AChR-antibody positive (AChR-Ab +) patients who received both inpatient and outpatient procedures, there was a significant increase in the proportion of inpatient procedures post-efgartigimod (<i>p</i> = 0.0035). Our study demonstrated a decrease in the overall use of chronic TPE for MG over the 2-year period following the release of efgartigimod. However, there will remain a role for TPE in the setting of acute MG flares, the inpatient setting, during pregnancy, and in those who do not tolerate the new medications.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565028","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 A Model to Predict Major Bleeding Among Hospitalized Patients Undergoing Therapeutic Plasma Exchange","authors":"Alexandre Soares Ferreira Junior,&nbsp;Morgana Pinheiro Maux Lessa,&nbsp;Kate Sanborn,&nbsp;Alexander Gordee,&nbsp;Maragatha Kuchibhatla,&nbsp;Matthew S. Karafin,&nbsp;Oluwatoyosi A. Onwuemene","doi":"10.1002/jca.70013","DOIUrl":"https://doi.org/10.1002/jca.70013","url":null,"abstract":"<div>\u0000 \u0000 <p>Although therapeutic plasma exchange (TPE) can be associated with bleeding, there are currently no known strategies to reliably predict bleeding risk. This study developed a TPE bleeding risk prediction model for hospitalized patients. To develop the prediction model, we undertook a secondary analysis of public use files from the Recipient Epidemiology and Donor Evaluation Study-III. First, we used a literature review to identify potential predictors. Second, we used Multiple Imputation by Chained Equations to impute variables with &lt; 30% missing data. Third, we performed a 10-fold Cross-Validated Least Absolute Shrinkage and Selection Operator to optimize variable selection. Finally, we fitted a logistic regression model. The model identified 10 unique predictors and seven interactions. Among those with the highest odds ratios (OR) were the following: &gt; 10 TPE procedures and antiplatelet agents (OR 3.26); nephrogenic systemic sclerosis (OR 3.15); and intensive care unit stay (OR 3.08). Among those with the lowest OR were the following: albumin-only TPE (OR 0.50); male sex (OR 0.82); and heart failure (OR 0.85). The model indicated an acceptable performance with a C-statistic of 0.71 (95% CI 0.699–0.717). A model to predict bleeding risk among hospitalized patients undergoing TPE identified key predictors and interactions. Although the model achieved acceptable performance, future studies are needed to validate and operationalize it.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554712","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":"G-CSF Only Versus Chemotherapy and G-CSF Peripheral Blood Stem Cell Mobilization for Autologous Hematopoietic Stem Cell Transplant—Assessing a Change in Regime due to the COVID-19 Pandemic","authors":"Julia S. Wolf,&nbsp;Frances Seymour,&nbsp;Christopher Parrish,&nbsp;Thea Chandler,&nbsp;Matthew Holt,&nbsp;James Griffin,&nbsp;Marina Karakantza","doi":"10.1002/jca.70012","DOIUrl":"https://doi.org/10.1002/jca.70012","url":null,"abstract":"<div>\u0000 \u0000 <p>Autologous stem cell transplant (ASCT) requires the collection of hematopoietic progenitor cells, commonly by apheresis (HPC-A). These CD34+ cells can be mobilized using Granulocyte Colony Stimulating Factor (G-CSF) only or chemomobilization plus G-CSF. Both methods may additionally include Plerixafor. The emergence of COVID-19 led to recommendations for preferential G-CSF only mobilization. To assess the impact of this recommendation on HPC-A harvesting, we analyzed data from the NHS Blood and Transplant Stem Cell Collection Registry for 1342 patients undergoing 2431 HPC-A procedures between 01/01/2019 and 31/12/2021. We compared G-CSF only, cyclophosphamide plus G-CSF (Cyclo-G) and G-CSF plus alternative chemotherapy (Chemo+G) mobilization. The outcomes collected were pre-apheresis CD34+ count, CD34+ yield per procedure, total CD34+ yield, number of apheresis procedures required to achieve the CD34+ target, mobilization failure, and Plerixafor use (+P). In multiple myeloma (MM), Cyclo-G (+/−P) mobilization produced significantly higher CD34+ yields than G-CSF only (7.44 vs. 4.75 × 10⁶/kg; <i>p</i> &lt; 0.0001). In Hodgkin lymphoma (HL) there was no statistically significant difference between regimes (CD34+ yield 4.53 × 10⁶/kg with G-CSF only (+/−P), 5.52 × 10⁶/kg with Cyclo-G (+/−P), 4.32 × 10⁶/kg with Chemo+G (+/−P)). In Non-Hodgkin lymphoma (NHL), Chemo+G (+/−P) was the most successful regime (5.98 × 10⁶/kg vs. 3.7 × 10⁶/kg with G-CSF only (+/−P) vs. 3.69 × 10⁶/kg with Cyclo-G (+/−P); <i>p</i> &lt; 0.00001). On demand Plerixafor use resulted in &gt; 95% successful mobilization in MM and NHL. CD34+ yields are higher using Cyclo-G and Chemo+G in NHL. In MM, G-CSF only resulted in yields sufficient for at least one transplant. In HL, our data show no evidence to support the use of Cyclo-G over G-CSF only.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530138","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":"Comparison of Adverse Reactions With Solvent/Detergent Treated Plasma Versus Untreated Plasma Use in Therapeutic Plasma Exchange in Pediatric Patients","authors":"Samantha Phou,&nbsp;Cari Berryhill,&nbsp;Frank Nizzi,&nbsp;Bryce Pasko","doi":"10.1002/jca.70011","DOIUrl":"https://doi.org/10.1002/jca.70011","url":null,"abstract":"<div>\u0000 \u0000 <p>Solvent/detergent treated plasma (SD plasma) use in therapeutic plasma exchange (TPE) in pediatric patients is not commonly reported. This study aimed to determine transfusion reaction rates using SD plasma and to compare transfusion reaction rates and adverse events when using SD plasma versus untreated plasma in pediatric TPE. A retrospective review was performed on TPE procedures performed at a single institution over a 3-year period. For each TPE procedure, replacement fluid was determined at the discretion of the transfusion medicine physician, consisting of either 5% albumin, untreated plasma, SD plasma, or a combination of untreated or SD plasma with 5% albumin. SD plasma was used in 51 TPE procedures performed on 17 patients. In comparison, untreated plasma was used in 254 procedures in 68 patients. Patient ages ranged from 6 days to 20 years old. With SD plasma use, 1 procedure (2% incidence) reported a non-severe allergic transfusion reaction, compared to 9 procedures (3.5% incidence) with untreated plasma use. These transfusion reaction rates were not statistically different (<i>p</i> = 0.7036, two-tailed Fisher's exact test). Circuit clotting issues were reported in one patient during two discrete TPE procedures utilizing untreated plasma. No other transfusion reactions or adverse events were reported. SD plasma used for TPE was well tolerated, with transfusion reaction rates similar to those observed in untreated plasma in our pediatric patients. SD plasma may be used for TPE in pediatric patients without apparent increased procedure-related risks or increased risks of transfusion reactions compared to untreated plasma.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521986","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":"Nurse-Led Apheresis Service in a Pediatric Restructured Hospital: The Past, the Present, and the Future","authors":"Pham Thi Ngoc Anh,&nbsp;Xinni Zhong,&nbsp;Siew Ling Yvonne Lim,&nbsp;Puaness Wari Periakaruppan,&nbsp;Vijayakumari K.","doi":"10.1002/jca.70009","DOIUrl":"https://doi.org/10.1002/jca.70009","url":null,"abstract":"<div>\u0000 \u0000 <p>Apheresis nurses are well equipped with not only the critical thinking skills but also the important aspects of operating the apheresis machine. As the demand for advanced cellular therapies grew, there was a need to recruit and train more nurses to be competent in apheresis nursing. A new service model was evolved from a physician-led to a nurse-led apheresis service, which empowered the apheresis nurses to lead the service. Since the commencement of the nurse-led service, a total of 32 peripheral hematopoietic progenitor cells collections were documented, and the outcomes of the cell yield were tabulated to study the collection efficiency. Ninety-four percent of the targeted cell yield was achieved with no collections needing beyond 2 days of harvesting. No apheresis-related major adverse event was reported following the implementation of the new service model too.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447213","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":"Therapeutic Plasma Exchange in Tandem With Other Types of Extracorporeal Circuits: The Experience of a Pediatric Center and a Review of Other Pediatric Center Reports","authors":"Lejla Music Aplenc,&nbsp;Nicole Wood,&nbsp;Nazia Tabassum Iqbal,&nbsp;Cindy George,&nbsp;Cherie Burroughsscanlon","doi":"10.1002/jca.70007","DOIUrl":"https://doi.org/10.1002/jca.70007","url":null,"abstract":"<div>\u0000 \u0000 <p>Therapeutic plasma exchange (TPE) concurrently performed in critically ill pediatric patients with other extracorporeal circuits is a complex process. We sought to characterize tandem procedures, including patient demographics, primary diagnosis, American Society for Apheresis (ASFA) category indications, survival at 24 h and 30 days after completion, blood product utilization, and complications. A retrospective analysis of medical records was performed. Data were collected from July 2014 to January 2021 with institutional review board approval. Patients' demographics, blood product utilization, and adverse events data were collected. In addition, we performed a literature review to identify studies in the pediatric population that were similar in design to our study. Fifty patients underwent 262 procedures. The median age was 9 years, and median weight was 21 kg (42% of patients weighed less than 10 kg). The most frequent indications for plasma exchange included sepsis with multiorgan failure (11 patients) and multiorgan failure (9 patients). ASFA indication category III was the most common (42 patients), followed by uncategorized indications (6 patients). The most common adverse events were hypocalcemia, occurring in 120 (45%) procedures, hypotension in 25 (9.5%) procedures, and circuit clotting in 12 (4.5%) procedures. Citrate, heparin, and bivalirudin were used as anticoagulants. Thirty-nine (78%) patients survived 24 h, and 26 (52%) patients were alive 30 days after completion of tandem procedures. Despite the high level of complexity, tandem procedures can be performed efficiently and safely in critically ill children.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431606","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":"Allergic Reaction to Alteplase Dwell in Chronic Automated Red Cell Exchange Patient","authors":"R. Jacob,&nbsp;M. Tran,&nbsp;T. Sommers,&nbsp;T. Lee","doi":"10.1002/jca.70008","DOIUrl":"https://doi.org/10.1002/jca.70008","url":null,"abstract":"<div>\u0000 \u0000 <p>Allergic reactions to intravenous, alteplase have been reported, usually in doses utilized for thrombolysis. Alteplase is also widely used for clearance of occluded catheter lumens, but allergic reactions have not been reported for this route of administration. A 14-year-old patient with sickle cell disease presented with an occluded apheresis port. During alteplase dwell for port occlusion, he developed an initial reaction concerning for anaphylaxis prior to automated red cell exchange, resulting in hospitalization. Findings included angioedema to the tongue and lip as well as urticaria on his abdomen and over a previous port scar, which became warm and firm. Of note, the patient also has a history of severe atopy, uncontrolled eczema, asthma, allergic rhinitis, and elevated eosinophils. The patient was referred to allergy and a skin test to alteplase was negative. The patient underwent an alteplase challenge through his catheter where he experienced anaphylaxis. Despite appropriate treatment, he again required inpatient admission. Post reaction serum tryptase level was not elevated. A clear temporal relationship to alteplase exposure and subsequent allergic reaction was documented in this case. To our knowledge, this is the first reported case of allergic reaction to intraluminal alteplase used for clearance of an occluded apheresis port. The non-elevated tryptase level suggests a non-IgE mediated reaction. Allergic reaction to alteplase dwell for clearance of occluded lumens can occur and is an entity apheresis providers should be aware of. Additionally, traditional skin testing may not be entirely predictive of safety upon rechallenge.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362724","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":"Safety and Efficacy of DPMAS in Patients With Acute-on-Chronic Liver Failure Based on Different Platelet Count Levels","authors":"Lingyun Niu,&nbsp;Jiamei Zhou,&nbsp;Ninghui Zhao,&nbsp;Aiqing Zhang,&nbsp;Qing Ye,&nbsp;Jia Lian,&nbsp;Baiguo Xu,&nbsp;Jing Wen,&nbsp;Jia Yao,&nbsp;Tao Han","doi":"10.1002/jca.70006","DOIUrl":"10.1002/jca.70006","url":null,"abstract":"<div>\u0000 \u0000 <p>To investigate the effect of different platelet (PLT) counts on the safety and efficacy of the double-plasma molecular absorption system (DPMAS) in patients with acute-on-chronic liver failure (ACLF). A total of 156 patients with ACLF receiving DPMAS were divided into the observed group (40 × 10⁹/L ≤ PLT &lt; 50 × 10⁹/L) and the control group (PLT ≥ 50 × 10⁹/L) according to PLT count level. The safety and efficacy indices of bleeding-related complications, PLT reduction rate, total bilirubin (TBIL) reduction rate, and 28-days survival rate after DPMAS were analyzed and compared between the two groups. The incidence of bleeding complications during and after DPMAS in the observed and control groups (14.3% vs. 14.9%, <i>p</i> = 0.922), the decline rate of PLT immediately and 24 h after treatment (0.13 vs. 0.11/0.05 vs. 0.09, <i>p</i> = 0.256/0.161), and the 28-days survival rate after treatment (76.2% vs. 75.4%, <i>p</i> = 0.923) were not significantly different. The thromboelastogram before DPMAS showed no significant difference in PLT function between the two groups (<i>p</i> &gt; 0.05). Although the TBIL level of the two groups rebounded 24 h after treatment compared with immediately after treatment, it decreased significantly immediately and 24 h after treatment compared with pre-treatment levels (<i>p</i> &lt; 0.05). There was no significant difference in the rate of decline of serum TBIL immediately after treatment and 24 h after treatment between the two groups (0.33 vs. 0.35/0.14 vs. 0.16, <i>p</i> = 0.193 and 0.653, respectively). DPMAS is safe and effective in patients with ACLF with 40 × 10⁹/L ≤ PLT count &lt; 50 × 10⁹/L.</p>\u0000 </div>","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006198","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":"Legendary Case of Factitious Disorder Presenting as ‘Sickle Cell Disease’ Creates Challenges for All Medical Specialties","authors":"Olivia Iverson,&nbsp;Theresa N. Kinard,&nbsp;Jeffrey L. Winters,&nbsp;Lance A. Williams III","doi":"10.1002/jca.70005","DOIUrl":"10.1002/jca.70005","url":null,"abstract":"","PeriodicalId":15390,"journal":{"name":"Journal of Clinical Apheresis","volume":"40 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983639","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}