Journal of diabetes and its complications最新文献

{"title":"Joint effect of nicotine use and diabetes distress on glycemic control in young adults with type 1 diabetes","authors":"Enzo G. Plaitano ,&nbsp;Catherine Stanger","doi":"10.1016/j.jdiacomp.2025.109083","DOIUrl":"10.1016/j.jdiacomp.2025.109083","url":null,"abstract":"<div><div>Nicotine inhibits glucose metabolism. In this national cross-sectional analysis of 388 young adults with type 1 diabetes and above target glycemic control, vaping was the most common route of nicotine use, and heavy nicotine use plus higher type 1 diabetes distress was related to worse objective measures of glycemic control.</div><div><strong>Trial registration</strong>: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> <span><span>NCT04646473</span><svg><path></path></svg></span>; <span><span>https://clinicaltrials.gov/ct2/show/NCT04646473</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109083"},"PeriodicalIF":2.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090287","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":"Differential impact of short-term and long-term glycemic variability on peripheral nerve function in type 2 diabetes: A 5-year cohort study","authors":"Takamasa Iwamoto ,&nbsp;Machiko Morita ,&nbsp;Shuji Hidaka ,&nbsp;Kentaro Sada ,&nbsp;Miyuki Iwamoto ,&nbsp;Hirotaka Shibata","doi":"10.1016/j.jdiacomp.2025.109081","DOIUrl":"10.1016/j.jdiacomp.2025.109081","url":null,"abstract":"<div><h3>Aims</h3><div>Several studies have demonstrated the association between glycemic variability (GV) and diabetic peripheral neuropathy (DPN). However, none has compared the effects of short-term and long-term GV on DPN in a cohort. This study evaluates the association between short-term and long-term GV and peripheral nerve function in a cohort of outpatients with type 2 diabetes.</div></div><div><h3>Methods</h3><div>Overall, 230 patients who had continuously attended the outpatient hospital for 5 years were enrolled. Short-term GV was assessed using continuous glucose monitoring (FreeStyle Libre Pro®), focusing on metrics such as the glucose levels’' standard deviation and time in range. Long-term GV was evaluated by using visit-to-visit variability in glycated hemoglobin (HbA1c), including the HbA1c standard deviation and coefficient of variation. Nerve conduction was assessed using DPNCheck™ by measuring sural nerve action potential (SNAP) amplitude and sensory conduction velocity (SCV). Multiple regression models were built to determine independent associations of GV and HbA1c variability metrics with SCV and SNAP amplitude.</div></div><div><h3>Results</h3><div>Most short-term GV indices were not associated with SNAP amplitude but significantly correlated with SCV; these associations were not evident after adjusting for HbA1c. Long-term GV showed minimal correlation with SCV, while strong associations with SNAP amplitude persisted after adjusting for the 5-year mean HbA1c.</div></div><div><h3>Conclusions</h3><div>Our findings demonstrate that short-term and long-term GVs have differential impacts on peripheral nerve function in outpatients with type 2 diabetes; with short-term GV associated with SCV and long-term with SNAP amplitude.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109081"},"PeriodicalIF":2.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147529","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":"Contents/Barcode","authors":"","doi":"10.1016/S1056-8727(25)00127-8","DOIUrl":"10.1016/S1056-8727(25)00127-8","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 7","pages":"Article 109074"},"PeriodicalIF":2.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069210","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":"Achievement of low-density lipoprotein cholesterol goals in patients with diabetes-related foot ulceration","authors":"Nick S.R. Lan ,&nbsp;Jonathan Hiew ,&nbsp;Ivana Ferreira ,&nbsp;J. Carsten Ritter ,&nbsp;Laurens Manning ,&nbsp;P. Gerry Fegan ,&nbsp;Girish Dwivedi ,&nbsp;Emma J. Hamilton","doi":"10.1016/j.jdiacomp.2025.109069","DOIUrl":"10.1016/j.jdiacomp.2025.109069","url":null,"abstract":"<div><div>Despite their elevated risk for cardiovascular complications, two-thirds of patients with diabetes-related foot ulceration in this contemporary real-world study were not achieving guideline-recommended goals for low-density lipoprotein cholesterol. Implementation research is needed to identify the barriers and facilitators to optimal lipid management in this high priority population.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109069"},"PeriodicalIF":2.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068943","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":"Effect of initial combination therapy vs. step-therapy on adherence and persistence in drug naïve type 2 diabetes patients","authors":"Zahra Majd ,&nbsp;Hua Chen ,&nbsp;Michael L. Johnson ,&nbsp;Kim K. Birtcher ,&nbsp;Omar Serna ,&nbsp;Bilqees Fatima ,&nbsp;Susan Abughosh","doi":"10.1016/j.jdiacomp.2025.109080","DOIUrl":"10.1016/j.jdiacomp.2025.109080","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Emerging evidence supports the early use of intensive combination treatments among type 2 diabetes (T2D) patients for rapid and sustained glycemic control. However, the impact of initial combination therapy on treatment adherence and persistence has not been explored. Therefore, we aimed to compare adherence and persistence to antidiabetic treatments between patients receiving initial combination therapy vs. conventional step-therapy.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study of MarketScan® research database (2017–2019) was conducted. We included drug naïve T2D patients who received step-therapy or initial combination therapy and were continuously enrolled in Commercial, Medicare, or Medicaid health plans during the pre-index and follow-up period. Primary outcomes of interest were antidiabetic treatment adherence and persistence during the first year of treatment initiation.</div></div><div><h3>Results</h3><div>In the Commercial/Medicare population, out of the total 116,597 patients, 52 % were nonadherent and 58 % were nonpersistent. Similarly, in the Medicaid population of 18,295 patients, 63 % were nonadherent and 67 % were nonpersistent. Patients receiving step-therapy were more likely to be adherent compared to the initial combination group in both populations (Commercial/Medicare: OR 1.52, 95 % CI 1.46–1.57; Medicaid: OR 1.24, 95 % CI 1.11–1.38). Additionally, in the Commercial/Medicare population, the multivariable Cox regression model showed that the step-therapy cohort had a significantly lower hazard for time to non-persistence compared to the initial combination cohort (HR 0.9, 95 % CI 0.86–0.94). However, this was not significantly different in the Medicaid population.</div></div><div><h3>Conclusions</h3><div>This study suggests that step-therapy as an initial pharmacotherapy approach may be associated with improved adherence and persistence in managing diabetes compared to initial combination therapy.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 9","pages":"Article 109080"},"PeriodicalIF":2.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178364","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":"Physical activity and albuminuria in individuals recently diagnosed with type 2 diabetes","authors":"T. Norlén ,&nbsp;T.B. Olesen ,&nbsp;S.L. Domazet ,&nbsp;J.S. Nielsen ,&nbsp;J.C. Brønd ,&nbsp;M.H. Olsen ,&nbsp;K. Højlund ,&nbsp;J.V. Stidsen","doi":"10.1016/j.jdiacomp.2025.109065","DOIUrl":"10.1016/j.jdiacomp.2025.109065","url":null,"abstract":"<div><h3>Aims</h3><div>We aimed to investigate the association between objectively measured physical activity and the presence and development of albuminuria in individuals recently diagnosed with type 2 diabetes at baseline.</div></div><div><h3>Methods</h3><div>This study was based on data from The Danish Centre for Strategic Research in Type 2 diabetes cohort (N = 832). We assessed moderate to vigorous physical activity (MVPA) and sedentary time by 24-hour dual-monitor accelerometry at baseline and 4-years follow-up and investigated the association with albuminuria, defined as urine albumin/creatinine-ratio (UACR) ≥30 mg/g, measured from a urine sample. The odds ratio (OR) for the presence and development of albuminuria were investigated using multiple logistic regressions.</div></div><div><h3>Results</h3><div>We found an inverse association between baseline MVPA and both presence (OR: 0.82; 95 % CI: 0.69–0.98) and incidence of albuminuria (OR: 0.74; 95 % CI: 0.59–0.94), independent of known confounding factors. However, sedentary time was not significantly associated with increased development of albuminuria. Moreover, neither decrease in MVPA (OR: 0.79; 95 % CI: 0.42–1.49) nor increase in sedentary time (OR: 1.03; 95 % CI: 0.98–1.09) were significantly associated with development of albuminuria from baseline to 4-years follow-up.</div></div><div><h3>Conclusions</h3><div>Our findings demonstrate an inverse association between baseline MVPA and development of albuminuria in individuals recently diagnosed with type 2 diabetes. An increase in MVPA from baseline to follow-up inferred 21 % lower incidence of albuminuria after 4-years follow-up, albeit insignificant, likely due to the relatively small sample size at follow-up and the lack of larger changes in physical activity.</div></div><div><h3>Clinical trial registration number</h3><div><span><span>NCT02015130</span><svg><path></path></svg></span></div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109065"},"PeriodicalIF":2.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090396","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":"Age different effects of SGLT2 inhibitors on body composition in individuals with type 2 diabetes: A retrospective cohort study","authors":"Kengo Miyoshi,&nbsp;Tomohisa Aoyama,&nbsp;Saori Kameda,&nbsp;Nagisa Ishibashi,&nbsp;Yumi Sakai,&nbsp;Takao Yamanaka,&nbsp;Tomoya Kawaguchi,&nbsp;Yuri Kadowaki,&nbsp;Toshimasa Yamauchi","doi":"10.1016/j.jdiacomp.2025.109068","DOIUrl":"10.1016/j.jdiacomp.2025.109068","url":null,"abstract":"<div><h3>Purpose</h3><div>This study investigates the long-term impact of sodium-glucose cotransporter 2 inhibitors (SGLT2i)on body composition in individuals with type 2 diabetes (T2D), with a focus on age-related differences. We evaluated changes in body mass index (BMI), body fat percentage, skeletal muscle mass and skeletal muscle mass index (SMI) over 4.4 years on average.</div></div><div><h3>Methods</h3><div>This retrospective, single-center clinical cohort study utilized electronic medical records from the University of Tokyo Hospital. 70 people with T2D treated with SGLT2i for more than two years were included. Body compositions were assessed using bioelectrical impedance analysis (BIA) at three time points: before SGLT2i therapy, 1 year after SGLT2 therapy initiation and the latest along with SGLT2i therapy.</div></div><div><h3>Results</h3><div>During the 4.4-year average treatment period, significant reductions were observed in BMI (30.5 to 29.1, <em>p</em> &lt; 0.0001) and skeletal muscle mass (30.3 kg to 29.0 kg, <em>p</em> &lt; 0.0001). ΔBMI was positively correlated with ΔBody fat percentage and ΔSkeletal muscle mass (all p &lt; 0.0001). Age-stratified analysis showed that in younger individuals, ΔSkeletal muscle mass was significantly associated with both treatment duration and ΔBMI. In contrast, older individuals showed a weaker correlation between ΔSkeletal muscle mass and ΔBMI, and experienced significant muscle mass decline at an earlier point.</div></div><div><h3>Conclusion</h3><div>SGLT2i are effective in managing T2D and reducing BMI and body fat. However, careful monitoring of body composition is crucial, especially in older individuals, to mitigate the risk of sarcopenia and maintain overall health.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109068"},"PeriodicalIF":2.9,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937095","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":"Subtypes of disordered eating and their diabetes-related and psychosocial concomitants in adults with type 1 diabetes","authors":"Lilli-Sophie Priesterroth,&nbsp;Jennifer Grammes,&nbsp;Thomas Kubiak","doi":"10.1016/j.jdiacomp.2025.109067","DOIUrl":"10.1016/j.jdiacomp.2025.109067","url":null,"abstract":"<div><h3>Aims</h3><div>To identify subtypes of disordered eating behaviors (DEB) in type 1 diabetes, describing their behavioral patterns, clinical features, psychosocial well-being, and diabetes-related complications.</div></div><div><h3>Methods</h3><div>Baseline data of the Disordered Eating Behaviors and Eating Disorders in Diabetes Type I (DEBBI) study were analyzed (<em>N</em> = 645). Participants completed questionnaires assessing DEB, diabetes-related outcomes, and psychosocial well-being. Latent profile analysis identified subtypes based on DEPS-R indicators, followed by comparisons of demographic, clinical, and psychosocial variables.</div></div><div><h3>Results</h3><div>Four distinct DEB subtypes were identified, that differed in intensity and behavioral characteristics: restrained eating (moderate DEB), disinhibited eating (moderate DEB), maintaining high glucose (severe DEB), and dual compensatory behaviors (severe DEB). All DEB subtypes reported significant poorer psychosocial well-being, including elevated diabetes distress, fear of hypoglycemia, depression, and anxiety. The severe DEB subtypes showed poorer diabetes self-management and higher HbA_1c levels.</div></div><div><h3>Conclusions</h3><div>The diversity of DEB presentations in type 1 diabetes underscores the need to examine specific behavioral patterns. The subtypes revealed distinct clinical features, behavioral patterns, and variations in self-management quality, demonstrating that harmful DEB extends beyond insulin purging alone. Even moderate forms of DEB were linked to significant psychosocial burden, highlighting the importance of early detection and intervention.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 8","pages":"Article 109067"},"PeriodicalIF":2.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071473","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":"External validation of a clinical risk score for the presence of cardiovascular autonomic neuropathy in type 1 diabetes","authors":"Pietro Pertile,&nbsp;Ilenia D'Ippolito,&nbsp;Beatrice De Santis,&nbsp;Aikaterini Andreadi,&nbsp;Davide Lauro,&nbsp;Vincenza Spallone","doi":"10.1016/j.jdiacomp.2025.109066","DOIUrl":"10.1016/j.jdiacomp.2025.109066","url":null,"abstract":"<div><h3>Aims</h3><div>To validate in an independent external population a CAN Risk Score previously developed in type 1 diabetes (T1D) and validated for cardiovascular autonomic neuropathy (CAN) with a good diagnostic accuracy.</div></div><div><h3>Methods</h3><div>Forty-seven participants with T1D (age 47.7 ± 13.2 years, duration of diabetes 30.0 (19.0–40.5) years, 24 males) underwent 4 cardiovascular reflex tests (CARTs) to diagnose early and confirmed CAN (according to 1 or 2 abnormal results). CAN Risk Score was calculated from resting heart rate, HbA1c, retinopathy and/or nephropathy, cardiovascular disease, HDL cholesterol, systolic blood pressure and smoking (range 0–10).</div></div><div><h3>Results</h3><div>Eleven participants (23.4 %) had CAN. The CAN Risk Score was higher in subjects with overall CAN (early and confirmed) (<em>P</em> = 0.0498) and with confirmed CAN (<em>P</em> = 0.0142) compared to those without, and correlated with CARTs severity (rho = 0.32, <em>P</em> = 0.026), Expiration/Inspiration ratio (<em>r</em> = −0.33, <em>P</em> = 0.0258) and Valsalva ratio (<em>r</em> = −0.47, <em>P</em> = 0.0015). A CAN Risk Score ≥ 4 was found in 19 participants and was associated with the presence of confirmed CAN (<em>P</em> = 0.0129). The CAN Risk Score showed an area under the ROC curve (AUC) of 0.802 ± 0.080 for confirmed CAN, and at the cut-off of 4, sensitivity, specificity and negative predictive values of 85.71 %, 67.50 % and 96.43 %.</div></div><div><h3>Conclusions</h3><div>This study confirmed the diagnostic value of the CAN Risk Score and supports its inclusion in a diagnostic algorithm to identify candidates for CARTs, thereby reducing universal screening. Using routinely available clinical data as categorical variables, the score is easy to calculate and implement in clinical settings.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 7","pages":"Article 109066"},"PeriodicalIF":2.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924393","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":"Evaluating the effect of Semaglutide as add-on therapy on glycemic control and continuous glucose monitoring outcomes in adults with type 1 diabetes: A two-year real-world data study","authors":"Ayman Al Hayek ,&nbsp;David C. Klonoff ,&nbsp;Wael M. Al Zahrani ,&nbsp;Suzan Eid Ibrahim ,&nbsp;Mohammed A. Al Dawish","doi":"10.1016/j.jdiacomp.2025.109064","DOIUrl":"10.1016/j.jdiacomp.2025.109064","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate the long-term efficacy of a GLP-1 receptor agonist (GLP-1RA, Semaglutide) as an adjunct to insulin therapy in adults with type 1 diabetes (T1D), using continuous glucose monitoring (CGM) metrics alongside weight and metabolic outcomes.</div></div><div><h3>Methods</h3><div>In this retrospective chart review of adults with T1D on intensive insulin therapy, GLP-1RA was initiated and maintained for two years. Glycemic and metabolic parameters were evaluated at baseline, 12 months (T12), and 24 months (T24) during combination therapy.</div></div><div><h3>Results</h3><div>A total of 67 adults with T1D (56.7 % males, 43.3 % females; mean age 31.8 years, SD: 6.11; mean diabetes duration 16.6 years, SD: 5.16) were included. By 24 months, we observed improved %TIR_70–180 from 46 % to 71 % and %TIR_70–140 from 28.1 % to 47.9 % (<em>p</em> <em>&lt;</em> <em>0.001 for both</em>). GRI, including CHypo and CHyper, showed sustained reductions, and glycemic variability improved, with CV% falling from 46.3 % to 33.6 % (<em>p</em> <em>&lt;</em> <em>0.001</em>). HbA1c improved from 8.2 % to 7.1 %, with total daily insulin dose decreasing from 1.4 to 0.7 IU/kg/day (<em>p</em> <em>&lt;</em> <em>0.001</em>). Body weight and lipid profile improved, with significant reductions in weight (<em>p</em> <em>&lt;</em> <em>0.001</em>), LDL (<em>p</em> <em>&lt;</em> <em>0.001</em>), and triglycerides (<em>p</em> <em>&lt;</em> <em>0.05</em>). No hospitalizations for DKA or major adverse cardiovascular events (MACE) occurred, and short discontinuation had no significant impact on metabolic or glycemic outcomes.</div></div><div><h3>Conclusions</h3><div>The adjunctive use of GLP-1RA in T1D shows potential for improving glycemic stability and metabolic parameters without increasing hypoglycemia risk. However, further studies are needed to confirm these effects across diverse populations and over more extended periods to fully establish their long-term efficacy and safety.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 7","pages":"Article 109064"},"PeriodicalIF":2.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894577","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}