Stephanie R. Partridge, Amber Knight, Allyson Todd, Bronwyn McGill, Sara Wardak, Laura Alston, Katherine M. Livingstone, Anna Singleton, Louise Thornton, Sisi Jia, Julie Redfern, Rebecca Raeside
{"title":"Addressing disparities: A systematic review of digital health equity for adolescent obesity prevention and management interventions","authors":"Stephanie R. Partridge, Amber Knight, Allyson Todd, Bronwyn McGill, Sara Wardak, Laura Alston, Katherine M. Livingstone, Anna Singleton, Louise Thornton, Sisi Jia, Julie Redfern, Rebecca Raeside","doi":"10.1111/obr.13821","DOIUrl":"10.1111/obr.13821","url":null,"abstract":"<p>Adolescence is a high-risk life stage for obesity. Digital strategies are needed to prevent and manage obesity among adolescents. We assessed if digital health interventions are contributing to disparities in obesity outcomes and assessed the adequacy of reporting of digital health equity criteria across four levels of influence within the digital environment. The systematic search was conducted on 10 major electronic databases and limited to randomized controlled trials (RCTs) or cluster-RCTs for prevention or management of obesity among 10–19 year olds. Primary outcome was mean body mass index (BMI), or BMI <i>z</i>-score change. The Adapted Digital Health Equity Assessment Framework was applied to all studies. Thirty-three articles (27 unique studies with 8483 participants) were identified, with only eight studies targeting adolescents from disadvantaged populations. Post-intervention, only three studies reported significantly lower BMI outcomes in the intervention compared to control. Of the 432 digital health equity criteria assessed across 27 studies, 82% of criteria were “not addressed.” Studies are not addressing digital health equity criteria or inadequately reporting information to assess if digital health interventions are contributing to disparities in obesity outcomes. Enhanced reporting is needed to inform decision-makers and support the development of equitable interventions to prevent and manage obesity among adolescents.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"25 12","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.13821","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142219338","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}
Min Seo Kim, Inhyeok Lee, Pradeep Natarajan, Ron Do, Yeongkeun Kwon, Jae Il Shin, Marco Solmi, Jong Yeob Kim, Hong-Hee Won, Sungsoo Park
{"title":"Integration of observational and causal evidence for the association between adiposity and 17 gastrointestinal outcomes: An umbrella review and meta-analysis","authors":"Min Seo Kim, Inhyeok Lee, Pradeep Natarajan, Ron Do, Yeongkeun Kwon, Jae Il Shin, Marco Solmi, Jong Yeob Kim, Hong-Hee Won, Sungsoo Park","doi":"10.1111/obr.13823","DOIUrl":"10.1111/obr.13823","url":null,"abstract":"<p>We systematically reviewed observational and Mendelian randomization (MR) articles that evaluated the association between obesity and 17 gastrointestinal (GI) diseases to integrate causal and observational evidence. A total of 594 observational studies from 26 systematic reviews and meta-analyses and nine MR articles were included. For every 5 kg/m<sup>2</sup> increase in body mass index (BMI), there was an increased risk of GI diseases ranging from 2% for rectal cancer (relative risk [RR]: 1.02, 95% confidence interval [CI]: 1.01 to 1.03) to 63% for gallbladder disease (RR: 1.63, 95% CI: 1.50 to 1.77). MR articles indicated that risks of developing GI diseases elevated with each 1 standard deviation increase in genetically predicted BMI, ranging from 11% for Crohn's disease to 189% for nonalcoholic fatty liver disease. Moreover, upper GI conditions were less susceptible, whereas hepatobiliary organs were more vulnerable to increased adiposity. Among the associations between obesity and the 17 GI conditions, causal relationships were inferred from only approximately half (10/17, 59%). This study reveals a substantial gap between observational and causal evidence, indicating that a combined approach is necessary to effectively inform public health policies and guide epidemiological research on obesity and GI diseases.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"25 12","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.13823","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131387","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}
Seo Young Yun, Joo Young Yun, Chaeseong Lim, Hyeoncheol Oh, Eunjeong Son, Kihyuk Shin, Kihun Kim, Dai Sik Ko, Yun Hak Kim
{"title":"Exploring the complex link between obesity and intelligence: Evidence from systematic review, updated meta-analysis, and Mendelian randomization","authors":"Seo Young Yun, Joo Young Yun, Chaeseong Lim, Hyeoncheol Oh, Eunjeong Son, Kihyuk Shin, Kihun Kim, Dai Sik Ko, Yun Hak Kim","doi":"10.1111/obr.13827","DOIUrl":"10.1111/obr.13827","url":null,"abstract":"<div>\u0000 \u0000 <p>Obesity is a major public health concern associated with a higher risk of various comorbidities. Some studies have explored the impact of obesity on cognitive function and, conversely, how lower intelligence might increase the risk of later obesity. The aim of this study is to analyze a complex relationship between body mass index (BMI) and intelligence quotient (IQ), employing a comprehensive approach, including a systematic review, meta-analysis, and Mendelian randomization (MR). We extracted the data from Medline and Embase to identify relevant studies published since June 22, 2009. MR analysis relied on genetic databases such as the Genome-Wide Association Study (GWAS) and the Genetic Investigation of Anthropometric Traits (GIANT) to explore potential causal relationships. The systematic review and meta-analysis encompassed 34 and 17 studies, respectively. They revealed a substantial correlation between obesity and reduced IQ, particularly notable among school-age children (mean difference −5.26; 95% CI: −7.44 to −3.09). Notably, within the IQ subgroup, verbal IQ also exhibited a significant association with a mean difference of −7.73 (95% CI: −14.70 to −0.77) in school-age children. In contrast, the MR did not unveil a significant causal relationship between BMI and IQ, both in childhood and adulthood. This comprehensive analysis underscores a significant correlation between BMI and IQ, particularly in school-age children. However, the MR analysis implies a potentially weaker causal relationship. Future large-scale cohort studies should address potential confounding factors to provide further insights into the BMI-IQ relationship.</p>\u0000 </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"25 12","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124380","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}
{"title":"Gender differences in adherence and retention in Mediterranean diet interventions with a weight-loss outcome: A systematic review and meta-analysis","authors":"Laekin Rose, Amelia Wood, Timothy Gill","doi":"10.1111/obr.13824","DOIUrl":"10.1111/obr.13824","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Mediterranean diet has been shown to be effective in improving health outcomes and for weight loss. Adherence and retention in dietary interventions are critical to ensure the benefits of the exposure. No studies to date have assessed the role of gender in understanding participants who remain engaged and adhere to Mediterranean diet interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to explore gender differences in recruitment, adherence, and retention for Mediterranean diet interventions and whether these were associated with differences in weight-loss outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was completed in EMBASE, Medline, Cochrane, and clinicaltrials.gov from inception to March 2023. A meta-analysis of studies reporting retention by gender was completed using odds ratios comparing female to male dropout numbers. A second meta-analysis was completed for adherence comparing standardized mean difference of Mediterranean diet scores stratified by gender. Newcastle Ottawa score was used to assess risk of bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 70 articles were included in the systematic review with six articles included in the adherence meta-analysis and nine in the dropout meta-analysis. No statistically significant difference was shown for adherence or retention by gender. Weight-loss outcomes were inconsistent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results of the study suggest a higher adherence and lower dropout for women although these results were not statistically significant. Future studies of Mediterranean diet interventions should include adherence, retention, and weight-loss data stratified by gender to allow further investigation of this relationship.</p>\u0000 </section>\u0000 </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"25 12","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.13824","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124381","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}
Yangyang Deng, Mika Manninen, Yongju Hwang, Taewoo Kim, Sami Yli-Piipari
{"title":"Efficacy of lifestyle interventions to treat pediatric obesity: A systematic review and multivariate meta-analysis of randomized controlled trials","authors":"Yangyang Deng, Mika Manninen, Yongju Hwang, Taewoo Kim, Sami Yli-Piipari","doi":"10.1111/obr.13817","DOIUrl":"10.1111/obr.13817","url":null,"abstract":"<div>\u0000 \u0000 <p>The aim of this study was to provide a quantitative synthesis of the effects of randomized controlled pediatric lifestyle interventions in treating obesity among 11–17-year-old children. We conducted a systematic review and meta-analysis on the randomized controlled trials, consisting of actual exercise training and nutrition education, published between January 2000 and August 2022. The initial search yielded 2598 articles, with eight articles meeting the inclusion criteria. The articles were analyzed using a multivariate random effects model. The primary outcome variables were body mass index (BMI), standardized BMI (BMIz), and waist circumference (WC). Our analyses showed that lifestyle interventions were efficacious in improving BMI (−1.77 kg/m<sup>2</sup>, 95% CI [−2.70, −0.83], <i>p</i> < 0.001), BMIz (−0.30, 95% CI [−0.45, −0.16], <i>p</i> < 0.001), and WC (−3.32 cm, 95% CI [−5.35, −1.29], <i>p <</i> 0.001) in children with overweight and obesity. In addition, moderation analyses suggested that the efficacy of the lifestyle interventions correlated positively with participants' weight status and was enhanced when an intervention was boosted with a longer intervention duration and higher frequency. In conclusion, the current evidence suggests that lifestyle interventions are efficacious in treating children with obesity. The available evidence further indicates that duration, frequency, along weight status, were moderating the effectiveness of these lifestyle interventions.</p>\u0000 </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"25 11","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142102714","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}
Kaat Philippe, Shevaun M. Teo, Carla Perrotta, Fionnuala M. McAuliffe, Catherine M. Phillips
{"title":"Why do preconception and pregnancy lifestyle interventions demonstrate limited success in preventing overweight and obesity in children? A scoping review investigating intervention complexity, process evaluation components, and author interpretations","authors":"Kaat Philippe, Shevaun M. Teo, Carla Perrotta, Fionnuala M. McAuliffe, Catherine M. Phillips","doi":"10.1111/obr.13822","DOIUrl":"10.1111/obr.13822","url":null,"abstract":"<p>Preventing childhood obesity from early life is considered essential. However, evidence from recent systematic reviews has highlighted inconsistent results and limited effectiveness of preconception and pregnancy lifestyle interventions regarding offspring weight outcomes and adiposity. Therefore, to improve our understanding regarding the mixed success of these early life interventions, we conducted a scoping review examining intervention complexity, process evaluation components, and authors' statements. Eligible articles (preconception or pregnancy lifestyle trials with offspring data beyond 1 month of age) were identified by searching databases (PubMed, Embase, and CENTRAL), previous reviews, and performing CLUSTER searches. The Intervention Complexity Assessment Tool for Systematic Reviews (iCAT_SR) was used to evaluate intervention complexity. A thematic analysis provided insight into process evaluation components and authors' interpretations. Finally, an expert consultation on the results was conducted. We identified 40 eligible publications corresponding to 27 trials. Only two trials started before conception. Potential reasons for interventions' limited success included the late intervention initiation, short intervention duration, and insufficient sample size. Few studies reported process evaluations and included stakeholder involvement, which are essential according to the expert group. We discuss current limitations and outline suggestions for future interventions in this field of research.</p><p></p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"25 12","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.13822","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091253","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}
Runlin Gui, Yuanyuan Ren, Zhen Wang, Yang Li, Chengsong Wu, Xiaofang Li, Man Li, Yujia Li, Lu Qian, Yuyan Xiong
{"title":"Deciphering interleukin-18 in diabetes and its complications: Biological features, mechanisms, and therapeutic perspectives","authors":"Runlin Gui, Yuanyuan Ren, Zhen Wang, Yang Li, Chengsong Wu, Xiaofang Li, Man Li, Yujia Li, Lu Qian, Yuyan Xiong","doi":"10.1111/obr.13818","DOIUrl":"10.1111/obr.13818","url":null,"abstract":"<div>\u0000 \u0000 <p>Interleukin-18 (IL-18), a potent and multifunctional pro-inflammatory cytokine, plays a critical role in regulating β-cell failure, β-cell death, insulin resistance, and various complications of diabetes mellitus (DM). It exerts its effects by triggering various signaling pathways, enhancing the production of pro-inflammatory cytokines and nitric oxide (NO), as well as promoting immune cells infiltration and β-cells death. Abnormal alterations in IL-18 levels have been revealed to be strongly associated with the onset and development of DM and its complications. Targeting IL-18 may present a novel and promising approach for DM therapy. An increasing number of IL-18 inhibitors, including chemical and natural inhibitors, have been developed and have been shown to protect against DM and diabetic complications. This review provides a comprehensive understanding of the production, biological functions, action mode, and activated signaling pathways of IL-18. Next, we shed light on how IL-18 contributes to the pathogenesis of DM and its associated complications with links to its roles in the modulation of β-cell failure and death, insulin resistance in various tissues, and pancreatitis. Furthermore, the therapeutic potential of targeting IL-18 for the diagnosis and treatment of DM is also highlighted. We hope that this review will help us better understand the functions of IL-18 in the pathogenesis of DM and its complications, providing novel strategies for DM diagnosis and treatment.</p>\u0000 </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"25 11","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142078667","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}
Wenhui Chen, Jia Feng, Shiliang Dong, Jie Guo, Fuqing Zhou, Songhao Hu, Ruixiang Hu, Cunchuan Wang, Yi Ma, Zhiyong Dong
{"title":"Efficacy and safety of duodenal–jejunal bypass liner for obesity and type 2 diabetes: A systematic review and meta-analysis","authors":"Wenhui Chen, Jia Feng, Shiliang Dong, Jie Guo, Fuqing Zhou, Songhao Hu, Ruixiang Hu, Cunchuan Wang, Yi Ma, Zhiyong Dong","doi":"10.1111/obr.13812","DOIUrl":"10.1111/obr.13812","url":null,"abstract":"<div>\u0000 \u0000 <p>This study aimed to evaluate the efficacy and safety of duodenal–jejunal bypass liner (DJBL) for obesity and type 2 diabetes mellitus. A comprehensive search of electronic databases was conducted up to September 15, 2022. Thirty studies involving 1751 patients were included. At 12 months post-implantation, the reduction in body mass index (BMI) was 4.8 kg/m<sup>2</sup> (95% CI 4.1, 5.5), with an excess weight loss of 41.3% (95% CI 33.4%,49.2%) and a total weight loss of 13.1% (95% CI 10.1%, 16.0%). Significant decrease was observed in HbA1c and fasting glucose, with a standardized mean difference of − 0.72 (95% CI − 0.95, − 0.48) and − 0.62 (95% CI − 0.82, − 0.42), respectively. However, these improvements in weight loss and glycemic control were only partially sustained after explantation. In situ, DJBL significantly improves blood pressure and lipid levels. The pooled early removal rate was 19%, and the incidence of severe adverse events was 17%, including device migration (6%), gastrointestinal hemorrhage (4%), device obstruction (4%), and hepatic abscess (2%). DJBL offers significant improvement in weight loss and glycemic control, as well as cardiovascular parameters while in situ. Further studies are warranted to better understand the long-term efficacy and safety of DJBL. The benefits of DJBL need to be carefully weighed against the risks in clinical decision-making.</p>\u0000 </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"25 11","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142078668","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}
Aleksandra Paterek, Marta Załęska-Kocięcka, Zuzanna Wojdyńska, Małgorzata Kalisz, Anna Litwiniuk, Przemysław Leszek, Michał Mączewski
{"title":"Epicardial fat in heart failure—Friend, foe, or bystander","authors":"Aleksandra Paterek, Marta Załęska-Kocięcka, Zuzanna Wojdyńska, Małgorzata Kalisz, Anna Litwiniuk, Przemysław Leszek, Michał Mączewski","doi":"10.1111/obr.13820","DOIUrl":"10.1111/obr.13820","url":null,"abstract":"<div>\u0000 \u0000 <p>Epicardial adipose tissue (EAT) is a fat depot covering the heart. No physical barrier separates EAT from the myocardium, so EAT can easily affect the underlying cardiac muscle. EAT can participate in the development and progression of heart failure with preserved (HFpEF) and reduced ejection fraction (HFrEF). In healthy humans, excess EAT is associated with impaired cardiac function and worse outcomes. In HFpEF, this trend continues: EAT amount is usually increased, and excess EAT correlates with worse function/outcomes. However, in HFrEF, the opposite is true: reduced EAT amount correlates with worse cardiac function/outcomes. Surprisingly, although EAT has beneficial effects on cardiac function, it aggravates ventricular arrhythmias. Here, we dissect these phenomena, trying to explain these paradoxical findings to find a target for novel heart failure therapies aimed at EAT rather than the myocardium itself. However, the success of this approach depends on a thorough understanding of interactions between EAT and the myocardium.</p>\u0000 </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"25 12","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071612","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}
{"title":"The epigenetic mechanism of metabolic risk in bipolar disorder","authors":"Kexin Huang, Sujuan Li, Min Yang, Ziwei Teng, Baoyan Xu, Bolun Wang, Jindong Chen, Liping Zhao, Haishan Wu","doi":"10.1111/obr.13816","DOIUrl":"10.1111/obr.13816","url":null,"abstract":"<div>\u0000 \u0000 <p>Bipolar disorder (BD) is a complex and severe mental illness that causes significant suffering to patients. In addition to the burden of depressive and manic symptoms, patients with BD are at an increased risk for metabolic syndrome (MetS). MetS includes factors associated with an increased risk of atherosclerotic cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM), which may increase the mortality rate of patients with BD. Several studies have suggested a link between BD and MetS, which may be explained at an epigenetic level. We have focused on epigenetic mechanisms to review the causes of metabolic risk in BD.</p>\u0000 </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"25 11","pages":""},"PeriodicalIF":8.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071613","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}