Benedikt Holm, Michal Borsky, Erna S Arnardottir, Marta Serwatko, Jacky Mallett, Anna Sigridur Islind, María Óskarsdóttir
{"title":"BreathFinder: A Method for Non-Invasive Isolation of Respiratory Cycles Utilizing the Thoracic Respiratory Inductance Plethysmography Signal.","authors":"Benedikt Holm, Michal Borsky, Erna S Arnardottir, Marta Serwatko, Jacky Mallett, Anna Sigridur Islind, María Óskarsdóttir","doi":"10.2147/NSS.S468431","DOIUrl":"10.2147/NSS.S468431","url":null,"abstract":"<p><strong>Introduction: </strong>The field of automatic respiratory analysis focuses mainly on breath detection on signals such as audio recordings, or nasal flow measurement, which suffer from issues with background noise and other disturbances. Here we introduce a novel algorithm designed to isolate individual respiratory cycles on a thoracic respiratory inductance plethysmography signal using the non-invasive signal of the respiratory inductance plethysmography belts.</p><p><strong>Purpose: </strong>The algorithm locates breaths using signal processing and statistical methods on the thoracic respiratory inductance plethysmography belt and enables the analysis of sleep data on an individual breath level.</p><p><strong>Patients and methods: </strong>The algorithm was evaluated against a cohort of 31 participants, both healthy and diagnosed with obstructive sleep apnea. The dataset consisted of 13 female and 18 male participants between the ages of 20 and 69. The algorithm was evaluated on 7.3 hours of hand-annotated data from the cohort, or 8782 individual breaths in total. The algorithm was specifically evaluated on a dataset containing many sleep-disordered breathing events to confirm that it did not suffer in terms of accuracy when detecting breaths in the presence of sleep-disordered breathing. The algorithm was also evaluated across many participants, and we found that its accuracy was consistent across people. Source code for the algorithm was made public via an open-source Python library.</p><p><strong>Results: </strong>The proposed algorithm achieved an estimated 94% accuracy when detecting breaths in respiratory signals while producing false positives that amount to only 5% of the total number of detections. The accuracy was not affected by the presence of respiratory related events, such as obstructive apneas or snoring.</p><p><strong>Conclusion: </strong>This work presents an automatic respiratory cycle algorithm suitable for use as an analytical tool for research based on individual breaths in sleep recordings that include respiratory inductance plethysmography.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11345460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073332","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}
Firoj Al-Mamun, Mohammed A Mamun, Md Emran Hasan, Moneerah Mohammad ALmerab, David Gozal
{"title":"Exploring Sleep Duration and Insomnia Among Prospective University Students: A Study with Geographical Data and Machine Learning Techniques.","authors":"Firoj Al-Mamun, Mohammed A Mamun, Md Emran Hasan, Moneerah Mohammad ALmerab, David Gozal","doi":"10.2147/NSS.S481786","DOIUrl":"10.2147/NSS.S481786","url":null,"abstract":"<p><strong>Background: </strong>Sleep disruptions among prospective university students are increasingly recognized for their potential ramifications on academic achievement and psychological well-being. But, information regarding sleep issues among students preparing for university entrance exams is unknown. Thus, this study aimed to investigate the prevalence and factors associated with sleep duration and insomnia among university entrance test-takers in Bangladesh, utilizing both traditional statistical analyses and advanced geographic information system and machine learning techniques for enhanced predictive capability.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in June 2023 among 1496 entrance test-takers at Jahangirnagar University, Dhaka. Structured questionnaires collected data on demographics, academic information, and mental health assessments. Statistical analyses, including chi-square tests and logistic regression, were performed using SPSS, while machine learning models were applied using Python and Google Colab.</p><p><strong>Results: </strong>Approximately 62.9% of participants reported abnormal sleep duration (<7 hours/night or >9 hours/night), with 25.5% experiencing insomnia. Females and those dissatisfied with mock tests were more likely to report abnormal sleep duration, while repeat test-takers, those with unsatisfactory mock test results, or anxiety symptoms had a higher risk of insomnia. Machine learning identified satisfaction with previous mock tests as the most significant predictor of sleep disturbances, while higher secondary school certificate GPA had the least influence. The CatBoost model achieved maximum accuracy rates of 61.27% and 73.46%, respectively, for predicting sleep duration and insomnia, with low log loss values indicating robust predictive performance. Geographic analysis revealed regional variations in sleep disturbances, with higher insomnia prevalence in some southern districts and abnormal sleep duration in northern and eastern districts.</p><p><strong>Conclusion: </strong>Sleep disturbances are prevalent among prospective university students and are associated with various factors including gender, test-taking status, mock test satisfaction, and anxiety. Targeted interventions, including sleep education and psychological support, hold promise in ameliorating sleep health and overall well-being among students, potentially enhancing entrance test performance.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056122","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":"Self-Compassion as a Mediator Linking Sleep Disturbances with Non-Suicidal Self-Injury: A Four-Wave, Cross-Lagged Study.","authors":"Xuliang Shi, Miaomiao Hou, Xiaoyan Chen, Ya Zhu","doi":"10.2147/NSS.S470557","DOIUrl":"10.2147/NSS.S470557","url":null,"abstract":"<p><strong>Objective: </strong>This longitudinal study examined the reciprocal relationship between sleep disturbances with non-suicidal self-injury and whether self-compassion mediates these associations.</p><p><strong>Methods: </strong>A total of 5785 freshmen were sampled from a large-scale health-related cohort among Chinese college students at the baseline. This study spanned six waves with a six-month interval between each wave. Data from the last four waves were used because self-compassion or non-suicidal self-injury was not measured in the first two waves. The cross-lagged panel models were used to examine the longitudinal dynamic relationships between sleep disturbances, self-compassion, and non-suicidal self-injury.</p><p><strong>Results: </strong>The results showed that all the auto-regressive paths were significant. For the cross-lagged paths, there was a reciprocal relation between sleep disturbances and self-compassion. Importantly, self-compassion played a longitudinal mediating role in the prediction from sleep disturbances to non-suicidal self-injury (indirect effect = 0.007 to 0.009, all <i>p</i> values < 0.001).</p><p><strong>Conclusion: </strong>Psychological interventions targeting improved sleep quality and self-compassion may hold great promise for reducing the incidence of non-suicidal self-injury.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056123","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":"Immune Reconstitution Inflammatory Syndrome Due to HIV Treatment as a Potential Trigger: A Case Report with Late-Onset Narcolepsy.","authors":"Jiaqin Yu, Ting Shen, Zongshan Li, Tian Lv, Lisan Zhang","doi":"10.2147/NSS.S476922","DOIUrl":"10.2147/NSS.S476922","url":null,"abstract":"<p><p>Narcolepsy type 1 (NT1) is a unique central sleepiness disorder that affects individuals with excessive daytime sleepiness (EDS), cataplexy, sleep paralysis, and hypnagogic hallucinations. The etiology and pathogenesis of NT1 remains unclear, although some viral infections are thought to be related to NT1. This paper reports an unusual case of late-onset NT1 with human immunodeficiency virus (HIV) infection and antiretroviral therapy for five years. The relationship between HIV infection, immune, Immune reconstitution inflammatory syndrome (IRIS) and NT1 should be further investigated, as excessive daytime sleepiness is more common in HIV-infected patients than in the general population.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004855","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":"Time-Dependent Effects of Altered Prebedtime Light Exposure in Enclosed Spaces on Sleep Performance Associated with Human States.","authors":"Jianghao Xiao, Dengkai Chen, Suihuai Yu, Hui Wang, Yiwei Sun, Hanyu Wang, Zhiming Gou, Jingping Wang","doi":"10.2147/NSS.S472988","DOIUrl":"10.2147/NSS.S472988","url":null,"abstract":"<p><strong>Purpose: </strong>Exposure to artificial light influences human performance, which is essential for maintaining healthy work and sleep. However, existing research has not explored the intrinsic links between sleep performance and human states over time under prebedtime light exposure interventions (LEIs).</p><p><strong>Methods: </strong>To investigate the time-dependent effects of altered prebedtime light exposure, four LEI groupings (#L1 - #L4) and a Time factor (D8, D9, and D10) were chosen for sleep experiments in enclosed spaces. Forty-eight young adults recruited were available for data analysis. Subjective alertness (SA), negative affect (NA), subjective sleep, and objective sleep were measured via the Karolinska Sleepiness Scale, Positive and Negative Affect Schedule, Next-day Self-assessment Sleep Quality, and joint assessment of wrist actigraphy and sleep diaries, respectively. Statistical analysis was used for the effects of light exposure on the human states (corresponding to the SA and NA) and sleep performance, while the process model helped construct the associations between the two.</p><p><strong>Results: </strong>The statistical effects revealed that the Time had a significant main effect on subjective sleep and changes in prebedtime alertness; the LEI had a significant main effect only on sleep onset latency (SOL). After undergoing altered prebedtime light exposure, the mean SA increased at prebedtime of D9 (p = 0.022) and D10 (p = 0.044); No significant effect on the NA was observed; Mean subjective sleep had a significant increase from D8 to D10. Moreover, five actigraphy-estimated sleep parameters were interrelated. In light of this, a chained pathway relationship was identified. The SOL played a mediating predictor between prebedtime state and objective sleep, which was linked to the awakening state through subjective sleep.</p><p><strong>Conclusion: </strong>Our study suggests that time-dependent effects of altered prebedtime light exposure on sleep performance are associated with human states at prebedtime and awakening, with implications for its prediction of sleep health.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917134","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":"Cross-Lagged Panel Networks of Sleep Inertia Across Its Distinct Change Patterns Among Intern Nurses with Shift Work in China.","authors":"Zijuan Ma, Yunge Fan, Zhijun Yu, Wenxuan Wu, Xiangting Zhang, Huolian Li, Shaochen Zhao, Yang Li, Yuanyuan Li, Dongfang Wang, Fang Fan","doi":"10.2147/NSS.S467433","DOIUrl":"10.2147/NSS.S467433","url":null,"abstract":"<p><strong>Purpose: </strong>Although experimental psychopathology using PET, EEG, and fMRI is at the forefront of understanding the underlying mechanisms of sleep inertia, many questions concerning causality remain unanswerable due to ethical constraints and the use of small and heterogeneous samples in experimental methods. There is a pressing need for a novel perspective in a large and relatively homogeneous population to fully capture and elucidate longitudinal processes and dynamic causality that culminate in episodes of sleep inertia over time. Therefore, this study aimed to reveal the causal relationships between symptoms of sleep inertia across its distinct patterns.</p><p><strong>Patients and methods: </strong>A total of 1636 intern nurses participated in the first survey (94.1% validity rate), then 1277 intern nurses were followed up (82.9% tracing rate). Symptoms of sleep inertia were self-reported using the Sleep Inertia Questionnaire. The cross-lagged panel network models were used to examine unique longitudinal relationships between symptoms of sleep inertia across distinct trajectories.</p><p><strong>Results: </strong>Four distinct trajectories of sleep inertia were established. Additionally, we found differences in those symptoms with the highest influence on other symptoms at the subsequent point across the networks of four trajectories, particularly, \"Difficulty in concentrating\" in the persistent-high group and \"Feeling tense\" in the deteriorating groups.</p><p><strong>Conclusion: </strong>The current study highlights changes in sleep inertia based on the long-term course over time. Notably, symptoms of \"Difficulty in concentrating\" and \"Feeling tense\" are imperative to address these specific symptoms within subpopulations.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917132","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}
Yuxin Wang, Xiaona Wang, Jinmei Luo, Bintao Qiu, Rong Huang, Yi Xiao
{"title":"Urinary Epinephrine Sulfate Can Predict Cardiovascular Risk in Moderate-to-Severe OSA: A Metabolomics-Based Study.","authors":"Yuxin Wang, Xiaona Wang, Jinmei Luo, Bintao Qiu, Rong Huang, Yi Xiao","doi":"10.2147/NSS.S470154","DOIUrl":"10.2147/NSS.S470154","url":null,"abstract":"<p><strong>Purpose: </strong>There are currently no ideal indicators for predicting the cardiovascular risk of obstructive sleep apnea (OSA). This study aimed to employ urinary metabolomics to detect early cardiovascular risk in patients with moderate-to-severe OSA.</p><p><strong>Patients and methods: </strong>Male participants who underwent polysomnography from November 2020 to May 2021 were screened. Clinical data, polysomnography data and urine samples were collected. Untargeted metabolomics analyses of urine were performed. Multivariate analyses and receiver operating characteristic (ROC) curve analyses were subsequently performed to identify potential biomarkers. Associations between metabolites and clinical indicators and cardiovascular risk were examined through linear regression analyses with interaction and mediation analyses.</p><p><strong>Results: </strong>Thirty-six male participants were included in the study, comprising 22 males with moderate-to-severe OSA and 14 age-matched controls, with an average age of 39.6 ± 9.2 years. We identified 65 metabolites in the study, involving pathways including pyrimidine, androgen, estrogen, vitamin B6 and sulfate/sulfite metabolism. Among them, epinephrine sulfate was the most significantly altered metabolite. ROC analyses highlighted that epinephrine sulfate had the highest area under the curve (AUC=0.883) for detecting moderate-to-severe OSA. Epinephrine sulfate was statistically correlated with OSA severity, hypoxia-related indicators (apnea-hypopnea index: r=0.685; oxygen desaturation index: r=0.743, p<0.0001), arterial stiffness (arterial augmentation index: r=0.361, p=0.031) and long-term cardiovascular risk (Framingham cardiovascular risk: r=0.375, p=0.024). Linear regression analysis revealed that epinephrine sulfate was significantly associated with an increased in the Framingham risk (β = 0.004, 95% CI = 0.000-0.009, p = 0.049), with the effect partly mediated by systolic blood pressure (27.6%) and not moderated by other factors. Additionally, it also significantly associated with the increased in the arterial augmentation index (β = 0.019, 95% CI = 0.000-0.037, p = 0.046), with the effect fully mediated by blood pressure and not moderated by other indices statistically.</p><p><strong>Conclusion: </strong>There are significant metabolic pathway alterations in moderate-to-severe OSA patients. Urinary epinephrine sulfate markedly predicts early cardiovascular risk in OSA patients.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11314438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917135","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":"Healthy Sleep Pattern, Metabolic Diseases, and Risk of Stroke: The Kailuan Cohort Study.","authors":"Lili Huang, Yesong Liu, Tingting Geng, Nannan Zhang, Liang Sun, Shouling Wu, Xiang Gao","doi":"10.2147/NSS.S468522","DOIUrl":"10.2147/NSS.S468522","url":null,"abstract":"<p><strong>Background: </strong>Sleep complaints were reported to be associated with stroke, however, the evidence on the association between healthy sleep pattern and stroke risk in Chinese is limited.</p><p><strong>Objective: </strong>The aim of this study was to investigate the association between healthy sleep pattern and stroke in Chinese, and the influence of metabolic diseases on the association.</p><p><strong>Methods: </strong>A total of 11,851 participants from the Kailuan study in China without stroke at baseline were included. We calculated a healthy sleep score according to four sleep factors, and defined the low-risk groups as follows: no insomnia, no excessive daytime sleepiness, no frequent snoring, and sleep 7-8h/d. Each low-risk sleep factor was assigned a score of 1. Cox proportional hazard models were used to assess the association between healthy sleep score and stroke. Mediation analysis was used to estimate the role of metabolic diseases (obesity, diabetes, and hypertension) in the healthy sleep score-stroke association.</p><p><strong>Results: </strong>During a mean follow-up period of 7.7 years, 504 cases of stroke were identified. A higher healthy sleep score was associated with a lower risk of stroke in a dose-response manner (<i>P</i>-trend=0.03). The adjusted hazard ratio (HR) for participants with a healthy sleep score of 4 versus ≤2 was 0.75 (95% confidence interval [CI]: 0.56, 0.96). In addition, obesity, diabetes, and hypertension collectively explained 21.9% (95% CI: 17.2, 26.5) of the association between healthy sleep score and stroke.</p><p><strong>Conclusion: </strong>Adherence to healthy sleep pattern was associated with a lower risk of stroke, and the favorable association was partially mediated by metabolic diseases.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11314433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917133","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":"Washed Microbiota Transplantation Improves the Sleep Quality in Patients with Inflammatory Bowel Disease","authors":"Qianqian Li, Yujie Liu, Zulun Zhang, Sheng Zhang, Xiao Ding, Faming Zhang","doi":"10.2147/nss.s460882","DOIUrl":"https://doi.org/10.2147/nss.s460882","url":null,"abstract":"<strong>Purpose:</strong> There is scarce evidence to support the effectiveness of faecal microbiota transplantation (FMT) in improving sleep among individuals with inflammatory bowel disease (IBD). Our study aimed to evaluate the effect of washed microbiota transplantation (WMT) (the new method of FMT) on the sleep of patients with IBD in short term.<br/><strong>Patients and Methods:</strong> This prospective study was conducted as part of two interventional clinical trials (starting on February 2013 and expected to end on December 2025) and placed significant emphasis on evaluating sleep quality in patients with IBD. To measure subjective sleep, we used the Pittsburgh sleep quality index (PSQI). The primary endpoint was the PSQI score one month after WMT.<br/><strong>Results:</strong> This stage study included 52 eligible patients evaluated by PSQI questionnaire who underwent WMT from January 2020 to March 2021 and 47 patients were enrolled for analysis. The age of the patients ranged from 13 to 60 years, with a mean of 33.4 years, and 57.4% (25/47) of the patients were male. The PSQI scores for all 47 patients one month after undergoing WMT were significantly lower (Cohen d = 0.59, p < 0.001) compared to the baseline. Moreover, baseline PSQI score was correlated with the difference value of the PSQI score before and after WMT (post-PSQI minus pre-PSQI) (r = 0.61, p < 0.05).<br/><strong>Conclusion:</strong> The study suggests that WMT might be a helpful intervention for improving the sleep quality of patients with IBD, encouraging clinicians to consider its use in clinical practice for addressing poor sleep in IBD patients.<br/><strong>Clinical Trial Registration:</strong> ClinicalTrials.gov; ID: NCT01793831, NCT01790061.<br/><br/><strong>Keywords:</strong> faecal microbiota transplantation, transendoscopic enteral tubing, sleep disorder, Crohn’s disease, ulcerative colitis, inflammatory bowel disease<br/>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141884631","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}