Journal of Epidemiology最新文献

{"title":"Changes in Mortality During the COVID-19 Pandemic in Japan: Descriptive Analysis of National Health Statistics up to 2022.","authors":"Hirokazu Tanaka, Shuhei Nomura, Kota Katanoda","doi":"10.2188/jea.JE20240158","DOIUrl":"10.2188/jea.JE20240158","url":null,"abstract":"<p><strong>Background: </strong>Amidst the global coronavirus disease 2019 (COVID-19) pandemic, Japan has faced a significant public health challenge, evident from the significant increase in mortality rates since 2021. This study described the variations in all-cause and cause-specific changes in mortality up to 2022 in Japan.</p><p><strong>Methods: </strong>This study used official Vital Statistics from the Ministry of Health, Labour and Welfare (MHLW) to assess the impact of the pandemic on mortality trends. An analysis of all-cause and cause-specific age-standardized mortality rates (ASMRs) from 1995 to 2022 was conducted, employing the 2015 Japan Standard Population. Sex- and cause-specific ASMRs for a particular year were compared with those from the preceding year to assess annual changes.</p><p><strong>Results: </strong>Among men, the annual all-cause ASMR per 100,000 people increased from 1,356.3 in 2021 to 1,437.8 in 2022 (6.0% increase). Among women, the annual all-cause ASMR increased from 722.1 in 2021 to 785.8 in 2022 (6.5% increase). Compared with the period 2020 to 2021, COVID-19 (+29.1 per 100,000 people for men and +13.4 per 100,000 people for women), senility (+14.1 per 100,000 people for men and +12.5 per 100,000 people for women), heart disease, malignant neoplasms (for women) and \"other causes not classified as major causes\" substantially contributed to the increase in all-cause ASMR from 2021 to 2022.</p><p><strong>Conclusion: </strong>Further long-term monitoring from 2023 onwards is necessary, especially for conditions like senility, cardiovascular disease, and cancer, which may have long-term effects due to changes in healthcare settings, even though the strong countermeasures against COVID-19 were lifted in 2023.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"154-159"},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Self-reported Medical Condition in the Taiwan Biobank.","authors":"Chi-Shin Wu, Le-Yin Hsu, Chen-Yang Shen, Wei J Chen, Shi-Heng Wang","doi":"10.2188/jea.JE20240110","DOIUrl":"10.2188/jea.JE20240110","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to validate self-reported medical conditions in the Taiwan Biobank (TWBB), in which participants were inquired about 30 disease conditions, by comparing them with claims records from Taiwan's National Health Insurance (NHI) claims database.</p><p><strong>Methods: </strong>We identified 30 clinical diagnoses using International Classification of Diseases - Clinical Modification codes from ambulatory and hospital claims within the NHI claims database, matching diseases included in the TWBB. The concordance between self-reports and claims records was evaluated using tetrachoric correlation to assess the correlation between binary variables.</p><p><strong>Results: </strong>A total of 131,834 participants aged 30-70 years with data from the TWBB and NHI records were included. Concordance analysis revealed tetrachoric correlations ranged from 0.420 (chronic obstructive pulmonary disease) to 0.970 (multiple sclerosis). However, several disorders exhibited lower tetrachoric correlations. The concordance was higher among those with higher education attainment, and lower among married individuals.</p><p><strong>Conclusion: </strong>The concordance between self-reports in the TWBB and NHI claims records varied across clinical diagnoses, showing inconsistencies depending on participant characteristics. These findings underscore the need for further investigation, especially when these variables are crucial to research objectives. Integrating complementary databases, such as clinical diagnoses, prescription records, and medical procedures, can enhance accuracy through customized algorithms based on disease categories and participant characteristics and optimize sensitivity or positive predictive values to align with specific research objectives.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"141-146"},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-cancer-related Deaths in Cancer Survivors: A Nationwide Population-based Study in Japan.","authors":"Yasufumi Gon, Ling Zha, Toshitaka Morishima, Yasuyoshi Kimura, Kanako Asai, Haruka Kudo, Tsutomu Sasaki, Hideki Mochizuki, Isao Miyashiro, Tomotaka Sobue","doi":"10.2188/jea.JE20240230","DOIUrl":"10.2188/jea.JE20240230","url":null,"abstract":"<p><strong>Background: </strong>Advancements in cancer care have improved survivorship, potentially leading to changes in mortality causes. This study aimed to investigate the causes of death among cancer survivors, specially focusing on non-cancer-related mortality.</p><p><strong>Methods: </strong>This nationwide population-based cohort study analyzed the causes of death based on the time since cancer diagnosis using data from the National Cancer Registry in Japan between January 2016 and December 2019. Non-cancer-related deaths were identified, and mortality risks associated with non-cancer diseases were compared to those of the Japanese general population using standardized mortality ratios (SMRs) with 95% confidence intervals (CIs). The follow-up period was up to 4 years after cancer diagnosis.</p><p><strong>Results: </strong>A total of 3,990,661 patients (45.8% women) were included in the analysis, yielding 6,237,269 person-years of follow-up. Of these, 1,001,857 (25.1%) patients died during the study period. Cancer-related and non-cancer-related causes accounted for 86.6% and 13.4% of deaths, respectively. The proportion of non-cancer-related deaths increased from 10.2% at 6 months to 31.6% at 4 years after cancer diagnosis. Heart disease (21.8%), cerebrovascular disease (9.8%), and pneumonia (9.1%) were the leading cause of non-cancer-related deaths: the SMRs for these diseases were 2.69 (95% CI, 2.66-2.72), 2.07 (95% CI, 2.03-2.10), and 2.41 (95% CI, 2.36-2.45), respectively. The SMR for suicide was 1.81 (95% CI, 1.74-1.89); however, it lost significance in males and females 2 and 2.5 years after cancer diagnosis, respectively.</p><p><strong>Conclusion: </strong>The proportion of non-cancer-related deaths among cancer patients has increased over time, emphasizing the need to manage cancer and its comorbidities carefully.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"147-153"},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Variations and Inequalities in Testing for Early Detection of Breast and Cervical Cancer: Evidence From a Nationally Representative Survey in India.","authors":"Md Mahfuzur Rahman, Md Shafiur Rahman, Md Rashedul Islam, Stuart Gilmour, Rei Haruyama, Atul Budukh, Abhishek Shankar, Gauravi Mishra, Ravi Mehrotra, Tomohiro Matsuda, Manami Inoue, Sarah Krull Abe","doi":"10.2188/jea.JE20240065","DOIUrl":"10.2188/jea.JE20240065","url":null,"abstract":"<p><strong>Background: </strong>The burden of cancer in India has been rising, yet testing for early detection remains low. This study explored inequalities in the uptake of breast cancer (BC) examination and cervical cancer (CC) among Indian women, focusing on socioeconomic, regional, and educational differences.</p><p><strong>Methods: </strong>Data from the 2019-21 National Family Health Survey (n = 353,518) were used to assess the uptake of BC examination and CC testing. Inequalities were quantified using the slope index of inequality (SII), relative index of inequality (RII), and relative concentration index (RCI). SII measured absolute inequality, while RII and RCI assessed relative inequality between disadvantaged and advantaged groups.</p><p><strong>Results: </strong>The ever uptake of tests for early detection of BC and CC were low at 9 and 20 per 1,000 women, respectively. Higher uptake was observed among women from the richest households compared to the poorest (SII: 1.1 for BC and 1.8 for CC). The magnitude of relative socioeconomic inequalities was more pronounced in rural areas (RCI: 22.5 for BC and 21.3 for CC) compared to urban areas. Similarly, higher-educated women were 4.84 times (RII: 4.84) and 2.12 times (RII: 2.12) more likely to undergo BC examination and CC testing, respectively, compared to non-educated women. The Northeastern region exhibited greater socioeconomic inequality, while the Western region showed more education-based inequality.</p><p><strong>Conclusion: </strong>The lower uptake of BC examination and CC testing and the marked inequalities underscore the need for targeted interventions to improve access and utilization of testing services, especially among lower-educated women, and those in rural areas.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"129-140"},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urgent support is needed for more tinnitus research.","authors":"Carlotta M Jarach, Jorge P Simoes, Winfried Schlee, Berthold Langguth, Silvano Gallus","doi":"10.2188/jea.JE20240427","DOIUrl":"https://doi.org/10.2188/jea.JE20240427","url":null,"abstract":"","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post COVID-19 condition in hospitalized survivors after one year of infection during the Alpha- and Delta-variant dominant waves in Japan: COVID-19 Recovery Study II.","authors":"Yoko Muto, Mariko Hosozawa, Miyuki Hori, Arisa Iba, Shuhei Maruyama, Shinichiro Morioka, Katsuji Teruya, Takeshi Nishida, Toshiyuki Harada, Hideki Yoshida, Satoshi Miike, Akira Kawauchi, Hideaki Kato, Junji Hatakeyama, Shigeki Fujitani, Tomohiro Asahi, Kensuke Nakamura, Yuichi Sato, Taku Oshima, Futoshi Nagashima, Kohei Ota, Tatsuya Fuchigami, Nobuyuki Nosaka, Hiroshi Kamijo, Takeshi Hattori, Hayato Taniguchi, Hiroyasu Iso","doi":"10.2188/jea.JE20240179","DOIUrl":"10.2188/jea.JE20240179","url":null,"abstract":"<p><p>BackgroundEvidence of post-COVID-19 condition (PCC) in the Alpha- and Delta-variant dominant waves is limited.MethodsIn a nationwide multicentre cohort study in collaboration with 20 hospitals, we collected data using self-administered questionnaires and electronic medical records of participants aged 20 or more diagnosed with COVID-19, hospitalized between Apr 1 2021 and Sept 30 2021, and discharged alive. Descriptive statistics were analyzed for PCC and mental health (HADS anxiety and depression scores), comparing Alpa and Delta-dominant waves.ResultsWe analyzed 1,040 patients (median age, 57 [IQR 49-66] years; men, 66.2%). Of the respondents, 45.4% had at least one PCC symptom one year after infection. The common symptoms included dyspnea (20.7%), fatigue/malaise (17.6%), muscle weakness (15.4%), decrease in concentration (13.4%), and sleep disorder (13.3%), followed by brain fog (8.4%). Among patients with PCC, 14.0% had anxiety (HADS-Anxiety ≥11), and 18.6% had depression (HADS-Depression ≥11), with four times higher proportions than those without PCC; only small variations by age, sex, and waves were observed. Associated factors for PCC were age 40 years or over, women, severity of COVID-19 during hospitalization, ex-smokers who quit smoking before COVID-19 infection and being infected during the Delta-variant dominant wave.ConclusionThe study described the prevalence of PCC, associated factors, and mental health of COVID-19 survivors hospitalized during the Alpha and Delta-variant dominant waves in Japan. Further follow-up will be conducted to examine the longer-term impact of COVID-19 on PCC, complications, daily life, and socioeconomic status.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between alcohol consumption and the risk of type 2 diabetes mellitus across different body mass index categories among Japanese workers.","authors":"Yu Wang, Yosuke Inoue, Shohei Yamamoto, Ami Fukunaga, Shuichiro Yamamoto, Toru Honda, Tohru Nakagawa, Takeshi Hayashi, Maki Konishi, Tetsuya Mizoue","doi":"10.2188/jea.JE20240259","DOIUrl":"https://doi.org/10.2188/jea.JE20240259","url":null,"abstract":"<p><strong>Background: </strong>While evidence from Western countries links low-to-moderate alcohol consumption to a lower risk of type 2 diabetes mellitus (T2D), findings have been inconsistent in Asia. Since T2D in Asia involves both insulin resistance and deficient insulin secretion, both of which are differently affected by alcohol, we prospectively examined whether the association differs according to body mass index (BMI) categories among the Japanese.</p><p><strong>Methods: </strong>Participants were 31,524 health checkup examinees (26,819 males and 4,705 females aged 20-64 years) who were free from diabetes at baseline. Self-reported data on alcohol use were used to estimate the average daily alcohol consumption at the baseline. Incident diabetes was identified at annual checkups during the follow-up period. A Cox proportional hazards model was used to estimate hazard ratios and 95% confidence intervals.</p><p><strong>Results: </strong>During a median follow-up of 12.0 years, 3,527 male and 287 female participants developed T2D. The association between alcohol consumption and T2D risk differed markedly by BMI in both sexes. Among males, low- and moderate-level alcohol consumption was associated with a lower T2D risk in individuals with BMI ≥25.0 kg/m², whereas consumption at a level of 2 go/day (approximately 46 g ethanol) was linked to an increased T2D risk in those with BMI ≤22.0 kg/m². In females, similar patterns were observed, although confidence intervals were broad due to smaller sample size.</p><p><strong>Conclusions: </strong>In Japan, low-to-moderate alcohol consumption may lower T2D risk in those with excess body weight, while high alcohol consumption may increase T2D risk in those with lower BMI.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sentinel Surveillance of COVID-19: The Importance of Epidemiologic Concepts and Reasoning.","authors":"Yuzo Arima, Takuri Takahashi, Ayu Kasamatsu, Takeshi Arashiro, Yusuke Kobayashi, Miyako Otsuka, Osamu Takahara, Reiko Shimbashi, Katsuhiro Komase, Taro Kamigaki, Motoi Suzuki","doi":"10.2188/jea.JE20240200","DOIUrl":"10.2188/jea.JE20240200","url":null,"abstract":"","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"106-107"},"PeriodicalIF":3.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Disparities in Measles Vaccination Coverage and Their Associated Factors: An Ecological Study in Japan.","authors":"Masaki Machida, Shinji Fukushima, Takahiro Tabuchi, Tomoki Nakaya, Wakaba Fukushima, Shigeru Inoue","doi":"10.2188/jea.JE20240129","DOIUrl":"10.2188/jea.JE20240129","url":null,"abstract":"<p><strong>Background: </strong>The decline in measles vaccination coverage is a global concern. In Japan, coverage of the first dose of measles vaccine, which had exceeded the target of 95.0% since fiscal year (FY) 2010, fell to 93.5% in FY 2021. Vaccination coverage increased to 95.4% in FY 2022 but varied by municipality. Few studies have focused on regional disparities in measles vaccination coverage. This study aimed to clarify the regional disparities in measles vaccination coverage by municipality in Japan and their associated factors.</p><p><strong>Methods: </strong>In this ecological study, the measles vaccination coverage in FY 2022; population density; area deprivation index (ADI; an indicator of socioeconomic status); proportion of foreign nationals, single-father households, single-mother households, and mothers aged ≥30 years; and number of medical facilities, pediatricians, and non-pediatric medical doctors in 1,698 municipalities were extracted from Japanese government statistics. Negative binomial regression was performed with the number of children vaccinated against measles as the dependent variable, number of children eligible for measles vaccination as the offset term, and other factors as independent variables.</p><p><strong>Results: </strong>Vaccination coverage was less than 95.0% in 54.3% of municipalities. Vaccination coverage was significantly positively associated with population density and negatively associated with the proportion of single-father households, mothers aged ≥30 years, and the ADI (incidence rate ratios: 1.004, 0.976, 0.999, and 0.970, respectively).</p><p><strong>Conclusion: </strong>This study showed regional disparities in measles vaccination coverage in Japan. Single-father households, age of mothers, and socioeconomic status may be key factors when municipalities consider strategies to improve vaccination coverage.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"100-105"},"PeriodicalIF":3.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Much Lower Prevalence and Mortality of Chronic Obstructive Pulmonary Disease in Japan Than in the United States Despite Higher Smoking Rates: A Meta-Analysis/Systematic Review.","authors":"Akira Sekikawa, Mengyi Li, Niva Joshi, Brandon Herbert, Curtis Tilves, Chendi Cui, Shiyao Gao, Yuefang Chang, Yasutaka Nakano, Frank C Sciurba","doi":"10.2188/jea.JE20240085","DOIUrl":"10.2188/jea.JE20240085","url":null,"abstract":"<p><strong>Background: </strong>A recent systematic review showed Japan's mortality from chronic obstructive pulmonary disease (COPD) is the lowest among 204 countries, despite notably higher smoking rates in men in Japan than in the United States. This study aims to compare (1) trends in smoking rates, (2) trends in COPD mortality, and (3) the spirometry-based COPD prevalence in the general adult population between Japan and the United States.</p><p><strong>Methods: </strong>Age- and sex-specific smoking rates from the 1980s through 2010s and COPD mortality from 1999 through 2019 were obtained from national surveys and official statistics (International Classification of Diseases-10^th codes J40-44), respectively. A systematic review and meta-analysis was performed to estimate COPD prevalence in Japan, while the National Health and Nutrition Examination Survey 2007-2012 was used for the United States. A fixed ratio of 0.7 of forced expiratory volume in the first second of forced vital capacity was used to define COPD.</p><p><strong>Results: </strong>Over the past 4 decades, men in Japan consistently had 20-30% higher smoking rates than their United States counterparts. From 1999-2019, age-adjusted COPD mortality in men in Japan was only a third of the United States, whereas that in women was less than a tenth in 2019. Synthesizing data from 11 studies, involving 89,955 participants, Japan's COPD prevalence was more than 10% lower than in the United States in almost all age groups for both sexes.</p><p><strong>Conclusion: </strong>This study showed markedly lower rates of COPD in Japan than in the United States. Investigating factors contributing to the paradoxical observations could lead to advancing COPD risk reduction strategies.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"90-99"},"PeriodicalIF":3.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}