Seminars in arthritis and rheumatism最新文献

{"title":"Comments on the article by Bilgin et al.","authors":"Adam Goldman, Ilan Ben-Zvi","doi":"10.1016/j.semarthrit.2024.152600","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2024.152600","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":" ","pages":"152600"},"PeriodicalIF":4.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819234","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":"Accrual of organ damage and one-year mortality in systemic sclerosis: A prospective observational study.","authors":"Laura Cano-García, Aimara García-Studer, Sara Manrique-Arija, Fernando Ortiz-Márquez, Rocío Redondo-Rodríguez, Paula Borregón-Garrido, Natalia Mena-Vázquez, Antonio Fernández-Nebro","doi":"10.1016/j.semarthrit.2024.152604","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2024.152604","url":null,"abstract":"<p><strong>Objective: </strong>To determine cumulative organ damage in patients with systemic sclerosis (SSc) according to the Scleroderma Clinical Trials Consortium Damage Index (SCTC-DI), assess 1-year mortality risk, and identify associated factors.</p><p><strong>Methods: </strong>A prospective, single-center study was conducted in a cohort of patients with SSc. A cross-sectional study and a 12-month longitudinal follow-up were carried out. The main outcomes were SCTC-DI and all-cause mortality at 12 months. Other variables included clinical-laboratory data, modified Rodnan Skin Score (mRSS), EuroQoL 5-D (EQ-5D), and Steinbrocker functional status. Multivariate models were used to study factors associated with SCTC-DI and mortality.</p><p><strong>Results: </strong>The study population comprised 75 patients (97.3% females) with a mean age of 59.6 years. The median (IQR) of the SCTC-DI was 4(6), and only 4 (5.3%) patients had severe SCTC-DI (≥13). The factors associated with SCTC-DI were disease duration (β=0.276), mRSS (β=0.287), C-reactive protein (CRP) concentration (β=0.311), and EQ-5D (β= -0.207). After 1 year of follow-up, 4 patients had died. The factors associated with mortality at 12 months (OR [95% CI]) were baseline SCTC-DI ≥13 (44.5 [1.6-1237.9]; p = 0.025) and visual analog scale (VAS) of the EQ-5D (0.9 [0.8-0.9]; p = 0.018).</p><p><strong>Conclusions: </strong>The SCTC DI can prove useful in clinical practice for assessing disease progression and short-term mortality risk. Cumulative damage was associated with disease duration, mRSS, CRP concentration, and a decline in EQ-5D, while the risk of death at 12 months was primarily associated with high SCTC-DI and low EQ-5D VAS. New studies are needed to improve assessment tools in patients with SSc.</p>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"70 ","pages":"152604"},"PeriodicalIF":4.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822692","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":"Prioritising domains of glucocorticoid therapy to measure in trials: Results from a modified delphi exercise from the OMERACT glucocorticoid impact working group.","authors":"Joanna Tieu, Jonathan Tl Cheah, Suellen Lyne, Kevin Yip, Nilasha Ghosh, Pamela Richards, Robin Christensen, Rachel J Black, Joanna C Robson, Sarah L Mackie, Catherine L Hill, Susan M Goodman","doi":"10.1016/j.semarthrit.2024.152602","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2024.152602","url":null,"abstract":"<p><strong>Introduction: </strong>There is no consensus amongst patients and healthcare professionals about how to measure important adverse effects of glucocorticoids (GCs) that includes the patient's perspective. The OMERACT GC Impact working group sought to identify the domains of greatest importance to both patients and healthcare professionals for use in a proposed core outcome set.</p><p><strong>Methods: </strong>Patients and healthcare professionals participated in a Delphi consensus exercise to rate the importance of previously identified candidate domains. Those deemed critical to include by at least 70% in both groups, after three rounds of a Delphi exercise were identified as meeting consensus. All participants were asked which additional domains should be measured in all trials in a final survey; those domains selected by more than 70% of all participants were added, resulting in a final list of potential core domains.</p><p><strong>Results: </strong>In total, 363 people (295 patients and 68 healthcare professionals) participated in the Delphi process. The final list of potential core domains included: bone fragility, diabetes, eye problems and/or changes in vision, high blood pressure, infection, osteonecrosis, mood disturbance, fatigue, sleep disturbance, weight.</p><p><strong>Conclusion: </strong>The 10 domains identified through this exercise informed the proposed core domain set of GC effects to be considered for use in future clinical trials involving GCs. This core domain set was endorsed at the OMERACT 2020 virtual workshop.</p>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":" ","pages":"152602"},"PeriodicalIF":4.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795108","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":"Damage Index for Antiphospholipid Syndrome (DIAPS): An Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking (APS ACTION) \"Damage\" working group report on strengths and limitations.","authors":"Gustavo G M Balbi, Pedro Gaspar, Hannah Cohen, David A Isenberg, Doruk Erkan, Danieli Andrade","doi":"10.1016/j.semarthrit.2024.152605","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2024.152605","url":null,"abstract":"<p><strong>Objectives: </strong>To gather the perspectives of APS ACTION members regarding the strengths and limitations of Damage Index for Antiphospholipid Syndrome (DIAPS); and establish recommendations for the improvement of DIAPS.</p><p><strong>Methods: </strong>APS ACTION members were invited to answer a survey regarding their satisfaction with DIAPS scoring system and individual items. The level of agreement (LoA) among members with the inclusion of individual items in DIAPS was calculated (LoA of <75% was considered disagreement). Respondents' open-ended comments about DIAPS limitations were also collected, which helped formulate our recommendations for DIAPS improvement.</p><p><strong>Results: </strong>Forty-two APS ACTION members (58.3%) answered the survey. Of them, 26 (61.9%) were satisfied, 4 (9.5%) were neutral, and 12 (28.6%) were dissatisfied with the current DIAPS scoring system. Fifteen items (39.5%) presented a LoA <75% regarding the inclusion in DIAPS. Respondents provided comments that were grouped under six main categories related to concerns about: a) definitions and attribution of damage (including causality and temporal relationship); b) scoring system; c) overlapping items; d) specific items (exclusion of redundant items and inclusion of additional ones); e) the need to incorporate multiple events; and f) feasibility and practicality. Finally, the APS ACTION \"Damage\" Working Group developed 7 recommendations that should be considered for the next generation DIAPS.</p><p><strong>Conclusion: </strong>Approximately 60% of respondents were satisfied with DIAPS and its definitions; however, our survey demonstrated that there is substantial room to improve the current damage index for APS. Efforts for updating DIAPS should consider the APS ACTION \"Damage\" Working Group recommendations.</p>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"70 ","pages":"152605"},"PeriodicalIF":4.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814218","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":"Phenotype of diffuse cutaneous systemic sclerosis patients with positive anticentromere antibodies: A systematic literature review and meta-analysis.","authors":"Marco Binda, Augusta Ortolan, Beatrice Moccaldi, Mariangela Salvato, Anna Cuberli, Roberto Padoan, Andrea Doria, Elisabetta Zanatta","doi":"10.1016/j.semarthrit.2024.152606","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2024.152606","url":null,"abstract":"<p><strong>Objectives: </strong>Anticentromere antibodies (ACA) are typically found in limited cutaneous systemic sclerosis (lcSSc), whereas patients with anti-topoisomerase I antibodies (ATA) usually exhibit diffuse cutaneous involvement (dcSSc). We aimed to investigate the clinical phenotype and outcome of ACA-dcSSc.</p><p><strong>Methods: </strong>A systematic literature review was conducted (January 1970 to April 2023) across MEDLINE, Scopus and OVID, to define whether SSc patients (population) within the ACA-dcSSc subset (exposure) had higher/lower risk for major organ involvement (interstitial lung disease-ILD, pulmonary hypertension-PH, primary myocardial involvement-PMI, scleroderma renal crisis-SRC) and mortality (outcomes) compared to ACA-lcSSc and ATA-dcSSc. Inclusion criteria were: 1) adult SSc patients with identifiable demographic and clinical features by subtype; 2) observational studies. The quality of the studies was evaluated by the Newcastle-Ottawa Scale. Random-effects meta-analysis was performed to compare odds ratios (OR) for major organ involvement, and the 5- and 10-year mortality of ACA-dcSSc with the other subsets.</p><p><strong>Results: </strong>Out of 1570 hits, six articles were included, identifying 177 ACA-dcSSc patients. In ACA-dcSSc, ILD was more frequent than in ACA-lcSSc (OR 2.60; 95 %CI 1.39-4.87) but less frequent compared to ATA-dcSSc (OR 0.17; 95 %CI 0.10-0.29). ACA-dcSSc patients had a higher prevalence of PH vs. both conventional subsets; PMI and SRC were more frequent in ACA-dcSSc compared to ACA-lcSSc, and similar to ATA-dcSSc. While 5-year survival rates were comparable among the subsets, ACA-dcSSc patients exhibited a lower 10-year mortality than ATA-dcSSc (OR 0.42; 95 %CI 0.2-0.85).</p><p><strong>Conclusion: </strong>Although uncommon, the ACA-dcSSc subset appears to have a distinct clinical phenotype, with a better prognosis than ATA-dcSSc.</p>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"70 ","pages":"152606"},"PeriodicalIF":4.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807850","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":"Peripartum maternal outcomes in individuals with systemic lupus erythematosus in a real-world electronic health record cohort.","authors":"Catherine Deffendall, Sarah Green, Ashley Suh, Nikol Nikolova, Katherine Walker, Raeann Whitney, Lee Wheless, Sarah Osmundson, April Barnado","doi":"10.1016/j.semarthrit.2024.152603","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2024.152603","url":null,"abstract":"<p><strong>Objective: </strong>Few studies have examined peripartum maternal outcomes in systemic lupus erythematosus (SLE). Using a de-identified electronic health record (EHR) cohort of individuals with and without SLE, we compared rates of peripartum maternal outcomes including maternal infections, blood transfusions, hospital length of stay, and SLE flares.</p><p><strong>Methods: </strong>We identified deliveries among individuals with SLE and individuals without autoimmune disease using a previously validated algorithm. Peripartum maternal infection was assessed up to 6 weeks postpartum. Using Chi-square and Mann-Whitney U tests, we compared peripartum outcomes in SLE and control deliveries. We performed mixed effects models to estimate the association of SLE case status with peripartum outcomes. We assessed for SLE flares up to 6 months postpartum using chart review of rheumatology notes and the 2009 revised SELENA Flare Index. We evaluated SLE medications prescribed during pregnancy and at time of delivery on peripartum outcomes.</p><p><strong>Results: </strong>We identified 185 deliveries to 142 individuals with SLE and 468 deliveries to 241 control individuals without autoimmune diseases. Mean length of hospital stay was longer for individuals with SLE compared to controls (3.1 ± 2.0 vs. 2.4 ± 1.0 days, p < 0.001). In a mixed effects model, peripartum infection was significantly associated with SLE case status (OR = 6.18, 95 % CI 2.73 - 13.98, p < 0.01), Cesarean section (OR = 5.00, 95 % CI 2.16 - 11.57, p < 0.01), and age at delivery (OR = 0.92, 95 % CI 0.86 - 0.99, p = 0.03) after adjusting for race. Transfusion was also significantly associated with SLE case status (OR = 9.05, 95 % CI 3.24-25.32, p < 0.01) and Black race (OR = 6.64, 95 % CI 1.47 - 30.02, p = 0.01) after adjusting for Cesarean section and age at delivery. We observed a postpartum flare rate of 32 % among individuals with SLE with 13 % characterized as mild, 41 % moderate, and 46 % severe. Antimalarial use in the postpartum period was associated with lower flare rate (43 % vs. 63 %, p = 0.04).</p><p><strong>Conclusions: </strong>Individuals with SLE have increased rates of blood transfusions, longer hospital stays, and more frequent infections compared to control individuals in the peripartum period. We observed a postpartum flare rate of 32 %, and antimalarial use was associated with lower flare rate. Our findings demonstrate that the peripartum period remains a high-risk time for individuals with SLE with an ongoing need for close monitoring.</p>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"70 ","pages":"152603"},"PeriodicalIF":4.6,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786938","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":"Quantification of coronary artery calcification in systemic sclerosis using visual ordinal and deep learning scoring: Association with systemic sclerosis clinical features","authors":"Yiming Luo ,&nbsp;Daniel Hanuska ,&nbsp;Jiehui Xu ,&nbsp;Mary M Salvatore ,&nbsp;Elana J Bernstein","doi":"10.1016/j.semarthrit.2024.152598","DOIUrl":"10.1016/j.semarthrit.2024.152598","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the association between systemic sclerosis (SSc) clinical features and the extent and progression of coronary artery calcifications.</div></div><div><h3>Methods</h3><div>We conducted a single-center retrospective cohort study of patients with SSc. In our primary aim, we investigated the association between SSc clinical features and the annual progression of coronary artery calcium (CAC) scores quantified using the visual ordinal scoring method. In our secondary aim, we utilized DeepCAC, a deep learning-based method, to quantify coronary artery calcifications (“deep learning CAC score”), and explored its association with SSc clinical features.</div></div><div><h3>Results</h3><div>Eighty-six SSc patients were included in the primary aim and 171 in the secondary aim. SSc disease duration was inversely associated with annual ordinal CAC score progression in the demographics-adjusted model (coefficient = -0.004, 95 % CI -0.006 to -0.001, p-value = 0.01) and the demographics- and cardiovascular (CV) risk factor-adjusted model (coefficient = -0.004, 95 % CI -0.008 to -0.0004, p-value = 0.03). The presence of \"fingertip ischemic ulcers or digital pitting scars\" (demographics-adjusted model: coefficient = 1.07, 95 % CI 0.29 to 1.85, <em>p</em> &lt; 0.01; demographics- and CV risk factor-adjusted model: coefficient = 1.39, 95 % CI 0.43 to 2.34, <em>p</em> &lt; 0.01) and Group 1 pulmonary hypertension (demographics-adjusted model: coefficient = 1.34, 95 % CI 0.34 to 2.35, <em>p</em> &lt; 0.01; demographics- and CV risk factor-adjusted model: coefficient = 1.52, 95 % CI 0.38 to 2.65, <em>p</em> &lt; 0.01) were both associated with the deep learning CAC score.</div></div><div><h3>Conclusion</h3><div>Our results suggest that the progression of coronary artery calcification accelerates early during the SSc disease course and that severe microvasculopathy may be a risk factor for atherosclerotic CVD.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"70 ","pages":"Article 152598"},"PeriodicalIF":4.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744215","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":"Response letter to the editor.","authors":"Don L Goldenberg","doi":"10.1016/j.semarthrit.2024.152597","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2024.152597","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":" ","pages":"152597"},"PeriodicalIF":4.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732484","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":"High prevalence and incidence of systemic sclerosis in Reunion Island, a French multi-ethnical and tropical territory","authors":"Arthur Dubernet ,&nbsp;Céline Roussin ,&nbsp;Nathalie Sultan-Bichat ,&nbsp;Aurélie Foucher ,&nbsp;Cécile Saint-Pastou Terrier ,&nbsp;Patrice Poubeau ,&nbsp;Julien Klisnick ,&nbsp;Antoine Bertolotti ,&nbsp;Loraine Gaüzère ,&nbsp;Frédéric Renou ,&nbsp;Anne Gerber ,&nbsp;Kelly Bagny ,&nbsp;Sophie Osdoit-Médart ,&nbsp;Tannvir Desroche ,&nbsp;Quentin Richier ,&nbsp;Nathalie Allou ,&nbsp;Stéphane Lecoules ,&nbsp;Stéphanie Fayeulle ,&nbsp;Damien Vagner ,&nbsp;Maïssa Safieddine ,&nbsp;Loïc Raffray","doi":"10.1016/j.semarthrit.2024.152594","DOIUrl":"10.1016/j.semarthrit.2024.152594","url":null,"abstract":"<div><h3>Objectives</h3><div>Systemic sclerosis’ (SSc) prevalence varies according to geographical location, presumably in link with environmental and genetic factors. We sought to determine SSc prevalence and incidence on Reunion Island, a southern hemisphere territory characterised by multi-ethnic background.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of SSc cases defined according to ACR/EULAR 2013 classification criteria. Cases were retrieved over the 2005–2021 period through multiple sources, mainly community and hospital follow-up. Patients were assigned to three clinical subsets: sine scleroderma (normal skin) (ss), limited cutaneous (lc) or diffuse cutaneous (dc) SSc. Prospective submission of questionnaires to patients in 2021 enabled determination of patients’ self-declared ethnicity and physician-assessed phototype group. Prevalence was calculated for 2021 and mean annual incidence between 2005 and 2021 after adjustment with WHO's standards.</div></div><div><h3>Results</h3><div>Overall, 207 patients were included in the retrospective cohort, including 175 SSc (108 lcSSc, 58 dcSSc and 9 ssSSc) and 32 mixed connective tissue disease. Prevalence and mean annual incidence were estimated to be 30.9 (95 %IC: 26.1–35.8) per 100,000 inhabitants in 2021 and 2.13 (95 %IC: 1.81–2.45) per 100,000 inhabitants/year respectively. The 5- and 10-year survival rates after diagnosis were 0.93 and 0.82 respectively. Phototypes and ethnicity were determined in 102 and 86 patients, respectively. Darker phototypes presented more frequently with pulmonary hypertension, while lighter phototypes had more severe gastro-intestinal manifestations and anti-centromere antibodies positivity.</div></div><div><h3>Conclusion</h3><div>Our study revealed high prevalence and incidence of SSc in Reunion Island which is consistent with the frequently described higher frequency among patients of African origin.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"70 ","pages":"Article 152594"},"PeriodicalIF":4.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on the article by Goldman et al.","authors":"Emre Bilgin, Sedat Kiraz","doi":"10.1016/j.semarthrit.2024.152595","DOIUrl":"https://doi.org/10.1016/j.semarthrit.2024.152595","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":" ","pages":"152595"},"PeriodicalIF":4.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732481","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}