Journal of Sleep Research最新文献

{"title":"Hypnotic-Induced Fall Risk Upon Awakening: A Network Meta-Analysis of Postural Stability Outcomes.","authors":"Flavia Rossano, Claudio Caiazza, Claudia Toni, Gaia Sampogna, Valeria Del Vecchio, Laura Palagini, Andrea Fiorillo","doi":"10.1111/jsr.70337","DOIUrl":"https://doi.org/10.1111/jsr.70337","url":null,"abstract":"<p><p>Chronic insomnia affects 10% of adults, with hypnotic medications widely prescribed. Residual pharmacological effects upon awakening may affect postural stability, increasing fall risk. We used a Network Meta-Analysis (NMA) framework to compare the influence of hypnotic medications on posture upon awakening. A systematic review and frequentist random-effects NMA was conducted following the PRISMA guidelines and a pre-determined protocol. We searched PubMed, EMBASE, ClinicalTrials.gov, WHO-ICTRP for randomized controlled trials until 10/21/2025, documenting the effects of hypnotics on static (body sway) and dynamic (walking test) balance. Risk-of-bias and confidence in evidence were assessed with RoB2 and CINeMA. Of 4459 identified records, 23 studies were included in the review. Most in-label doses of hypnotics showed no significant impact on postural stability in the morning compared to placebo, except zopiclone 7.5 mg both at bedtime (Standardized Mean Difference-SMD = 0.22, 95% C.I.[0.22;0.1.24]) and middle-of-the-night awakening (SMD = 4.45, 95% C.I.[3.54;5.36]), while zolpidem 6.5 mg extended-release proved worse in the subset including older adults (SMD = 0.39, 95% C.I.[0.01;0.76]). Same applied to middle-of-the-night evaluations for zopiclone 7.5 mg (SMD = 0.98, 95% C.I.[0.07;1.90]), zolpidem 6.5 mg extended-release (SMD = 1.14, 95% C.I.[0.30;1.98]), and zolpidem 10 mg (SMD = 1.60, 95% C.I.[0.63;2.58]). Confidence in the evidence was mainly low/very-low. Most regulatory-approved hypnotics did not significantly impair postural balance at in-label doses. However, caution is warranted for longer-acting and high-doses, particularly in high fall-risk individuals, including older adults. Given the age-related decline in postural reflexes and heightened sensitivity to CNS depressants, lower doses and shorter half-life drugs should be preferred whenever hypnotic therapy is necessary. Future research is needed to explore dynamic balance further to optimize prescribing guidelines for fall prevention in vulnerable populations.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70337"},"PeriodicalIF":3.9,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633322","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":"Individual and Situational Predictors of Threatening Dream Content During the COVID-19 Pandemic.","authors":"Ville Loukola, Jarno Tuominen, Eveliina Malinen, Katariina Tienhaara, Henri Olkoniemi, Antti Revonsuo, Katja Valli","doi":"10.1111/jsr.70336","DOIUrl":"https://doi.org/10.1111/jsr.70336","url":null,"abstract":"<p><p>Previous studies have examined how the COVID-19 pandemic affected dream recall, dream content, and nightmares. However, relatively little attention has been devoted to the individual and situational factors associated with pandemic-induced changes in dreams. The threat simulation theory of dreaming predicts that threatening situations in our waking life (situational factors) influence threatening dream content. At the same time, individual differences predispose some people to be more prone to experiencing threatening dreams more frequently than others. Using a large Finnish sample of prospective dream diaries, we analysed the relative importance of individual (e.g., belonging to a COVID-19 risk group, life satisfaction, depression and anxiety symptoms) and situational factors (e.g., daily COVID-19 worry, COVID-19 media consumption, negative and positive emotions) to determine the best predictors for threatening events and COVID-19-related threatening events in dreams. Random forest analyses revealed that individual factors were consistently better predictors than situational factors for both threatening events and pandemic-related threatening events in dreams. Lower life satisfaction was the only statistically significant predictor of threatening events and experiencing fewer positive emotions in the past 2 weeks was the only statistically significant predictor of pandemic-related threatening events in dreams. These findings suggest that the propensity to experience threatening dream content, including pandemic-related threatening events, is more of a stable trait rather than a daily fluctuating feature of dreams. In light of the threat simulation theory, it could be argued that individual variation in the proneness to simulate threatening events adaptively interacts with daily experiences to modulate threatening dream content.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70336"},"PeriodicalIF":3.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592887","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 Effects of Daridorexant on Patients With Comorbid Insomnia Disorder and Untreated Mild Obstructive Sleep Apnoea: A Post Hoc Subgroup Analysis of a Phase 3, Randomised Clinical Trial.","authors":"Christopher J Lettieri, Orestis Briasoulis, Damien Léger, Pierre-Philippe Luyet, Jean-Louis Pépin, Stuart F Quan, Janna Raphelson, Paul Saskin, Atul Malhotra","doi":"10.1111/jsr.70135","DOIUrl":"10.1111/jsr.70135","url":null,"abstract":"<p><p>Daridorexant, a dual orexin receptor antagonist, is approved for the treatment of insomnia disorder in adults. Approximately 30%-35% of patients with insomnia disorder also have obstructive sleep apnoea (OSA) of any severity. It is unclear whether sleep medications provide safe and effective treatment for insomnia in these patients. This post hoc analysis evaluated the efficacy and safety of daridorexant 25 and 50 mg on objective and self-reported insomnia variables and self-reported daytime functioning in patients with untreated mild OSA and comorbid insomnia disorder (COMISA). This analysis included participants with insomnia disorder enrolled in the Phase 3 study assessing either daridorexant 25 or 50 mg with an apnoea/hypopnoea index 5-< 15 events/h ('mild OSA'). Wake after sleep onset (WASO), latency to persistent sleep (LPS), self-reported total sleep time (sTST) and the Insomnia Daytime Symptoms and Impacts Questionnaire (IDSIQ) were assessed at Months 1 and 3. Safety endpoints were treatment-emergent adverse events, daytime somnolence and next-morning residual effects. In participants with mild OSA, daridorexant improved WASO, LPS, sTST and IDSIQ total score over time. The average treatment effect size for all efficacy parameters was numerically greater with daridorexant 50 mg than with daridorexant 25 mg; daridorexant 25 mg was not always greater than placebo. No safety concerns were reported for daridorexant 50 or 25 mg. In participants with comorbid insomnia and untreated mild OSA, daridorexant 50 mg versus placebo improved all sleep parameters over time and was well tolerated. Daridorexant warrants further investigation in COMISA. Trial Registration: ClinicalTrials.gov identifier: NCT03545191.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70135"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring Kleine-Levin Syndrome Recovery Using Human-Smartphone Interactions: A Digital Phenotyping Approach.","authors":"Yi-Guang Wang, Hsiang-Chih Chang, Chen Lin, Yu-Hsuan Lin, Tien-Yu Chen","doi":"10.1111/jsr.70157","DOIUrl":"https://doi.org/10.1111/jsr.70157","url":null,"abstract":"<p><p>Kleine-Levin syndrome is a rare neurological disorder marked by recurrent hypersomnia and behavioural disturbances such as hyperphagia and hypersexuality. We report a 25-year-old Taiwanese male experiencing episodes of sleep exceeding 15 h per day. Using Rhythm, a validated smartphone app that tracks human-smartphone interactions, we monitored his sleep-wake patterns and functional changes. Inactivity during episodes and progressively structured usage during recovery reflected clinical states. Interdaily stability, a circadian rhythm metric (range: 0-1), improved from low values during episodes to > 0.37 upon return to full-time work, indicating circadian recovery. This case illustrates how digital phenotyping can longitudinally assess functional and circadian dynamics in Kleine-Levin syndrome, offering a scalable tool beyond traditional assessments.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":"35 2","pages":"e70157"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486474","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 at Onset and Delays in Diagnosis of Central Disorders of Hypersomnolence Over the Past 30 Years.","authors":"Zhongxing Zhang, Lucie Barateau, Séverine Béziat, Ramin Khatami, Yves Dauvilliers","doi":"10.1111/jsr.70170","DOIUrl":"10.1111/jsr.70170","url":null,"abstract":"<p><p>Patients with narcolepsy type 1 (NT1), type 2 (NT2), idiopathic hypersomnia (IH) usually suffer from symptoms for years, even decades, before being diagnosed. We aimed to assess age at onset, age at diagnosis and changes in the diagnostic delays of these patients from 1990 to 2020 in a single centre. Age at onset, age at diagnosis and diagnostic delays of patients with NT1, NT2 and IH were collected at the Reference Narcolepsy Centre, Montpellier-France. Age at onset for each disorder was categorised into three life periods (< 18, 18-25, > 25 years). Diagnostic delays were compared among disorders, taking into account sex, different life periods and time periods. NT1 was diagnosed in 415 patients (242 males), NT2 in 127 patients (68 males) and IH in 289 patients (75 males). Age at onset was not different between disorders (peak between 10 and 20 years in NT1, and 15-20 in IH and NT2). NT1 patients had the shortest diagnostic delays compared to NT2 and IH (median 4, 5 and 8 years respectively). Diagnostic delay is getting shorter in NT1 and IH over the last decades. In patients who started symptoms in childhood, diagnostic delays were the shortest in NT1 and the longest in IH. No sex difference in diagnostic delays was found in NT1 and NT2, but IH females had shorter delays than males. In conclusion, patients with NT1 and IH are diagnosed earlier nowadays compared to the 2000s. Increased public awareness and education efforts should be made to increase knowledge of the diseases and to early identify excessive daytime sleepiness.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70170"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Positive Airway Pressure Improves Marital Relationship and Sexual Satisfaction in Obstructive Sleep Apnea Patients and Partners.","authors":"J Chorvoz, C Rabec, M Labruyère, H Devilliers, P Sabot, A Berrier, D Schenesse, P Mouillot, P Bonniaud, M Georges","doi":"10.1111/jsr.70167","DOIUrl":"10.1111/jsr.70167","url":null,"abstract":"<p><p>Symptoms of obstructive sleep apnea and hypopnea can interfere with sleep and quality of life for the patient's partner and affect marital relationships. Our primary objective was to assess how continuous positive airway pressure (CPAP) treatment affects couples using the Dyadic Adjustment Questionnaire (DAS-16). Secondary objectives focused on the effects on the dyad's quality of life and sleep, depending on the technical characteristics of the device. Prospective monocentric study including consecutive couples in which one of the partners began treatment by CPAP between July 2022 and February 2024 at Dijon University Hospital. After inclusion, dyads were evaluated 2 and 6 months after treatment initiation. Fifty-four couples were analysed. After 2 months under CPAP, the dyadic adjustment score (DAS-16) significantly improved in partners (ΔDAS-16 = +1 [-1; 3], p = 0.025) and in patients (ΔDAS-16 = +2 [-1; 5], p = 0.002). DAS-16 improvement was stable after 6 months. Sexual satisfaction followed the same trend. Sleep quality assessed by the Pittsburgh Sleep Quality Index (patients) and the Athens Insomnia Scale (partners) improved significantly, as did daytime sleepiness. A significant reduction in anxiety and depression scores, as well as an improvement in several domains of the SF-36 questionnaire, were also demonstrated in both groups. Our study shows that the use of CPAP improves the quality of marital relationships, as perceived by both partners. These findings could provide clinicians with additional tools to enhance patient adherence and compliance with therapy.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70167"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Once-Nightly Sodium Oxybate Meets American Academy of Sleep Medicine Criteria for Treatment of Narcolepsy.","authors":"Luis E Ortiz, Anne Marie Morse, Michael J Thorpy, Clete A Kushida, John Harsh, Thomas Roth, Jennifer Gudeman, Yves Dauvilliers","doi":"10.1111/jsr.70189","DOIUrl":"10.1111/jsr.70189","url":null,"abstract":"<p><p>Data from the REST-ON trial were not available before the 2021 American Academy of Sleep Medicine (AASM) clinical practice guideline update, which included a literature review through August 2020. This post hoc analysis from REST-ON assessed participants who achieved clinically significant improvements on individual AASM clinical significance thresholds (CSTs). Composites of the coprimary endpoints and a secondary endpoint were also analysed. Participants with narcolepsy aged ≥ 16 years were randomised 1:1 to once-nightly sodium oxybate (ON-SXB) or placebo for 13 weeks. Coprimary endpoints were mean sleep latency on the Maintenance of Wakefulness Test (MWT), Clinical Global Impression of Improvement (CGI-I) rating, and number of cataplexy episodes; secondary endpoints included the Epworth Sleepiness Scale (ESS) score. Outcomes with ON-SXB treatment compared with baseline were assessed according to the CSTs, and for those who met CSTs, the proportions of participants who experienced clinically significant improvements on a composite of ≥ 2, ≥ 3, or 4 endpoints were calculated. For improvements from baseline with ON-SXB at Week 13 (9-g dose), mean sleep latency on the MWT increased 10.8 min (CST, ≥ 2-min increase), 92.8% rated improvement on the CGI-I (CST, ≥ 33% of participants reporting improvement), reduction in number of cataplexy episodes was 60.8% reduction (CST, ≥ 25% reduction), and reduction in ESS score was -6.5 (CST, ≥ 2-point decrease). At Weeks 3, 8 and 13, significantly more participants treated with ON-SXB versus placebo experienced clinical improvements on ≥ 2, ≥ 3, or 4 endpoints (p ≤ 0.05). These data demonstrate the robust efficacy of ON-SXB across multiple clinically important narcolepsy symptoms per established CSTs, further supporting the use of ON-SXB in clinical practice. Trial Registration: This manuscript presents the results of a post hoc analysis from the REST-ON clinical trial (NCT02720744).</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70189"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Associations of Physical Activity Volume, Intensity, and Timing With Sleep in Preschool-Aged Children.","authors":"Wendy Yajun Huang, Jie Feng, Cindy Hui-Ping Sit, John J Reilly, Asaduzzaman Khan","doi":"10.1111/jsr.70162","DOIUrl":"10.1111/jsr.70162","url":null,"abstract":"<p><p>This study aimed to investigate the temporal relationships between accelerometer-derived physical activity metrics-specifically volume, intensity, and timing-with the preceding and subsequent nights' sleep in preschool-aged children. This analysis used the baseline data from a randomised controlled trial among 93 children (53 boys) aged 3-5.9 years who provided daily, repeated measures for at least four days. Open-source R package GGIR was used to generate daily measures of average acceleration, intensity gradient, timing of the most active 10 h (M10 start), sleep duration, sleep efficiency, and sleep midpoint. Linear mixed models were performed to examine temporal associations between waketime physical activity and the subsequent night's sleep, and between nocturnal sleep and physical activity the following day, at both within- and between-person levels. A higher intensity gradient compared to the personal average during the day predicted a lower sleep efficiency on the subsequent night (β = -10.71, 95% CI: -17.20, -4.21). At the between-person level, children with longer sleep duration (β = 0.87, 95% CI: 0.45, 1.29), a later sleep midpoint (β = 1.03, 95% CI: 0.79, 1.27), or lower sleep efficiency (-0.09, 95% CI: -0.14, -0.03) were more likely to have their active periods later in the following day. These findings suggest that the timing of physical activity and sleep midpoint showed consistent bidirectional associations at both within- and between-person levels. The findings suggest that incorporating lower intensity activities that are scheduled at appropriate times into daily routines may be crucial for better sleep for young children.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70162"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CPAP to Reduce the Risk of Cancer in OSA?-A Meta-Analysis of 3 RCTs.","authors":"Jenny Theorell-Haglöw, Yüksel Peker, Nathaniel S Marshall","doi":"10.1111/jsr.70153","DOIUrl":"10.1111/jsr.70153","url":null,"abstract":"<p><p>Obstructive sleep apnea (OSA) has been hypothesised to promote cancer via intermittent hypoxia, and assessing what happens when OSA is controlled by continuous positive airway pressure (CPAP) may provide valuable insight. We conducted a meta-analysis of three randomised controlled trials (SAVE, RICCADSA, ISAACC) assessing cancer incidence from adverse event data on neoplasms among OSA patients randomised to continuous positive airway pressure (CPAP) versus control. Across trials, cancer incidence was similar between groups, and meta-analysis showed no statistically significant difference (CI 0.55-1.68). Treating sleep apnea with CPAP does not appear to markedly reduce the risk of incident cancers.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":"35 2","pages":"e70153"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing Custom-Fit CPAP Mask Prototype in Patients With Obstructive Sleep Apnea.","authors":"Rutvi Sheth, Soham Sheth, Michel Audette","doi":"10.1111/jsr.70146","DOIUrl":"10.1111/jsr.70146","url":null,"abstract":"<p><p>Obstructive sleep apnea (OSA) is a common condition linked to increased cardiovascular risk. Continuous positive airway pressure (CPAP) therapy is the standard treatment; however, poor mask fit-due to limited size options-often reduces patient adherence. This study explores the feasibility of developing a fully customised CPAP mask prototype using accessible 3D scanning, computer-aided design, and 3D printing technologies. A high-resolution facial scan was obtained using a Structure Sensor (ST01) attached to an iPad and imported into Autodesk Fusion 360 to generate a personalised nasal mask design. The masks were fabricated using desktop masked stereolithography (MSLA) printers (Elegoo Saturn 3 12K) with standard resin. To enhance comfort and prevent direct skin contact with rigid surfaces, a medical-grade foam lining was added. The prototype underwent key safety evaluations, including exhaust flow rate, pressure drop, and CO₂ rebreathing. The estimated production cost per mask was approximately $25. These findings highlight the potential for in-office fabrication of custom-fit CPAP masks using affordable tools and materials. With further biocompatibility testing and user feedback, this approach may offer a practical and scalable solution for improving comfort, fit, and adherence in CPAP therapy.</p>","PeriodicalId":17057,"journal":{"name":"Journal of Sleep Research","volume":" ","pages":"e70146"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649760","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}