Journal of the National Medical Association最新文献

{"title":"COVID-19 vaccine uptake and intention of Black adults: A county-wide analysis of an online survey","authors":"Krissy Moehling Geffel ,&nbsp;Harika P. Dyer ,&nbsp;Andrea D. Casas ,&nbsp;Stephanie N. Christian-Afflu ,&nbsp;Dara D. Méndez ,&nbsp;Tiffany L. Gary-Webb","doi":"10.1016/j.jnma.2024.07.007","DOIUrl":"10.1016/j.jnma.2024.07.007","url":null,"abstract":"<div><h3>Background</h3><div>There are demonstrated racial inequities in coronavirus 2019 (COVID-19) disease burden, and the initial vaccine rollout did not equitably address these disparities.</div></div><div><h3>Methods</h3><div>We conducted analyses of a national Facebook survey restricted to Black adult residents of Allegheny County, Pennsylvania for the period of May 2021 to January 2022. We assessed the associations between demographics, health status, social normative context, perceived racial discrimination, and beliefs about COVID-19 mitigation strategies on vaccine uptake and intention and compared reasons reported for vaccine hesitancy, and vaccine non-intention among the unvaccinated. Multivariable logistic regression was conducted on a subset of unvaccinated respondents to explore variables associated with vaccine intent.</div></div><div><h3>Results</h3><div>Over 85 % of 1,552 respondents were vaccinated against COVID-19 at the time of the survey. Compared to the unvaccinated, vaccinated respondents were older and more highly educated (<em>P </em>&lt;<em></em>0.001), more likely to have at least one chronic health condition (<em>P </em>=<em></em>0.03) and had a stronger social normative context in support of vaccination (<em>P </em>&lt;<em></em>0.001). Vaccinated respondents also reported greater personal adherence to wearing face masks when out in public and were more likely to report positive perceptions of the effectiveness of mitigation strategies (e.g., face masks) towards preventing COVID-19 transmission (<em>P </em>&lt;<em></em>0.001).</div><div>Unvaccinated respondents were more likely to report intention to be vaccinated if they felt that face masks were very effective in the prevention of COVID-19 compared to those who felt this mitigation strategy was only moderately/slightly/not at all effective (OR: 4.52; 95 % CI: 1.23–16.59; <em>P </em>=<em></em>0.02) and if they did not report mistrust in the government or COVID-19 vaccines compared to those reporting mistrust (OR: 7.72; 95 % CI: 1.34–44.64; <em>P </em>=<em></em>0.02).</div></div><div><h3>Conclusion</h3><div>COVID-19 vaccination levels were high among Black adult residents of Allegheny County who responded to the survey. Future efforts should continue to strive towards addressing reasons for mistrust with focused attention from healthcare institutions and the government on increasing their trustworthiness, alongside employment of evidence-based strategies to increase vaccination rates. Additionally, efforts should continue to engage unvaccinated and vaccine hesitant persons’ perspectives to inform ongoing health equity interventions.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 526-538"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142020096","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":"Cardiovascular complications of sickle cell disease: A primer for the general clinician","authors":"Chibuzo Ilonze ,&nbsp;Gift C. Echefu ,&nbsp;Alexandria L. Broadnax ,&nbsp;Adedoyin Johnson ,&nbsp;Aniekeme Etuk ,&nbsp;Onyedika J. Ilonze","doi":"10.1016/j.jnma.2023.11.010","DOIUrl":"10.1016/j.jnma.2023.11.010","url":null,"abstract":"<div><div><span>Sickle cell disease<span> (SCD) is the most common hereditary hemoglobinopathy and mainly affects individuals of African ancestry. As survival has improved especially in high-income countries, increased rates of cardiopulmonary complications such as pulmonary hypertension, heart failure with </span></span>diastolic dysfunction<span>, and sudden death are encountered in clinical practice. These complications are the leading causes of morbidity and mortality as these individuals survive into adulthood. Understanding the need for, early identification, timely intervention, and implementation of preventive strategies are critical in reversing this trend and improving quality of life and survival rates. This manuscript aims to provide a comprehensive review of the pathogenesis of cardiovascular complications associated with sickle cell disease and equip the clinician with tools to facilitate the early diagnosis and management of patients with SCD as increasing numbers survive into adulthood.</span></div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 517-525"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138683604","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":"Protecting black lives: Reducing disparities in cardiovascular morbidity and mortality","authors":"Onyedika J. Ilonze ,&nbsp;Hakeem Ayinde ,&nbsp;Keith C. Ferdinand","doi":"10.1016/j.jnma.2023.11.011","DOIUrl":"10.1016/j.jnma.2023.11.011","url":null,"abstract":"","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 466-467"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138505073","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":"Trends in fatal opioid overdoses and opioid-related emergency department visits among the black population in California, 2011–2022","authors":"Sabrina L. Smiley,&nbsp;Heesung Shin","doi":"10.1016/j.jnma.2024.10.002","DOIUrl":"10.1016/j.jnma.2024.10.002","url":null,"abstract":"","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 607-610"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515782","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":"Knowledge, attitudes, and practices of sickle cell hemoglobinopathies: A case-control study from the sickle cell belt of Odisha, India","authors":"Basanta Kumar Bindhani ,&nbsp;Kallur Nava Saraswathy ,&nbsp;Jayanta Kumar Nayak ,&nbsp;Naorem Kiranmala Devi","doi":"10.1016/j.jnma.2024.10.003","DOIUrl":"10.1016/j.jnma.2024.10.003","url":null,"abstract":"<div><div>Despite the high prevalence of sickle cell haemoglobin (HbS) in Odisha, awareness and understanding of sickle cell trait (SCT) and sickle cell disease (SCD) remain low in affected communities. This cross-sectional study assesses the knowledge, attitude, and practice (KAP) regarding sickle cell hemoglobinopathies among 182 sickle cell carriers and 200 age-sex-community matched controls. The overall knowledge of sickle cell hemoglobinopathies was very low among both case and control groups (score 2.8/10). Although most respondents had heard about SCD (85.71% vs. 82%), few were aware of SCT (34.07% vs. 27%). Notably, none of the participants knew their haemoglobin genotype or carrier status. Only a very small proportion were aware of symptoms, causes, and preventive measures. The overall attitude score was marginally higher in the control group (4.75/11) than in the case group (4.55/11), with an average score of 42.25%. While most recognized the need for regular treatment and screening of children (82.4% carriers, 90.5% controls), many were undecided about the necessity of premarital screening. The overall practice score was very low in both groups (0.4/5), but the mean practice score was significantly higher in cases than controls (11.01% vs. 7.55%). Most participants did not undergo regular health check-ups or engage in preventive measures (97.25%). Traditional health practices were commonly relied upon for treatment. Participants reported a lack of awareness about SCT and fear of discrimination, social isolation, and marriage refusal as major barriers to screening participation.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 611-625"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515780","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":"Primary care physician density and mortality in the United States","authors":"Ali Bin Abdul Jabbar ,&nbsp;Khawaja M Talha ,&nbsp;Vijay Nambi ,&nbsp;Dmitry Abramov ,&nbsp;Abdul Mannan Khan Minhas","doi":"10.1016/j.jnma.2024.10.001","DOIUrl":"10.1016/j.jnma.2024.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Geographic physician availability differences are associated with healthcare outcomes. However, the association between primary care physician (PCP) density and mortality outcomes is less well-established.</div></div><div><h3>Methods</h3><div>The study analyzed 2019 county-level nonfederal PCP data from the Health Resources and Services Administration Area Health Resource File and mortality data using the CDC WONDER (Wide-ranging Online Data for Epidemiologic Research). All-cause and cardiovascular disease (CVD)- related age-adjusted mortality rates (AAMR) per 100,000 population stratified by the number of PCPs per 100,000 quartiles were extracted. Using AAMRs as continuous variables, linear regression was performed to determine the association of AAMRs with PCPs per 100,000 (reference, first quartile), adjusting for the social vulnerability index (SVI).</div></div><div><h3>Results</h3><div>A total of 3142 counties were included in the analysis. Among counties stratified by PCPs per 100,000 quartiles, all-cause AAMRs were 828 (95% CI, 824–832) in the first quartile, 798 (95% CI, 796–801) in the second quartile, 737 (95% CI, 735–739) in the third quartile, and 679 (95% CI, 678–680) in the fourth quartile. Similar trends were seen in CVD-related AAMRs, which were 446 (95% CI, 443–449), 439 (95% CI, 437–441), 403 (95% CI, 402–404), and 365 (95% CI, 364–366), respectively. Counties without PCP (221, included in first quartile) had all-cause and CVD-related AAMR of 797 (95%CI, 783–812) and 430 (95%CI, 419–440), respectively. Compared with the first quartile, SVI-adjusted analyses showed β-coefficient (95%CI) of all-cause mortality for the second, third, and fourth quartiles of −4.11 (95% CI, −18.31, 10.08), −35.37 (95% CI, −49.57, −21.17) and −85.79 (95% CI, −100.10, −71.48). Similar results were observed for CVD-related AAMR.</div></div><div><h3>Conclusion</h3><div>Higher PCP per 100,000 is generally associated with better all-cause and CVD-associated mortality outcomes, however complex factors likely play a role in determining these outcomes in counties with lower PCP per 100,000, which warrant further investigation.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 600-606"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515781","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":"Validating the factor structure and reliability of the sleep quality scale in a community-based study in Ibadan, Nigeria","authors":"Osahon Jeffery Asowata ,&nbsp;Aderonke Busayo Sakpere ,&nbsp;Anthony Ike Wegbom ,&nbsp;Charles Emaikwu ,&nbsp;David Kadan Danladi ,&nbsp;Innocent Okoro ,&nbsp;Sunday Oladiran ,&nbsp;Tobi Elisha Adekolurejo ,&nbsp;Akinkunmi Paul Okekunle ,&nbsp;Onoja Matthew Akpa","doi":"10.1016/j.jnma.2024.09.001","DOIUrl":"10.1016/j.jnma.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><div>The sleep quality scale (SQS) is a comprehensive multidimensional sleep assessment scale used to evaluate sleep quality (SQ) among adults in the general population. However, the scale is yet to be validated among indigenous African populations such as in Nigeria. This study validated the factor structure and evaluated the reliability of a previously developed SQS among community-based adults in Ibadan, Nigeria.</div></div><div><h3>Methods</h3><div>Data on SQ was extracted from 3,635 adult (≥18 years) from the Community-based Investigation of the Risk Factors for Cardiovascular Disease (COMBAT-CVDs) study. Cronbach-alpha (<span><math><mi>α</mi></math></span>) was used to evaluate the internal consistency or reliability of the SQS (&gt;50 % cut-off), while the original 6-factor model of the SQS was explored using exploratory (≥0.5 cut-offs) and confirmatory factor analyses. The chi-square goodness of fit test and multiple fit indices were used to assess model fit at a two-sided <em>P</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Overall, the participant's mean age was 35.33±15.20 years, and 54.60 % were male. The overall reliability estimate for the SQS was 86.00 %, while the restoration after sleep subscale reliability was 93.00 %. The exploratory and confirmatory factor analysis showed that the original 6-factor model of the SQS is a more plausible model for this sample of community-based adults: comparative fit index &gt;0.92, Tucker-Lewis index &gt; 0.91, root mean square error of approximation ≤ 0.05.</div></div><div><h3>Conclusion</h3><div>Our findings revealed that the SQS is promising for population-based assessment of SQ and may also assist in identifying sleep-related disorders and monitoring the efficacy of sleep treatment among indigenous Africans.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 553-565"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515783","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":"Try not to think about food: An association between fasting, binge eating and food cravings","authors":"Jônatas de Oliveira ,&nbsp;João Ferro ,&nbsp;Victor Hugo Dantas Guimarães ,&nbsp;Felipe Quinto da Luz","doi":"10.1016/j.jnma.2024.09.005","DOIUrl":"10.1016/j.jnma.2024.09.005","url":null,"abstract":"<div><h3>Background</h3><div>When individuals follow a diet or limit their food intake, they activate cognitive restraint, which is defined as a mental effort to restrict dietary behavior with the goal of losing weight. As an example, fasting has also been associated with the recruitment of cognitive restraint, but further research is needed to fully understand its underlying mechanisms.</div></div><div><h3>Aims</h3><div>The aim of this study was to examine the relationship between the duration of fasting and disordered eating, such as food cravings, binge eating, and potential changes in eating habits.</div></div><div><h3>Methods</h3><div>An online survey was conducted among 853 first-semester university students to investigate their fasting practices and frequency over a three-month period prior to data collection. Participants who were on diets were excluded (n=214). After controlling the sample for biases, a comparison was made between 89 fasters and 369 non-fasters. The study compared levels of cognitive restraint, binge eating, food cravings, and consumption of ‘forbidden’ foods. A Poisson model was used to examine the association between hours of fasting and disordered eating traits. In the context of this study, the rate ratio was used to examine the relationship between fasting hours and disordered eating characteristics, such as binge eating and food cravings.</div></div><div><h3>Results</h3><div>The study found that fasters experienced an increase in food cravings and binge eating. However, fasters consumed fewer bread slices than non-fasters. The rate ratio of fasting hours practiced is 115% higher among binge eaters (RR 2.15; CI95% 1.70-2.73) compared to those who did not binge. The rate ratio of fasting hours is 29% higher in participants with moderate binge eating (RR 1.29; CI95% 1.05-1.59), increasing to 140% (RR 2.40; CI95% 1.86-3.11) in people with severe binge eating. As for food cravings (state), the rate ratio was 2% higher (RR 1.02; CI 95% 1.01-1.03) for each increase in the unit of the scale.</div></div><div><h3>Conclusions</h3><div>Our study has indicated that fasting is positively associated with increased levels of binge eating and food cravings.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 5","pages":"Pages 588-599"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485018","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":"Racial and socioeconomic disparities in the treatment of unruptured intracranial aneurysms: A county hospital experience","authors":"Taylor Smith ,&nbsp;Kelley Wormmeester ,&nbsp;John Attia ,&nbsp;Mesha Martinez ,&nbsp;Nicolas Useche ,&nbsp;Juan Tejada","doi":"10.1016/j.jnma.2024.07.008","DOIUrl":"10.1016/j.jnma.2024.07.008","url":null,"abstract":"<div><h3>Background</h3><p>With increasing prevalence of unruptured intracranial aneurysms (UIAs), there is a need to provide appropriate management. Several studies have suggested that minorities in the United States have limited access to non-invasive imaging leading to increased presentation of aneurysmal subarachnoid hemorrhages (aSAHs). Given our medical institution's commitment to ensuring racial equality within our health care system, we chose to analyze our practice to assess the utilization of care provided by our neuroendovascular team. We hypothesized that given our diverse neuroendovascular care team along with our dedication to equity in healthcare, that we would find no difference in care provided to minority patients versus white patients who presented with UIAs.</p></div><div><h3>Methods</h3><p>We conducted a retrospective electronic medical record-based review of all patients with UIAs (<em>n</em> = 140) between September 2010 and June 2022 treated at a county hospital. Data regarding age at the time of treatment, gender, race, insurance type and aneurysm location were obtained.</p></div><div><h3>Results</h3><p>Of the 140 patients that underwent treatment, 54 % of patients were from the Black/Hispanic group and 46 % were from the white/non-Hispanic group. Commercial/private insurance was more common among White/NonHispanic patients (57.7 % vs 51.4 %) whereas Medicaid or uninsured status was more common among Black/Hispanic patients (25.7 % vs 15.4 %), although these differences were not statistically significant.</p></div><div><h3>Conclusion</h3><p>Building a diverse neuroendovascular physician team with intentionality to equity in healthcare, and providing appropriate funding and resources to facilities used by marginalized populations, such as safety-net institutions, can mitigate minority patients’ limited access to intracranial aneurysmal care.</p></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 4","pages":"Pages 410-414"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141862013","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":"Disparities in Advanced Care Planning: Exploring Factors, Outcomes, and Equity","authors":"Toni-Ann J'nelle Lewis Degrees MD, MPH,&nbsp;Fatiah Joseph MD,&nbsp;Michael E. Kaiser MD, MPH,&nbsp;Gabriella J. Phillip MD,&nbsp;Joshua Green DPM,&nbsp;Francin Alexis MD,&nbsp;Louis Mudannayake MD,&nbsp;Anna Goehring MD,&nbsp;Kwesi Blackman MD, MBA,&nbsp;David Conner MD, MPH,&nbsp;William M. Briggs PhD","doi":"10.1016/j.jnma.2024.07.050","DOIUrl":"10.1016/j.jnma.2024.07.050","url":null,"abstract":"<div><h3>Purpose</h3><p>ACP is pivotal in patient care. It emphasizes respecting an individual's values, preferences, and goals in decision-making. Although ACP is beneficial to patients and families, disparities persist, particularly among marginalized groups. We undertook this study to assess these disparities between ACP among patients of various groups and evaluate the relationship between these factors on shared-decision making.</p></div><div><h3>Methods</h3><p>A retrospective cohort analysis collected data from a single facility spanning March to September 2023, focusing on palliative care encounters. Data were categorized by demographics (race, age, gender) and factors affecting patient and family decisions, including religion, marital status, diagnosis, and ultimate choices (DNR/DNI, comfort-measures, hospice). We examined these variables through logistic regression models, chi-square tests, and F-tests (p &lt; 0.05) to uncover potential correlations with advanced care planning.</p></div><div><h3>Results</h3><p>End-stage dementia patients showed a significant association with the likelihood and probability of undergoing ACP. Patients opting for comfort-directed care, DNR/DNI, and hospice care correlated significantly with ACP. Interestingly, there was no statistically significant association (p-value &gt;0.05) between race, gender, marital status, religion, or age and the likelihood of undergoing ACP.</p></div><div><h3>Conclusion</h3><p>Our results diverge from past trends, showing diminished rates of ACP completion among specific ethnic and religious demographics. One potential rationale is the integration of social workers within our facility, actively engaging in ACP with patients. This approach facilitates early interventions and ensures comprehensive patient services across both outpatient and inpatient settings. Overcoming obstacles to ACP conversations and embracing diverse perspectives is essential to achieving equitable and compassionate end-of-life care.</p></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 4","pages":"Page 433"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142089193","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}