Postgraduate Medical Journal最新文献

{"title":"AI-enhanced telemedicine for personalized antiretroviral therapy in HIV patients with neurological comorbidities: a narrative review.","authors":"Nadine Mugisha, Olivier Uwishema, Boluwatife Samuel Fatokun, Rawan Noureddine, Lolita Fawaz, Jack Wellington","doi":"10.1093/postmj/qgaf069","DOIUrl":"https://doi.org/10.1093/postmj/qgaf069","url":null,"abstract":"<p><strong>Background: </strong>Human immunodeficiency virus (HIV), while now manageable as a chronic health condition with highly active antiretroviral therapy (HAART), often precipitates the onset of neurological comorbidities such as HIV-associated neurocognitive disorders (HAND) and a number of neuropathies. ART, though effective, may lead to neurotoxic adverse drug reactions, impacting patient adherence and clinical outcomes. Innovative approaches are warranted to balance ART efficacy with minimized neurological risk.</p><p><strong>Objective: </strong>This paper investigates how artificial intelligence (AI) may improve telemedicine for individualized ART management to reduce neurotoxicity and raise patient adherence to medication regimes.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted using PubMed/MEDLINE, and Google Scholar, among other electronic search databases, with keywords comprising \"Artificial Intelligence,\" \"Telemedicine,\" \"HIV,\" and \"Neurological Comorbidities.\" Studies were selected based on relevance to AI applications in personalized HIV care. Inclusion criteria included peer-reviewed articles, systematic reviews, and clinical trials on AI in HIV care. Exclusion criteria omitted non-peer-reviewed articles and studies lacking direct AI relevance. Titles and abstracts were screened before full-text review.</p><p><strong>Results: </strong>There is potential for individualized ART management with AI-integrated telemedicine. By anticipating clinical concerns pertaining to ART-associated neurotoxicity, machine learning systems allow for preemptive therapeutic modifications. Wearable technology and AI-powered mHealth apps enable real-time adherence and symptom monitoring, facilitating the prompt adjustments to therapy if necessitated whilst lowering neurotoxic adverse drug reactions.</p><p><strong>Conclusions: </strong>AI-enhanced telemedicine promotes customized ART regimens that bolster clinical outcomes and individual quality of life, providing a revolutionary approach to HIV management in populations affected by neurological sequalae. In order to provide fully personalized HIV care, future research should concentrate on improving AI model accuracy across a range of demographics while tackling moral issues pertaining to patient confidentiality and data privacy.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079329","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":"The optimal slice to quantify the volumes of subcutaneous adipose tissue and skeletal muscle on chest computed tomography as imaging marker for body composition estimation.","authors":"Linlin Lang, Liping Zuo, Kai Dou, Jinlei Fan, Donglai Li, Yuqing Tang, Weiwei Ji, Dexin Yu","doi":"10.1093/postmj/qgaf076","DOIUrl":"https://doi.org/10.1093/postmj/qgaf076","url":null,"abstract":"<p><strong>Background/objectives: </strong>This study aims to identify the optimal anatomical site that best predicts the total thoracic subcutaneous adipose tissue (SAT) and skeletal muscle (SM) volumes on chest computed tomography (CT), and to evaluate the relationships between SAT and SM areas at optimal slice and lung function.</p><p><strong>Subjects/methods: </strong>Healthy participants and chronic obstructive pulmonary disease (COPD) patients undergoing chest CT between January 2022 and April 2023 were retrospectively included. On chest CT, cross-sectional areas of SAT and SM at 14 specific anatomical levels, and thoracic SAT and SM volumes were measured using 3D Slicer software. Correlations were calculated by Spearman's correlation coefficients.</p><p><strong>Results: </strong>About 58 healthy participants and 68 COPD patients were included. In healthy participants, the T4 SAT area correlated most strongly with thoracic SAT volume (r = 0.888, P < 0.01), and the aortic arch SM area with SM volume (r = 0.941, P < 0.01). The combined Spearman's correlation coefficients reached their highest sum (1.816) at the aortic arch level. In COPD patients, correlations were identified between SAT area at the aortic arch slice with forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) (r = 0.472, P < 0.001), while SM area with both FEV1(r = 0.431, P < 0.001) and FVC (r = 0.522, P < 0.001).</p><p><strong>Conclusion: </strong>Considering measurement simplicity and accuracy, the aortic arch slice was identified as the optimal single slice for predicting total thoracic SAT and SM volumes. Additionally, the clinical significance of SAT and SM area at this slice was verified with lung function in COPD patients. Key messages What is already known on this topic: Specific abdominal slices have been shown to estimate abdominal volumes accurately, while the optimal slice to predict thoracic volumes is uncertain. What this study adds: To identify the optimal slice for simultaneously predicting both thoracic SAT and SM volumes. How this study might affect research, practice or policy: The optimal slice in the chest for measurement is crucial for advancing research on thoracic SAT and SM.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079518","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":"Nephrotoxicity of direct factor Xa inhibitors: a pharmacovigilance study using real-world data from the Federal Adverse Event Reporting System database.","authors":"Xitong Zhang, Bing Lv, Bin Liu, Faping Li","doi":"10.1093/postmj/qgaf067","DOIUrl":"https://doi.org/10.1093/postmj/qgaf067","url":null,"abstract":"<p><strong>Background: </strong>Factor Xa inhibitors (FXaIs) may induce nephrotoxicity despite their FDA approval for thrombotic diseases, which has raised concerns due to its severe consequences. This study utilizes the FAERS database to assess the potential link between direct FXaIs and nephrotoxicity.</p><p><strong>Methods: </strong>Data from the FAERS database, spanning from the third quarter of 2011 to the fourth quarter of 2023, were used to perform a disproportionality analysis on Apixaban, Edoxaban, and Rivaroxaban. Disproportionality analysis and statistical processing were conducted using R software.</p><p><strong>Results: </strong>Descriptive analysis revealed that males and individuals aged 65-85 are more susceptible to nephrotoxic adverse events. The disproportionality analysis indicated that all three drugs are associated with acute renal failure and renovascular disorders, with Edoxaban showing the strongest correlation.</p><p><strong>Conclusions: </strong>This study quantitatively analysed the relative risk of nephrotoxic adverse reactions associated with direct FXaIs, emphasizing the importance of renal function monitoring for these medications. The results indicate that Edoxaban has a significant association with nephrotoxicity, necessitating closer attention to its use and recommending additional renal function tests and drug concentration testing for high-risk patients.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989900","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":"Valproate induced obsessive-compulsive symptoms: unique side effect of a commonly used drug.","authors":"Pallavi Priyam, Payel Talukdar","doi":"10.1093/postmj/qgaf066","DOIUrl":"https://doi.org/10.1093/postmj/qgaf066","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045222","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":"Effectiveness of different music tempos in guiding cardiopulmonary resuscitation training.","authors":"Chen Lan, Hao Shen, Yang Li","doi":"10.1093/postmj/qgaf068","DOIUrl":"https://doi.org/10.1093/postmj/qgaf068","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the effectiveness of different musical tempos on the quality of cardiopulmonary resuscitation (CPR).</p><p><strong>Methods: </strong>A total of 150 untrained intern doctors and nurses were randomly assigned to three groups: No Music (NM group), Slow tempo Music (AS group), and Fast tempo Music (BR group), with 50 participants in each group. Following the theoretical study of CPR, three groups of trainees were assessed. Trainees in the NM group performed CPR without any music, whereas the AS group practiced with the background music of \"All Star\" (104 bpm) and the BR group utilized \"Bad Romance\" (119 bpm) during their assessments. Outcome measures included overall compression scores, compression rate, compression depth, rate of adequate compression depth and rate of adequate chest recoil.</p><p><strong>Results: </strong>The overall compression score for the AS group was 86.0 (interquartile range [IQR] 59.0-93.0), which was significantly higher than the BR group's score of 57.0 (IQR 40.0-84.0) and the NM group's score of 54.0 (IQR 39.5-72.0) (P < .05). The AS group demonstrated significant differences in both compression rate and depth compared to the BR and NM groups (P < .05). However, there were no significant differences in the rate of adequate chest recoil among the three groups (P > .05).</p><p><strong>Conclusion: </strong>In CPR training for untrained medical students, using music with a tempo of 104 bpm enhances CPR effectiveness. However, it does not increase the rate of adequate chest recoil.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020701","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":"Roles of macrophages and monocytes in resistance to immunotherapy in breast cancers.","authors":"Siyuan Liu, Lihong Hu, Jiejie Hu, Chengdong Qin, Chuner Jiang, Yang Yu","doi":"10.1093/postmj/qgaf065","DOIUrl":"https://doi.org/10.1093/postmj/qgaf065","url":null,"abstract":"<p><strong>Background: </strong>Immunotherapy is increasingly integral to breast cancer treatment, yet a subset develops resistance, partly mediated by macrophages and monocytes in the tumor immune microenvironment. While macrophages play essential roles in phagocytosis and pathogen clearance, their dual role in breast cancer-acting as both barriers to therapy and potential therapeutic targets-complicates treatment efficacy.</p><p><strong>Strategy: </strong>Tumor-associated macrophages, polarized by tumor-derived signals, promote cancer progression and metastasis. Monocytes, subdivided into CD14+CD16- and CD14+CD16+ subsets, exhibit distinct functional profiles in cytokine secretion, antigen presentation, and migration. Modulating monocyte subset dynamics and functionality may enhance immunotherapy responsiveness.</p><p><strong>Conclusion: </strong>A multimodal strategy targeting macrophages, monocytes, and complementary immunotherapies offers promising avenues to overcome resistance. Further research into the heterogeneity and regulatory mechanisms of these cells is critical for developing optimized, safe immunotherapeutic protocols. This review underscores the necessity of combination immunotherapies to improve outcomes in breast cancer.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033346","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":"Varicose vein is associated with an increased risk of ischemic stroke: a population-based matched cohort study.","authors":"Feng-Renn Hsieh, Wei-Kai Lee, Sunny Ssu-Yu Chen, Cheuk-Kwan Sun, Wen-Bin Yeh, Yao-Min Hung, Fuu-Jen Tsai, Renin Chang, Li-Fei Pan","doi":"10.1093/postmj/qgaf063","DOIUrl":"https://doi.org/10.1093/postmj/qgaf063","url":null,"abstract":"<p><strong>Importance: </strong>The association between varicose veins (VVs) and stroke, and the influence of VV management on the risk of stroke remained unclear.</p><p><strong>Objective: </strong>To evaluate whether VVs are associated with an elevated risk of stroke and assess if interventions for VVs alter this risk.</p><p><strong>Design: </strong>From 1 January 2000 to 31 December 2015, adults with VVs were matched by propensity score with those without VVs. Patients with prior strokes were excluded. Follow-up continued until 31 December 2018.</p><p><strong>Outcomes: </strong>Relative hazards through comparing incidence rates of ischemic stroke (IS) and hemorrhagic stroke (HS) between the two groups using Cox proportional hazards models.</p><p><strong>Results: </strong>Comparison of the VV group (n = 23 238, mean [SD] age = 54.3 [15.6] years; 70% female) with the non-VV group (n = 92 952, mean [SD] age = 54.1 [15.7] years; 71% female) revealed a higher incidence rate of IS in the former than the latter (13.15 vs. 11.16 per 1000 person-years; 2555 vs. 8799 cases, respectively). The adjusted hazard ratio (aHR) for overall stroke in the VV group was 1.16 (95% CI = 1.11-1.21). Both females (aHR = 1.18 [95% CI = 1.11-1.25]) and males (aHR = 1.15 [95% CI = 1.07-1.24]) with VVs showed an increased IS risk. In patients aged ≥50, VVs were associated with a higher IS risk (aHR = 1.17 [95% CI = 1.12-1.23]). No significant correlation was found between VVs and HS. The association of VV management with a reduced risk of stroke (aHR = 0.82 [95% CI = 0.70-0.96]) was supported by sensitivity analyses.</p><p><strong>Conclusions: </strong>Adults with VVs showed an increased risk of IS but not HS. Key message What is already known on this topic.  Varicose veins (VVs) are linked to cardiovascular conditions, but their association with stroke risk and the impact of VV interventions remain unclear. What this study adds.  This study demonstrated that adults with VVs, especially those aged ≥50, have a higher ischemic stroke (IS) risk. VV interventions may reduce this risk. How this study might affect research, practice, or policy.  Stroke risk assessment and VV management should be considered in older patients to improve preventive care.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990917","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":"Clinical master of medicine students in China-focusing on their dilemma.","authors":"Jinming Zhang","doi":"10.1093/postmj/qgaf064","DOIUrl":"https://doi.org/10.1093/postmj/qgaf064","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053324","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":"Anticoagulation outcomes in cirrhotic patients with portal vein thrombosis: a tertiary center study.","authors":"Chengu Niu, Jing Zhang, Idoate-Domench Daniel-Jose, Teibel Zachary, Orakzai Abdullah, Purva Shah, Eltaher Basant, Devam Maity, Firoze A Abdullah, Nagesh Jadhav, Patrick I Okolo, Daglilar Ebubekir","doi":"10.1093/postmj/qgaf062","DOIUrl":"https://doi.org/10.1093/postmj/qgaf062","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study purpose: &lt;/strong&gt;This study assesses the efficacy and safety of direct oral anticoagulants (DOACs) compared to traditional anticoagulants in managing portal vein thrombosis (PVT), aiming to address critical gaps in both research and clinical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;We conducted a retrospective analysis at Rochester General Hospital from January 2011 to December 2023, involving 275 cirrhotic patients with PVT. The inclusion criteria included confirmed non-neoplastic PVT by imaging.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Analysis of 275 cirrhotic patients with PVT revealed no significant differences in age and gender between those treated with anticoagulants and those untreated. The mortality rate was significantly lower in the treated group (37.7%) compared to the untreated group (51.7%; P = 0.029). Gastrointestinal bleeding was slightly more prevalent in the treated group (60.7%) than in the untreated group (58.1%; P = 0.690), though not statistically significant. A significant reduction in intracranial hemorrhage was observed in the treated group (2.5% vs. 8.5% in the untreated group; P = 0.038). In a subgroup analysis comparing the outcomes and side effects of DOACs, Warfarin, and low molecular weight heparins (LMWH) in treated PVT patients, the DOAC group showed improved survival rates compared to traditional [vitamin K antagonists (VKA)/LMWH] treatment, a log-rank test indicated significant survival improvement (chi2 (1) = 8.27, P = 0.0040). DOACs demonstrated comparable mortality rates to VKAs (34.2% vs. 34.5%, P = 0.979) and a significant survival benefit over LMWH (33.3% vs. 60.0%, P = 0.030).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;DOAC in treating PVT among patients with liver cirrhosis, demonstrating better significant survival rate when compared to traditional anticoagulation. Key message What is already known on this topic  Portal vein thrombosis (PVT) is significantly more prevalent in patients with liver cirrhosis compared to the general population, posing substantial management challenges. Previous studies have primarily focused on small cohorts and retrospective data, underscoring the need for robust, large-scale analyses to validate the efficacy and safety of direct oral anticoagulants (DOACs) versus traditional therapies. What this study adds  This study provides concrete evidence from a large cohort that DOACs not only offer a survival benefit over traditional anticoagulation therapies like Warfarin and LMWH in cirrhotic patients with PVT but also maintain comparable safety profiles. These findings bridge significant gaps in current research by comparing the outcomes of modern versus traditional anticoagulant approaches in a real-world setting. How this study might affect research, practice, or policy  The results advocate for the inclusion of DOACs in clinical guidelines for managing PVT in cirrhosis, potentially shifting clinical practice toward these agents. Furthermore, the detailed comparison a","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975960","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":"A novel indicator derived from heart sound energy map obtained by a wearable device can evaluate LV function.","authors":"Zhi-Jian Liu, Xiao-Hong Liu, Qing-Xue Zhang, Xiao-Hui Zhao, Xiu-Chang Li","doi":"10.1093/postmj/qgaf012","DOIUrl":"https://doi.org/10.1093/postmj/qgaf012","url":null,"abstract":"<p><strong>Background: </strong>Assessing cardiac function is important for early diagnosis, prognosis, and out-hospital follow-up for heart failure patients. It is especially crucial to identify a cost-effective and easily adaptable approach for evaluating cardiac function at home.</p><p><strong>Objective: </strong>Our purpose was to investigate whether some metrics derived from the heart sound energy map obtained by a wearable heart acquisition device could reflect the cardiac function.</p><p><strong>Methods: </strong>99 subjects were categorized into two groups based on whether their left ventricular ejection fraction was <50%. In the heart sound energy map mode, time intervals of energy intensity between 2100 and 2400 of the first heart sound was denoted as \"a,\" 1500-1800 as \"b,\" 1200-1500 as \"c,\" and 600-900 as \"d.\" The ratio of the time difference between adjacent energy intensity intervals and the high-energy interval was calculated, referred to as the Red index [(b-a)/a], Brn index [(c-b)/b], and Yel index [(d-c)/c], respectively.</p><p><strong>Results: </strong>Significant differences were observed in the Red index and Yel index between the two groups (P < .001 and P = 0.017, respectively). The Red and Yel indices showed a significant correlation with ejection fraction (EF) value (r = -0.50 and -0.27, P < .001 and P = .008, respectively). The intraclass correlation coefficient conformance test indicated that the intragroup correlation coefficients of the Red index with EF were 0.57. Receiver operating characteristic analysis revealed that the Red index exhibits strong diagnostic value for EF values <50% with an AUC of 0.86 (95% CI: 78% ~ 94%).</p><p><strong>Conclusions: </strong>The Red index, derived from the heart sound energy map, demonstrates a significant correlation with both the EF value and Tei index and can identify the reduction of left ventricular EF.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978996","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}