Rheumatology International最新文献

{"title":"From skin to bone: sun avoidance and osteoarthritis risk.","authors":"Dinesh Kumar, Vrinda Gupta, Rajni Tanwar, Pooja Rani, Vikas Bansal","doi":"10.1007/s00296-025-05904-5","DOIUrl":"https://doi.org/10.1007/s00296-025-05904-5","url":null,"abstract":"","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 6","pages":"146"},"PeriodicalIF":3.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174753","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":"Underestimated pyridoxine consumption and neurotoxicity: a novel manifestation with rheumatologic relevance - a case-based review.","authors":"Iga Kościńska-Shukla, Marta Jaskólska, Kinga Grochowalska, Marcin Okrój, Michał Chmielewski","doi":"10.1007/s00296-025-05900-9","DOIUrl":"10.1007/s00296-025-05900-9","url":null,"abstract":"<p><p>The impact of vitamin B complex has long been studied and utilized in clinical practice, both for healthy and diseased individuals. Its beneficial effects on physical and mental performance have been proven by multiple studies leading to widespread supplementation among the general population. As of today's knowledge, vitamin B6 (pyridoxine) in excessive doses may lead to symptoms of neuropathy. Unfortunately, many of those supplementing vitamin B complex are unaware of such a risk. This case-based review presents three patients who initially searched for help due to neuropathic symptoms with the rheumatological diagnostic process following. All of them had a history of excessive vitamin B6 consumption, though through different sources. Cessation of supplementation led to prompt improvement in symptoms. These cases stress the importance of in-depth history taking and specifying instructions regarding prescribed supplements. The novelty of this article lies in the description of a patient who reported symptoms associated with central nervous system with concomitant abnormalities of the complement system, all of which resolved spontaneously upon normalization of pyridoxine concentration.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 6","pages":"144"},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143342","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":"Impact of combining magnetic resonance images and radiographs on radiographic grading of sacroiliitis and classification in axial spondyloarthritis: a reliability study.","authors":"Kemal Erol, Kevser Orhan, Işıl Yurdaışık, Salih Özgöçmen","doi":"10.1007/s00296-025-05898-0","DOIUrl":"10.1007/s00296-025-05898-0","url":null,"abstract":"<p><p>To investigate the reliability of sacroiliac radiographic grading based on the modified New York criteria, both through grading pelvic radiographs alone and in combination with sacroiliac magnetic resonance imaging and the influence of alone and multimodal interpretation on the categorization of radiographic and non-radiographic axial spondyloarthritis (r-axSpA and nr-axSpA). Radiographs of the SI joints from patients with axSpA were graded by two rheumatologists independently in two sessions (radiographs only and MRI + radiographs) and followed by consensus sessions with the participation of a radiologist. Overall, anteroposterior pelvic radiographs and T1 weighted MR scans of the sacroiliac joints from 138 patients with axSpA were eligible. Intra- and inter-reader reliability was fair to moderate for both techniques regardless of whether they were examined alone or in conjunction with MRI, however confidence levels of readers were relatively higher in the MRI + radiographs combined technique compared to radiographs only. Regarding the classification, both readers' intra and inter reader agreements were moderate to substantial. The kappa values and agreement were notably higher for the combined reading technique. In the consensus sessions, 10.2% of patients were recategorized. Merging the information from MRI scans with pelvic radiographs yielded no notable enhancement in the accuracy of radiographic grading of SI joint. Categorizing axSpA as either radiographic or non-radiographic based on pelvic radiography falls short in reliability even after combining with MR images and may likely call for a more reliable definition, axSpA with or without structural changes, relying on more advanced imaging techniques than radiographs.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 6","pages":"145"},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143297","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":"Central obesity and radiographic severity are associated with symptomatic hand osteoarthritis: a population-based cross-sectional study.","authors":"Sofia Pimenta, Hernâni Gonçalves, Madalena Pimenta, Ana Martins, Lúcia Costa, Tiago Guimarães, Ana Rodrigues, Raquel Lucas","doi":"10.1007/s00296-025-05891-7","DOIUrl":"10.1007/s00296-025-05891-7","url":null,"abstract":"<p><p>To investigate the association between cardiometabolic factors, obesity, radiographic severity, and symptomatic hand osteoarthritis (HOA), as the role of these factors in HOA remains unclear. A cross-sectional analysis in the EPIPorto cohort included participants with HOA (≥ 1 joint with Kellgren-Lawrence (KL) grade ≥ 2 and/or American College of Rheumatology criteria). Cardiovascular risk factors, anthropometric measures, and radiographic severity (sum of KL hand score [0-128]) and number of affected joints [0-32]) were analysed. We tested the association between these factors and symptomatic HOA (≥ 1 joint with KL ≥ 2 and hand pain in the last month) by multivariable logistic regression. Of the 858 participants with HOA (61% women, mean age 59.6 years), 807 met radiographic criteria, and 160 presented symptomatic HOA. Among these, 77% were overweight or obese, 81% hypertensive, 95% had dyslipidaemia, and 20% were diabetic. Body mass index, waist circumference, and waist-to-height ratio, were associated with symptomatic HOA (OR 1.04, 95% CI 1.00; 1.09), (OR 1.02, 95% CI 1.00; 1.04), (OR 1.03, 95% CI 1.01; 1.06). Diabetes, hypertension, and dyslipidaemia showed no association. We observed an association between the KL score, the number of affected joints, and symptomatic HOA (OR 1.09, 95% CI 1.07; 1.12), (OR 1.09, 95% CI 1.06; 1.12). Increased central obesity and radiographic severity are associated with symptomatic HOA, highlighting the potential role of adiposity in HOA pain. These findings underscore the importance of weight management to improve pain outcomes in HOA. Furthermore, assessing radiographic changes may aid monitoring of disease symptoms. Further studies are needed to validate these associations and inform evidence-based clinical practice.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 6","pages":"143"},"PeriodicalIF":3.2,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094584","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":"Development of a fibromyalgia-specific quality of life instrument: the Fibromyalgia Quality of Life Scale (FM-QoLS).","authors":"Ilke Coskun Benlidayi, Ceren Ornek, Aylin Sariyildiz, Yasar Sertdemir","doi":"10.1007/s00296-025-05895-3","DOIUrl":"10.1007/s00296-025-05895-3","url":null,"abstract":"<p><p>The study aimed to develop a quality of life (QoL) scale specific to patients with fibromyalgia. The scale development involved four steps: (1) Issue collection, (2) Face validity and selection of the most relevant items, (3) Formation of the preliminary scale and pilot testing, and (4) Psychometric evaluation. For psychometric evaluation, the scale was administered to a sample of fibromyalgia patients. Suitability for exploratory factor analysis (EFA) was assessed using the Kaiser-Meyer-Olkin (KMO) test and Bartlett's Test of Sphericity. Reliability was assessed with Cronbach's alpha, Guttman split-half test, and test-retest correlations. Construct validity was determined via EFA using Principal Axis Factoring. The correlation of the developed scale with established measures of QoL, fibromyalgia impact, fatigue, sleep, and mood was tested to assess convergent validity. Floor and ceiling effects were also examined. The initial item list included 25 issues related to QoL in fibromyalgia. Following the assessments and rating of the initial issue list through cognitive interviews, 10 issues were removed. The remaining questions were administered to 60 patients with fibromyalgia. The final version of the Fibromyalgia Quality of Life Scale (FM-QoLS) contained 14 items and two domains: symptomatology-functionality and psychosocial. Moderate-strong correlations between most items indicated that the scale has a homogeneous structure and measures the same construct. The FM-QoLS showed moderate-strong correlations with pain, anxiety, depression, sleep, fatigue, and established measures of QoL. Regarding the test-retest reliability of FM-QoLS items, the gamma values ranged from 0.923 to 0.995. The FM-QoLS is a 14-item QOL scale specific to patients with fibromyalgia. The scale has high validity and reliability, with no floor and ceiling effects. The FM-QoLS could help physicians address the multifaceted QoL challenges in fibromyalgia patients. Future research could refine the scale by exploring its use in different populations.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 6","pages":"142"},"PeriodicalIF":3.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079860","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":"Assessment and management of midfoot osteoarthritis by podiatrists in Australia: a cross-sectional survey of current practice.","authors":"Polly Q X Lim, Hylton B Menz, Karl B Landorf, Michelle R Kaminski, Kade L Paterson, Shannon E Munteanu","doi":"10.1007/s00296-025-05881-9","DOIUrl":"10.1007/s00296-025-05881-9","url":null,"abstract":"<p><p>Midfoot osteoarthritis (OA) is a common and disabling condition, yet lacks clinical guidelines for its assessment and management. This study aimed to investigate strategies used by Australian podiatrists to assess and manage midfoot OA. An exploratory cross-sectional survey of podiatrists working in Australia was conducted. Respondents were invited through professional organisations to complete an online questionnaire on their usual assessment and management practices for midfoot OA, based on a vignette. Between November 2022 and July 2023, 103 participants (52% women, mean age 40 years) with an average of 15 years of clinical experience responded. Physical assessments (including history taking and musculoskeletal assessments) (96%) and medical imaging (90%) were commonly used diagnostic methods, with palpation (96%), passive movement testing (95%) and x-ray imaging (62%) frequently reported. Associated impairments were assessed with range of motion testing of the midfoot (96%), gait analysis (95%), functional tests (83%), muscle strength (72%), and observation of static alignment (71%), including foot posture (69%). Most participants assessed comorbidities (93%), body composition (66%) and cognitive/psychosocial impairments (62%). Treatment approaches included footwear advice (97%), orthotic therapy (85%), strapping/taping (81%), education (79%), and exercise therapy (75%). One-third (34%) expected a 'satisfactory' treatment response within two months, and 36% would refer to another healthcare practitioner for co-management between two and three months if treatment was ineffective. A wide range of approaches are used to assess and manage midfoot OA. These findings have potential to inform the design of future studies in developing valid assessment approaches and effective interventions for this condition.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 6","pages":"141"},"PeriodicalIF":3.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034675","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":"High prevalence of HLA-B51 and ocular involvement in Behçet's disease: a multicenter cross-sectional study.","authors":"Shamma Ahmad Al Nokhatha, Najla Aljaberi, Jawaher Al Zeyoudi, Ahlam Almarzooqi, Farah Soukieh, Mumtaz Khan","doi":"10.1007/s00296-025-05892-6","DOIUrl":"10.1007/s00296-025-05892-6","url":null,"abstract":"<p><p>Behçet's disease (BD) is a rare multisystem vasculitis. Globally, BD exhibits a unique geographic distribution, with the highest prevalence along the historic Silk Road. To study the demographics, clinical characteristics, and outcomes of BD in the United Arab Emirates (UAE). A multicenter retrospective chart review study was conducted at hospitals in the UAE from 2008 to 2024. All adult and pediatric patients who were diagnosed with BD by a rheumatologist and treated within the timeframe were included in the study while those who received any alternative final diagnosis were excluded. The results were analyzed using descriptive and inferential statistics. One hundred and twenty-three patients were treated and monitored for BD. Most were female (n = 70, 57%). Their median age was 32 years (24-41), and approximately two-thirds were Emirati (n = 82, 67%). Twelve patients (10%) had a family history of BD, including 7 (6%) with first-degree BD. The time from the initial symptoms to diagnosis was 11.9 months (2.3-31.0). The most common clinical manifestations were oral ulcers (n = 99, 81%), arthralgia (n = 63, 51%), genital ulcers (n = 62, 50%), and ocular involvement (n = 37, 30%). Most of the patients were HLA-B51 positive (n = 92, 84%). At diagnosis, 36 (29%) met the ISG criteria, 73 (59%) met the ICBD criteria, and 50 (41%) met neither criteria. The male patients exhibited more major organ involvement (ocular, neurological, vascular, and cardiac), greater use of corticosteroids and anti-TNFa medications, and greater disease activity than the female patients. Among the patients with isolated ocular manifestations (n = 9) who met neither classification criteria, most were female (56%), with a median age of 37 years (26.5-3.5). None had a family history of autoimmune conditions, and all were HLA-B51 positive. Most of these patients (n = 8, 89%) received corticosteroids, 5 (56%) received azathioprine, and 2 (22%) received anti-TNFa therapies. These findings provide insights into the clinical profile of BD in the UAE. Notably, we found a high proportion of patients with positive HLA-B51 and ocular manifestation. Further research with larger sample sizes is needed to better understand these associations.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 6","pages":"140"},"PeriodicalIF":3.2,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015253","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":"A novel approach to cardiovascular events in patients with systemic lupus erythematosus: risk factor assessment and treatment analysis.","authors":"Dorota Suszek, Magdalena Popławska, Jakub Prośniak, Katarzyna Siemieniec, Karolina Przeniosło, Weronika Wallach, Monika Żybowska-Męczyńska, Klaudia Ostrowicz, Anna Rzewuska-Fijałkowska, Bożena Targońska-Stępniak","doi":"10.1007/s00296-025-05894-4","DOIUrl":"10.1007/s00296-025-05894-4","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) patients have a significantly increased risk of developing cardiovascular disease (CVD). Despite the implementation of preventive measures and treatment of lipid disorders, as well as reduced use of glucocorticoids, CVD remains one of the leading causes of death in this patient group. It is crucial to develop an appropriate CVD risk assessment strategy that considers the distinctive characteristics of this patient population. This paper provides a comprehensive analysis of the methods used to assess CVD risk in SLE patients. It also presents effective strategies for the reduction of the effects of traditional and non-traditional risk factors for atherosclerosis.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 6","pages":"139"},"PeriodicalIF":3.2,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980848","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":"Implementation of a novel patient reported experience measure (PREM) in rheumatology: a cross-sectional online survey of Australian rheumatology outpatients.","authors":"Madeleine J Bryant, Susan Lester, Oscar Russell, Samuel Whittle, Vidya Limaye, Susanna Proudman, Rachel J Black, Catherine L Hill","doi":"10.1007/s00296-025-05882-8","DOIUrl":"10.1007/s00296-025-05882-8","url":null,"abstract":"<p><p>To determine rheumatology patient care experience using the novel Commissioning for Quality in Rheumatoid Arthritis-PREM-Australian version (CQRA-PREM-AU). Patients attending Central Adelaide Local Health Network rheumatology outpatient clinics were invited to complete a cross-sectional web-based survey, comprising CQRA-PREM-AU (22 items, 8 domains, scored 1-5), demographics, Patient Global Assessment (PGA) and Patient Reported Disease Activity (PRDA) Visual Analogue Scales (VAS) (scored 0-100), Single Item Literacy Screener (SILS). Analysed were multivariable linear regression analysis of CQRA-PREM-AU overall score with patient-related covariates (diagnosis, age, sex, SILS, PGA, PRDA), and univariate regression analysis with clinic-related covariates (site, nurse contact, type/number of consultations). Response rate was 1408/4591(31%). 214 incomplete records were excluded; 1194 records were analysed. Respondent characteristics: 68% female, median age 64 years (IQR 54, 73), 29% rural, 7% non-English language at home. PGA median score 50 (IQR 27, 63) and PRDA median score 50 (IQR 26, 69). CQRA-PREM-AU Domain 1 (regarding patient Needs and Preferences) had the best overall mean score (4.1, SD 0.86). Scored poorly were Domain 3 (Information about care, 3.5, SD 0.89), Domain 4 (Daily living, 3.5, SD 1.06) and Domain 5 (Emotional care, 3.6, SD 1.04). Worse PGA, and diagnoses of systemic lupus erythematosus, \"other\", or \"unknown\" were all associated with significantly lower CQRA-PREM-AU score (p < 0.01). Older age, and rheumatology nurse contact were associated with better experience score (p < 0.01). Use of CQRA-PREM-AU highlights the association between contact with a rheumatology nurse and better care experience, and identifies other targets for improving healthcare delivery.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 6","pages":"138"},"PeriodicalIF":3.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996369","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":"Damage accrual and predictors of mortality in ANCA-associated vasculitis: a retrospective observational study.","authors":"Murat Bektaş, Burak Ince, Sibel Zaralı, Übeyde Ayşe Gülseren, Ece Ük, Besim Fazıl Ağargün, Damla Yenersu Güzey, Yasemin Yalçınkaya, Bahar Artım-Esen, Ahmet Gul, Murat İnanç","doi":"10.1007/s00296-025-05883-7","DOIUrl":"10.1007/s00296-025-05883-7","url":null,"abstract":"<p><p>In this study, we aimed to evaluate the factors affecting the development of damage and mortality in patients with AAV treated at our tertiary referral center. This retrospective study included data on patients with AAV who fulfilled the Chapel Hill Consensus Conference (CHCC) criteria. Patients were divided into c-ANCA/PR3( +) and p-ANCA/MPO ( +) groups based on ANCA immunofluorescence and/or ELISA results, and relapse, damage, and mortality data were compared across the groups. Data from 254 patients (n = 136, 53.5% female) were included in the analysis. Clinical diagnosis was GPA in 186 (73.2%) and MPA in 68 (26.8%) patients. During the follow-up, 217 of 242 (89.7%) patients developed damage, and the median VDI score of the cohort was 2 (IQR: 2). VDI scores were higher in the first period (1997-2011) than in the second period (2011-2021) in the entire cohort (p = 0.012) and in patients with GPA compared with MPA (p = 0.034). Five-year and overall survival rates were 88.1% and 80.3% in the entire cohort; 87.8% and 81% in c-ANCA/PR3 ( +); 86.2% and 76% in p-ANCA/MPO ( +) (Log-Rank: p = 0.35); 91% and 84.5% in GPA; 81% and 67.2% in MPA patients (Log-Rank: p < 0.001). Development of malignancy, severe infection, and active/persistent disease after the induction phase were associated with higher mortality in patients with AAV. In our AAV cohort, permanent organ damage was detected in the majority of the patients. Although the median VDI score decreased over time, mortality did not change.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 5","pages":"137"},"PeriodicalIF":3.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051298","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}