Journal of tissue viability最新文献

{"title":"Wound cleansing solutions versus normal saline in the treatment of diabetic foot ulcers – A systematic review","authors":"Anneli Ringblom, John Ivory, Ingegerd Adlerberth, Agnes E. Wold, Caroline McIntosh, Axel Wolf","doi":"10.1016/j.jtv.2024.08.010","DOIUrl":"https://doi.org/10.1016/j.jtv.2024.08.010","url":null,"abstract":"Diabetic foot ulcers (DFUs) are a major complication of diabetes mellitus, defined as infection, ulceration and/or destruction of deep tissues and/or peripheral artery disease in the lower extremities. Efficient cleansing is essential for the treatment of wounds, as it removes debris and necrotic tissue and decreases the burden of wound-colonizing microorganisms.","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"27 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261882","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":"Pressure ulcer prevention for people with long-term neurological conditions (LTNCs) who self-manage care and live at home.","authors":"Delia Muir, Laura McLarty, Jessica Drinkwater, Carole Bennett, Yvonne Birks, Andrea Broadway-Parkinson, Vanessa Cooksey, Phil Gleeson, Christy Holland, Lisa Ledger, Daniella-Jade Lowe, Andrea McGoverin, Jane Nixon, Tanya Perry, Heidi Sandoz, Brian Rawson, Yvonne Rawson, Nikki Stubbs, Kay Walker, Helen Whitaker, Susanne Coleman","doi":"10.1016/j.jtv.2024.08.007","DOIUrl":"https://doi.org/10.1016/j.jtv.2024.08.007","url":null,"abstract":"To develop a Theory of Change (ToC) pathway to facilitate the development of a multi-component intervention package supporting pressure Ulcer (PU) risk identification and management, in partnership with people with Long Term Neurological Conditions (LTNC) who self-manage care and live at home, their informal carers and PAs. A participatory approach, with extensive input from those whose lives are the focus of the research, was used throughout the 4 interlinked work packages (WP): Overall, 74 participants contributed across the 4 WPs, incorporating 31 Service Users (SU), 8 carers, 9 Personal Assistants (PAs) and 26 professional stakeholders. We identified 8 key themes related to PU prevention, incorporating, learning, safe routines, third sector and peer support, navigating complex systems, adapting and reacting to change, perceptions of risk, risk negotiation and supporting roles. The findings indicate systemic and professional barriers which hamper people’s ability to self-care and seek help. The study highlights the complexities and impact of managing PU prevention activities at home for people with LTNC and areas of learning for health professionals and systems. By understanding these complexities we developed a systems map, identified resource requirements and illustrated a Theory of Change (ToC) pathway, to underpin future work to develop and user test an interactive, multi-component intervention.","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"184 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142224380","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":"Silicone adhesive multilayer foam dressings to prevent hospital-acquired sacrum pressure ulcers: An economic evaluation based on a publicly funded pragmatic randomized controlled trial linked with real-world data.","authors":"Mattias Neyt,Christophe De Meester,Stephan Devriese,Elisabeth Marynen,Dimitri Beeckman","doi":"10.1016/j.jtv.2024.08.011","DOIUrl":"https://doi.org/10.1016/j.jtv.2024.08.011","url":null,"abstract":"OBJECTIVESTo estimate the cost-effectiveness of sacrum multilayer silicone foam dressings as an adjuvant prophylactic therapy compared to standard pressure ulcer prevention in a hospital population at high risk for pressure ulcer development.METHODSAn economic evaluation is performed from a healthcare payer's perspective. This evaluation is based on a Belgian publicly funded pragmatic randomized controlled trial (RCT), linked with real-world data from administrative claims database and a Belgian cost analysis. A cost-consequences analysis with a one-year time horizon is performed.RESULTSThe RCT has shown that the risk of developing a new pressure ulcer on the sacrum was statistically significantly reduced by 41 % in the treatment group (RR = 0.59, 95 % CI 0.35-0.98, p = 0.04). The absolute risk reduction of 2.0 % (95 % CI -0.1-4.1 %) coincides with a number needed to treat of 50.0 to prevent one new pressure ulcer of category II or worse. The evolution of quality of life is on average negative for patients who developed a pressure ulcer before day 3, while it is positive for patients without pressure ulcers. In a scenario with conservative assumptions, i.e. without inclusion of price discounts for the multilayer silicone foam dressings and only including costs during the hospitalization, pressure ulcer prevention with dressings on the sacrum was already cost-neutral.CONCLUSIONSThe preventive use of silicone adhesive multilayer foam dressings on the sacrum for a population similar to the pragmatic trial population can be supported both from a clinical and economic point of view.","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"13 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142186013","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":"Body mass index and pressure injuries risk in hospitalized adult patients: A dose-response analysis","authors":"Yi-Jie Jia ,&nbsp;Hai-Rong Yu ,&nbsp;Fei-Hong Hu ,&nbsp;Wen Tang ,&nbsp;Wan-Qing Zhang ,&nbsp;Meng-Wei Ge ,&nbsp;Lu-Ting Shen ,&nbsp;Wei Du ,&nbsp;Bo Cai ,&nbsp;Hong Xu ,&nbsp;Xiao-Peng Xia ,&nbsp;Hong-Lin Chen","doi":"10.1016/j.jtv.2024.06.006","DOIUrl":"10.1016/j.jtv.2024.06.006","url":null,"abstract":"<div><h3>Background</h3><p>The association between underweight and pressure injuries (PIs) has been established in several studies. However, there is a lack of well-designed research investigating the connection between overweight and obesity with these injuries.</p></div><div><h3>Objective</h3><p>This meta-analysis aims to investigate the dose-response relationship between body mass index (BMI) and the risk of PIs in adult hospitalized patients.</p></div><div><h3>Methods</h3><p>PubMed, Web of Science, and MEDLINE Databases were searched from inception to May 2024. Observational articles with at least three BMI categories were included in the study. BMI was defined as underweight, normal weight, overweight, and morbid obesity for the meta-analysis. The non-linear relationship between BMI and the risk of PIs in hospitalized adults was investigated using restricted cubic spline models. Fractional polynomial modeling was used.</p></div><div><h3>Results</h3><p>Eleven articles reporting at least 3 categories of BMI met the inclusion criteria, including 31,389 participants. Compared to patients with normal weight, those with underweight, obesity, and morbid obesity exhibited an increased risk of PIs, with odds ratios of 1.70 (95%CI:1.50–1.91), 1.12 (95%CI:1.02–1.24), 1.70 (95%CI:1.13–2.55), respectively. A J-shaped dose-response model was established for the relationship between PI risk and BMI (P_{non-linearity} &lt; 0.001, P_linearity = 0.745).</p></div><div><h3>Conclusion</h3><p>The J-shaped dose-response pattern revealed that underweight, obesity and morbid obesity heightened the risk of PIs in hospitalized adults. Lower and higher BMI values may signify an increased risk for PIs, particularly among the elderly with lower BMI, providing valuable guidance for medical staff.</p></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"33 3","pages":"Pages 405-411"},"PeriodicalIF":2.4,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141406621","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":"Associations between body mass index and interface pressure after 3 h loading in healthy adults","authors":"Do Eun Kyung ,&nbsp;Yong Soon Shin","doi":"10.1016/j.jtv.2024.06.005","DOIUrl":"10.1016/j.jtv.2024.06.005","url":null,"abstract":"<div><h3>Aim of the study</h3><p>The purpose of this study was to determine the associations between body mass index and interface pressure after 3 h loading in healthy adults and to establish a foundation for the development of interventions tailored to body mass index.</p></div><div><h3>Material and methods</h3><p>A secondary data analysis based on a clinical trial involving 75 adults was conducted. Data were analyzed using descriptive statistics, repeated measure ANOVA, and ANCOVA. The statistics program IBM SPSS Statistics 27.0 was used for data analysis.</p></div><div><h3>Results</h3><p>Loading caused a significant increase in average pressure in the obesity group compared to the underweight group. There was a significant increase in risk area ratio calculated based on 30 mmHg and 45 mmHg in both obesity and overweight groups compared to the underweight group. On both support surfaces, average pressure, peak pressure, and risk area ratio were higher in the obese group compared to the normal weight group. However, these differences were not statistically significant.</p></div><div><h3>Conclusion</h3><p>Given the emphasized risk of pressure injuries, long-term observation of body mass index-specific changes in interface pressure can provide crucial evidence for pressure injury prevention nursing. The results of this study suggest the need to implement pressure injury prevention interventions that consider the pressure characteristics according to BMI.</p></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"33 3","pages":"Pages 399-404"},"PeriodicalIF":2.4,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141397513","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":"Prevention and care for moisture-associated skin damage: A scoping review","authors":"Lin Qi ,&nbsp;Qingsheng Zhao ,&nbsp;Lianrong Guo ,&nbsp;Bingnan Zhao ,&nbsp;Min Zhang","doi":"10.1016/j.jtv.2024.06.002","DOIUrl":"10.1016/j.jtv.2024.06.002","url":null,"abstract":"<div><h3>Objective</h3><p>Moisture-associated skin damage (MASD) is an inflammatory skin condition caused by long-term exposure to a moist environment, which can compromise the integrity of the barrier and increase pain. This scoping review aimed to systematically analyze the research status of prevention and care for MASD.</p></div><div><h3>Methods</h3><p>We conducted a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. PubMed, MEDLINE, Scopus, Web of Science, CINAHL, and the Cochrane Database of Systematic Reviews were searched for relevant articles until March 2023.</p></div><div><h3>Results</h3><p>Based on eligibility criteria, 34 research studies and review articles were included. The prevalence of MASD varies greatly in different medical environments and patient groups. The high-risk factors included prolonged exposure to excessive water, chemical irritation such as urine or feces, mechanical factors such as friction or improper removal of medical adhesives and local bacterial colonization. Prevention measures mainly include avoiding skin exposure to moisture, skin cleansing, moisturizing and the treatment of secondary bacterial infection.</p></div><div><h3>Conclusion</h3><p>A variety of factors have an impact on MASD. Nurses should select suitable tools to screen high-risk patients and take targeted preventive measures according to the related types of skin injury to reduce the incidence of MASD.</p></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"33 3","pages":"Pages 362-375"},"PeriodicalIF":2.4,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141405661","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":"Adjunctive hyperbaric oxygen treatment for challenging pyoderma gangrenosum cases","authors":"Emma L. Hodson ,&nbsp;Allison Kranyak ,&nbsp;Iman Salem ,&nbsp;Jay C. Buckey Jr.","doi":"10.1016/j.jtv.2024.06.001","DOIUrl":"10.1016/j.jtv.2024.06.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Pyoderma gangrenosum (PG) is a rare, difficult-to-treat neutrophilic ulcerative cutaneous condition that severely impacts those affected. Treatment options for PG are limited, and disease remission is not guaranteed. Hyperbaric oxygen treatment is a potential therapeutic option for treating various ulcerative conditions not frequently utilized for PG.</p></div><div><h3>Case report</h3><p>We present a case of a patient with treatment-resistant PG who achieved remission with adjunctive HBOT, and then later had difficulty achieving remission without HBOT during a future flare.</p></div><div><h3>Discussion</h3><p>HBOT should be more readily considered as a treatment option for those with PG.</p></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"33 3","pages":"Pages 449-451"},"PeriodicalIF":2.4,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965206X24000767/pdfft?md5=e6913ac720cca9927f4ecf3c78660f9a&pid=1-s2.0-S0965206X24000767-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293437","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":"Corrigendum to “The relationship between pressure injuries and ultrasonographically measured rectus femoris muscle thickness” [J. Tissue Viability 33 (2024) 60–66]","authors":"Ayfer Durak ,&nbsp;Vildan Binay Safer ,&nbsp;Nezahat Muge Catikkas","doi":"10.1016/j.jtv.2024.05.013","DOIUrl":"10.1016/j.jtv.2024.05.013","url":null,"abstract":"<div><h3>Aim</h3><p>Pressure injuries (PI) are an important quality indicator in healthcare, we aimed to evaluate the relationship between PIs and ultrasonographic muscle mass measurements.</p></div><div><h3>Materials and methods</h3><p>This study was conducted prospectively between May 2022 and August 2022. The ultrasonography method was used for muscle mass measurement. The presence of PIs was assessed according to the PI classification system of the EPUAP (European Pressure Ulcer Advisory Panel), (NPIAP) National Pressure Ulcer Advisory Panel &amp; PPPIA (Pan Pacific Pressure Injury Alliance).The demographics, age, sex, history of previous hospitalization, the place where patients are admitted (home/other service/intensive care unit), length of hospitalization, presence of a urinary catheter, diaper usage, and presence of tracheostomy were recorded.</p></div><div><h3>Results</h3><p>Of the included 50 patients (mean age: 77.2 ± 9.7 (48–92), female: 56%), 42% had PIs, mostly staged 2 in the sacrum. The patients with PIs had significantly more urinary catheter and diaper usage, lower albumin levels, and reduced rectus femoris muscle thickness (RF MT) and rectus femoris cross-sectional area (RF CSA) values (p = 0.014, 0.018, 0.016, 0.018, and 0.042, respectively). In multivariate logistic regression analysis, RF MT was found independently associated with the PIs (p = 0.048).</p></div><div><h3>Conclusion</h3><p>Pressure injuries are more common in patients cared for in palliative care settings than in the general population and severely affect the quality of life. We found an independent relationship between PIs and RF MT. We consider that ultrasonographic muscle mass assessment may be a useful predictor of PIs.</p></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"33 3","pages":"Page 511"},"PeriodicalIF":2.4,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965206X24000755/pdfft?md5=bdabc64e0dc782edeef522163b29c41f&pid=1-s2.0-S0965206X24000755-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262063","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":"Changes of transcutaneous oxygen pressure in compressed areas of surgical patients: A prospective study of influencing factors","authors":"Yuan Chen,&nbsp;Wei Wang,&nbsp;QianJian Qian,&nbsp;Bei Wen Wu","doi":"10.1016/j.jtv.2024.05.012","DOIUrl":"10.1016/j.jtv.2024.05.012","url":null,"abstract":"<div><h3>Objective</h3><p>To compare the transcutaneous oxygen pressure (tcpO2) measurement values and changes in compressed areas of surgical patients before and after surgery and to explore the related factors influencing the tcpO2 changes before and after surgery.</p></div><div><h3>Methods</h3><p>Researchers selected 100 patients who underwent elective surgery in a tertiary comprehensive hospital from November 2021 to September 2022. A self-designed general information questionnaire was used to collect patient general information and disease-related data, including gender, age, smoking and drinking history, hypertension, diabetes, local skin temperature and humidity, related biochemical indicators, and activities of daily living score. Researchers used a transcutaneous oxygen pressure meter to measure and record the tcpO2 of the compressed areas (sacrococcygeal area, scapula area, and heel area) before and after surgery.</p></div><div><h3>Results</h3><p>Among the 100 patients, 37.00 % (37/100) developed type I/II pressure ulcers after surgery, and 30 patients (81.08 %) showed regression within 2 h after surgery. There was no statistically significant difference in the preoperative tcpO2 measurement values of the scapula and heel areas between the group with and without pressure ulcers, but the preoperative tcpO2 measurement value of the sacrococcygeal area in the group without pressure ulcers was higher than that in the group with pressure ulcers (<em>P</em> &lt; 0.01). The factors affecting the preoperative tcpO2 measurement value of the sacrococcygeal area were smoking and surgical type. After surgery, the tcpO2 measurement values of the three areas in the group with pressure ulcers were significantly lower than those in the group without pressure ulcers (<em>P</em> &lt; 0.01). Comparing the tcpO2 values of different areas, it was found that the tcpO2 value was lowest in the sacrococcygeal area, followed by the heel area, and the tcpO2 value in the scapula area was highest both before and after surgery (<em>P</em> &lt; 0.01). The main factors affecting the postoperative tcpO2 measurement value were diabetes, Glassgow score, surgical time, and intraoperative red blood cell transfusion.</p></div><div><h3>Conclusion</h3><p>The measurement of tcpO2 is related to the incidence of surgically acquired pressure ulcers, and this technology may become an important tool for quantitative assessment of the risk of pressure ulcers.</p></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"33 3","pages":"Pages 452-457"},"PeriodicalIF":2.4,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306238","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":"An ingenious deep learning approach for pressure injury depth evaluation with limited data","authors":"Kento Ikuta ,&nbsp;Kohei Fukuoka ,&nbsp;Yuka Kimura ,&nbsp;Makoto Nakagaki ,&nbsp;Makoto Ohga ,&nbsp;Yoshiko Suyama ,&nbsp;Maki Morita ,&nbsp;Ryunosuke Umeda ,&nbsp;Mamoru Konishi ,&nbsp;Hiroyuki Nishikawa ,&nbsp;Shunjiro Yagi","doi":"10.1016/j.jtv.2024.05.009","DOIUrl":"10.1016/j.jtv.2024.05.009","url":null,"abstract":"<div><h3>Background</h3><p>The development of models using deep learning (DL) to assess pressure injuries from wound images has recently gained attention. Creating enough supervised data is important for improving performance but is time-consuming. Therefore, the development of models that can achieve high performance with limited supervised data is desirable.</p></div><div><h3>Materials and methods</h3><p>This retrospective observational study utilized DL and included patients who received medical examinations for sacral pressure injuries between February 2017 and December 2021. Images were labeled according to the DESIGN-R® classification. Three artificial intelligence (AI) models for assessing pressure injury depth were created with a convolutional neural network (Categorical, Binary, and Combined classification models) and performance was compared among the models.</p></div><div><h3>Results</h3><p>A set of 414 pressure injury images in five depth stages (d0 to D4) were analyzed. The Combined classification model showed superior performance (F1-score, 0.868). The Categorical classification model frequently misclassified d1 and d2 as d0 (d0 Precision, 0.503), but showed high performance for D3 and D4 (F1-score, 0.986 and 0.966, respectively). The Binary classification model showed high performance in differentiating between d0 and d1–D4 (F1-score, 0.895); however, performance decreased with increasing number of evaluation steps.</p></div><div><h3>Conclusion</h3><p>The Combined classification model displayed superior performance without increasing the supervised data, which can be attributed to use of the high-performance Binary classification model for initial d0 evaluation and subsequent use of the Categorical classification model with fewer evaluation steps. Understanding the unique characteristics of classification methods and deploying them appropriately can enhance AI model performance.</p></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"33 3","pages":"Pages 387-392"},"PeriodicalIF":2.4,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141145042","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}