Scandinavian Journal of Clinical & Laboratory Investigation最新文献

{"title":"LC-MS/MS method for simultaneous quantification of antibiotics in dialysis effluent and human serum for routine therapeutic drug monitoring.","authors":"Mathilde Lacroix, Yessica De Leon, Kyle Woodward, Sandye Chauncey, Gabriele Stocco, Martina Franzin, Riccardo Addobbati, Yani Ameziane, Sumit Mohan, Jacob Stevens, Milan Stojanovic, Alex K Lyashchenko, Serge Cremers","doi":"10.1080/00365513.2026.2712648","DOIUrl":"10.1080/00365513.2026.2712648","url":null,"abstract":"<p><p>Accurate drug dosing in critically ill patients, especially those undergoing continuous renal replacement therapy (CRRT), poses significant challenges due to altered pharmacokinetics. These changes increase the risk of treatment failure, toxicity, and resistance, emphasizing the need for precise and timely therapeutic drug monitoring (TDM) and improved analytical techniques. Therefore, this study aimed to develop and validate a multiplex LC-MS/MS method for the routine quantification of 4 antibiotics (cefepime, levofloxacin, meropenem, and piperacillin) and a β-lactamase inhibitor (tazobactam) in human serum and CRRT effluent. Effluent and serum samples were prepared <i>via</i> protein precipitation, and quantification was performed using LC-MS/MS, utilizing a gradient of aqueous (water, acetonitrile, formic acid) and organic (acetonitrile, 2-propanol) phases, with a total run time of 6.5 min. The method employed identical calibration and quality control sets for both serum and effluent. Calibration curves were linear across compound-specific ranges. The method met the validation criteria, showing reproducibility with CV ≤ 10.6%, a mean recovery of 102.2% in serum and 99.1% in effluent, and an accuracy ranging from 94.7% to 98.9% in serum and 99.5% to 103.0% in effluent. Carry-over effects observed for levofloxacin and piperacillin and compounds' stability were effectively managed through proper sample handling procedures. The developed method confirms its suitability for routine clinical application, providing a reliable tool for antibiotics TDM in critically ill patients. Additionally, measuring drug concentrations in CRRT effluent offers valuable insights into drug clearance and pharmacokinetics, which could ultimately lead to better patient management and more tailored, effective treatments in the future.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"524-536"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697829","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":"Reference interval for total alkaline phosphatase in adults.","authors":"Line Philipsen, Lærke Andersen, Stine Linding Andersen","doi":"10.1080/00365513.2026.2632328","DOIUrl":"10.1080/00365513.2026.2632328","url":null,"abstract":"<p><p>Alkaline phosphatase (ALP) is a marker of liver and bone disorders and assessment of the total ALP concentration in plasma is a commonly requested biochemical test as part of routine care. We established reference interval (RI) for total ALP in adults across routinely used methods. Cross-sectional study in the North Denmark Region including results of plasma ALP in samples from 120 blood donors (BD) and in 183,267 routinely requested samples from patients managed in general practice (GP). The total ALP concentration was measured using an enzymatic method on Alinity, Abbott Laboratories (method 1a; no correction factor, method 1b; with a correction factor of 0.91), Atellica, Siemens Healthineers (method 2), and Cobas, Roche Diagnostics (method 3). RIs were established non-parametrically (2.5 and 97.5 percentiles) stratified by population and method after exclusion of outliers using Tukey's fences. The established RIs among BD and GP samples, respectively, were for method 1a: 45-132 IU/L and 46-131 IU/L, method 1b: 41-120 IU/L and 42-119 IU/L, method 2: 42-119 IU/L and 42-121 IU/L, and method 3: 42-118 IU/L and 42-119 IU/L. When a RI of 40-120 IU/L was applied among GP samples, altogether 0.7%/8.7% (method 1a), 1.6%/5.4% (method 1b), 1.5%/5.6% (method 2), and 1.7%/5.1% (method 3) of samples were below/above the RI. The established RIs for total ALP were largely consistent across methods when a correction factor was applied for the Alinity method. Based on these results, a uniform RI of 40-120 IU/L has been implemented in our region of Denmark.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"150-157"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220788","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":"Digital droplet PCR for detection of <i>SMN1</i> deletion in low-concentration fragmented cell-free DNA: a proof of concept study.","authors":"Erhan Parıltay, Özge Güngör, Zeki Sakallı, Mert Gürgün","doi":"10.1080/00365513.2026.2632724","DOIUrl":"10.1080/00365513.2026.2632724","url":null,"abstract":"<p><p>Spinal Muscular Atrophy (SMA), an autosomal recessive neuromuscular disorder, is primarily caused by homozygous deletions in the <i>SMN1</i> gene. Although multiplex ligation-dependent probe amplification (MLPA) is the gold standard for SMA diagnosis, invasive prenatal procedures (e.g. amniocentesis or chorionic villus sampling) carry risks, including fetal loss. Non-invasive prenatal testing using digital droplet PCR (ddPCR) to detect <i>SMN1</i> deletions in cell-free fetal DNA (cffDNA) from maternal plasma presents a safer alternative. This study evaluates the feasibility of ddPCR for non-invasive prenatal detection of <i>SMN1</i> exon 7 deletions using simulated cffDNA mixtures. Blood samples were collected from two children with SMA (homozygous SMN1 deletions), their carrier mothers, and healthy controls. Genomic DNA was fragmented to simulate fetal (80-160 bp) and maternal (160-300 bp) cfDNA profiles. Simulated mixtures were prepared at varying maternal-to-fetal ratios (1:1 to 64:1). ddPCR was performed using the Bio-Rad SMN1 Copy Number Determination Kit, and *SMN1/RPP30* ratios were calculated. Linear regression analysis assessed quantitative performance. ddPCR accurately distinguished affected (mean ratio ∼0.00), carrier (∼0.46), and healthy (∼0.93) genotypes. A strong linear correlation existed between fetal DNA fraction and *SMN1/RPP30* ratio (*r* = 0.995, *p* < 0.0001). The assay detected affected fetal DNA at fractions as low as 5%, with reliable diagnostic separation at ≥10%. ddPCR exhibits high sensitivity and specificity for detecting SMN1 exon 7 deletions in simulated cffDNA, supporting its potential application in non-invasive prenatal SMA screening. Controlled evaluation under defined maternal-fetal mixture provides a reference for optimizing ddPCR-based prenatal testing for SMA.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"158-165"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228383","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 association between ionized and total magnesium in critically ill patients: a prospective cohort study.","authors":"Eyrun A Kristinsdottir, Svajunas Statkevicius, Martin I Sigurdsson, Fredrik Hansson, Marcus E Broman","doi":"10.1080/00365513.2026.2643860","DOIUrl":"10.1080/00365513.2026.2643860","url":null,"abstract":"<p><p>Most clinical laboratories measure total magnesium (tMg) which includes both the ionized (iMg) and bound forms. Only the ionized component is biologically active, and it may be influenced by acid-base status, plasma protein concentrations and electrolyte disturbances, potentially altering how well tMg reflects iMg. This multicenter observational study evaluated the relationship between tMg and iMg using paired samples collected within a 2-hour window. Association was assessed with linear regression and Pearson's correlation coefficient, and agreement with Bland-Altman analysis. Ionized magnesium constituted 77.9% of tMg (95% CI 77.5%-78.4%). There was a strong correlation between iMg and tMg (<i>r</i> = 0.916, <i>p</i> < 0.0001). Bland-Altman analysis showed that tMg was, on average, 0.20 mmol/L higher than iMg (95% LoA 0.03-0.37 mmol/L). Proportional bias was observed (slope = 0.22, <i>p</i> < 0.001), with increasing discrepancies at higher concentrations. Stepwise multiple linear regression analysis including acid-base parameters, albumin and electrolytes, was used to identify variables independently associated with ionized and total magnesium concentrations. In this multivariable model, pH and ionized calcium were independently associated with both ionized and total magnesium. In conclusion, ionized and total magnesium were strongly correlated. However, proportional bias indicated that total magnesium increasingly deviates from the biologically active ionized fraction at higher concentrations. Therefore, derived equations to estimate one measure from the other are not reliable for clinical use.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"237-244"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147459593","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":"Comparison between the blood urea nitrogen (BUN)-to-creatinine ratio and four urinary biomarkers of dehydration; a cross-sectional study in fasting patients awaiting surgery.","authors":"Yuhong Li, Robert G Hahn","doi":"10.1080/00365513.2026.2713141","DOIUrl":"10.1080/00365513.2026.2713141","url":null,"abstract":"<p><p>The blood urea nitrogen (BUN)-to-plasma creatinine ratio is a conventional method for diagnosing dehydration. We examined the relationship between this method and the more recently promoted urine biomarkers of dehydration. Blood and urine sampling was performed in 921 patients who were fasting before surgery. The blood was analyzed for the BUN-to-plasma creatinine ratio which was divided into three ranges: low (<50), normal (50-100), and high (>100 mmol/L). The fractions of the cohort that belonged to these ranges were 8.9%, 76.7%, and 14.4%, respectively. The urine was analyzed for color, specific gravity, osmolality, and creatinine, and the results summarized in the Fluid Retention Index, which is a robust measure of renal water conservation. The analysis shows that none of the four urine biomarkers differed statistically between these three groups. The Fluid Retention Index was 2.3, 2.0, and 1.7, respectively (<i>p</i> = 0.17), which means that the degree of urine concentration varied in the opposite direction to that expected. Moreover, no linear correlations were found when individual blood and urine measurements were compared. Patients who were classified as being dehydrated according to the Fluid Retention Index had a mean BUN to creatinine ratio of 77 while the others had 76 mmol/L (<i>p</i> = 0.94). In conclusion, the BUN-to-ratio did not correlate with urine biomarkers of dehydration in fasting pre-surgical patients. This result suggests that the BUN-to-creatinine ratio may not reliably reflect hydration status and motivates a repeat study where the body volume deficit is known or the water consumption is monitored over time.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"554-560"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674055","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":"Estimation of biological variability of inflammatory biomarkers EDN, suPAR and plasma calprotectin.","authors":"Rasmus Skjold Stolberg, Michael Waldhauer Hunderup, Signe Bek Sørensen, Anne Lindegaard Christiansen, Maj-Britt Fruekilde, Steen Antonsen, Eva Rabing Brix Petersen, Thor Aage Skovsted","doi":"10.1080/00365513.2026.2713138","DOIUrl":"10.1080/00365513.2026.2713138","url":null,"abstract":"<p><p>Knowledge of intra-individual and inter-individual biological variation (BV) of a measurand is essential for its optimal use in clinical practice. This study estimated biological variation, reference change values (RCV), index of individuality (II), and analytical performance specifications (APS) for the inflammatory biomarkers eosinophil-derived neurotoxin (EDN), plasma calprotectin (pCalprotectin), and soluble urokinase plasminogen activator receptor (suPAR), for which prior evidence has been scarce. Twenty healthy individuals (15 women, 5 men; 25-60 years) were included. Blood samples were drawn weekly for eight consecutive weeks and identical preanalytical procedures were applied at each visit. Plasma samples were prepared within 1 h after blood sampling and stored at -80 °C until analysis in duplicates. suPAR was measured by turbidimetry (ViroGates A/S), whereas EDN and pCalprotectin were analyzed using fluoro-enzymeimmunoassay (Phadia GmbH). Data were evaluated for outliers, variance homogeneity, and steady-state conditions before analysis was performed using a linear mixed model applied to transformed data. Within-subject (CV_I) and between-subject (CV_G) BV, respectively, were: EDN 15.6% and 43.8%; pCalprotectin 24.5% and 55.0%; and suPAR 5.7% and 20.0%. Low indices of individuality were observed for all measurands, indicating the need for RCVs to guide clinical interpretation. This study is the first to report BV estimates with accompanying APS, II and RCV for EDN, suPAR and pCalprotectin.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"571-580"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797470","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":"Long-term analytical drift of serum creatinine and its association with CKD staging consistency based on eGFR: a retrospective study.","authors":"Zhigang Yang, Yuan Tian, Yang Yang","doi":"10.1080/00365513.2026.2724492","DOIUrl":"10.1080/00365513.2026.2724492","url":null,"abstract":"<p><p>To evaluate whether long-term IQC-derived analytical variability of serum creatinine (SCr), even within allowable limits, is associated with estimated glomerular filtration rate (eGFR)-based chronic kidney disease (CKD) staging consistency and stage reclassification. This single-center retrospective study included 4,215 patients with stable kidney function and 10,481 SCr records from 2022-2024. Daily relative analytical deviation was estimated using a 5-day moving median of IQC results. After analytical-deviation adjustment, eGFR was recalculated using the 2021 CKD-EPI equation and CKD stages were reassigned. Reclassification was defined as stage inconsistency before versus after adjustment. Associated factors were analyzed using multivariable generalized estimating equation logistic regression. All IQC-derived analytical deviations remained within the CLIA 2025 limit (±10%). Positive deviation occurred in 89.2% of records, and 31.6% had an absolute deviation ≥ 5%. Overall, 5.3% (559/10,481) of records were reclassified, with 98.2% shifting from higher-risk to lower-risk CKD stages. Reclassification rates for CKD stages G3a, G3b, and G4 were 12.73%, 19.48%, and 44.44%, respectively. Each 1% increase in analytical-deviation magnitude was associated with higher reclassification risk (aOR = 1.39, 95% CI: 1.34-1.43, <i>p</i> < 0.001), whereas reagent change within 30 days was not significant. Within permissible limits, long-term IQC-derived analytical deviation of SCr assays is significantly associated with CKD stage reclassification, especially near eGFR decision thresholds. Positive IQC-derived analytical deviation was associated with a higher likelihood of apparent CKD stage overestimation. These findings inform quality control and eGFR interpretation, but generalizability requires multicenter prospective validation.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"593-605"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040576","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":"Postoperative stress assessment using PPG-based heart rate variability and exploratory ECG analysis in colorectal surgery.","authors":"Seyedsadra Miri, Juha K A Rinne, Jyrki Kössi, Niku Oksala, Antti Vehkaoja","doi":"10.1080/00365513.2026.2703029","DOIUrl":"10.1080/00365513.2026.2703029","url":null,"abstract":"<p><strong>Clinicaltrials.gov identifier: </strong>NCT04996511.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"505-517"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472574","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":"CHI3L1 combined with Th17/Treg cells: a novel marker for the degree of HBV-related liver fibrosis.","authors":"Huiyuan Chen, Qiuying Fan, Wei Jiao, Yuanfang Tan, Xi Gou, Weiming Yang, Hui Liu, Qiong Wu, Juanjuan Chen","doi":"10.1080/00365513.2026.2640367","DOIUrl":"10.1080/00365513.2026.2640367","url":null,"abstract":"<p><p>Several methods are available to differentiate non-fibrosis from advanced liver fibrosis; however, data regarding intermediate stages remain limited. A total of 246 patients with chronic hepatitis B (CHB) were enrolled and classified into four groups according to fibrosis stage: non- or mild fibrosis (Group A), significant fibrosis (Group B), progressive fibrosis (Group C), and cirrhosis (Group D). The serum chitinase-3-like protein 1 (CHI3L1) levels in Groups A, B, C, and D were 40.33, 52.96, 92.28, and 153.63 μg/L, respectively. Significant differences were observed between Groups A and B (<i>p</i> = 0.040), Groups C and D (<i>p</i> < 0.0001), and Groups B and D (<i>p</i> < 0.0001). The percentage of regulatory T cells (Tregs) was 0.67 in the CHB-low fibrosis (CHB-L) group and 0.26 in the CHB-moderate to severe fibrosis (CHB-MS) group, representing a statistically significant difference (<i>p</i> = 0.039). The T helper 17 cells (Th17)/Treg ratio was 10.00 in the CHB-L group and 61.26 in the CHB-MS group, representing a statistically significant difference (<i>p</i> = 0.010). For predicting significant fibrosis, progressive fibrosis, and cirrhosis, the area under the curve (AUC) for the combined conventional markers - hyaluronic acid, laminin, type III procollagen N-terminal peptide, collagen type IV, and cholyglycine were 0.736, whereas those for CHI3L1 and Th17/Treg were 0.774 and 0.750, respectively. The combination of CHI3L1 and Th17/Treg cells yielded an AUC of 0.814, demonstrating the highest sensitivity (100%) and high specificity. These findings suggest that CHI3L1 combined with Th17/Treg cells may serve as a novel biomarker for staging hepatitis B virus-related liver fibrosis.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"198-207"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378432","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":"Effects of extended storage of blood samples on the results of platelet function testing: an <i>in vitro</i> stability study.","authors":"Artur Hausch, Maria Deisenhammer, Nenad Mitrovic, Ulrich J Sachs, Thomas Mueller","doi":"10.1080/00365513.2026.2630329","DOIUrl":"10.1080/00365513.2026.2630329","url":null,"abstract":"<p><p>In the present study, we aimed to explore the effects of extended storage of blood samples from 30 patients on the results of platelet function testing using the PFA-200 device (Collagen/EPI and Collagen/ADP tests), Multiplate instrument (ASPI, ADP, and TRAP tests), and VerifyNow analyzer (Aspirin and PRU tests). We determined platelet function (1) immediately after blood collection (baseline), (2) after storage of blood samples at room temperature for 3-4 h (i.e. the maximum sample storage period permitted by the manufacturers), and (3) after storage of blood samples for 5 h at room temperature (extended storage). Per the concept of acceptable change limits, platelet function was considered stable in time course if the median relative deviation from baseline values at a given time was <19% or <28%, depending on the test used. By applying our analyte stability limits, we found that blood samples could be stored for up to 5 h when performing the Collagen/ADP, ASPI, ADP, TRAP, Aspirin, and PRU tests. However, we observed significant deviations in the Collagen/EPI test results over time. The PFA-200 Collagen/EPI test results showed a median percentage deviation of 35% after 5 h of storage. However, no significant differences were observed between the measurements taken after 4 and 5 h of storage. We assume, that the baseline values of the Collagen/EPI test are measured incorrectly (presumably owing to malfunction of the test cartridges) and the following results are measured correctly.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"117-125"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197907","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}