Southern Medical Journal最新文献

{"title":"Travel Costs and Health Disparities: The Impact of Rurality and Social Vulnerability on Hand Therapy Access in Alabama.","authors":"Luke Anderson, Emily Hecox, Shelley Edwards, Marc E Walker","doi":"10.14423/SMJ.0000000000001952","DOIUrl":"10.14423/SMJ.0000000000001952","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative hand therapy is important for recovery and enhanced functional outcomes following hand surgery. Access to this essential care is limited in Alabama, however, particularly for vulnerable populations in rural areas where public transportation is scarce. These challenges are further amplified for patients who are unable to drive due to their injuries. This study aimed to quantify disparities and barriers to certified hand therapy access in Alabama.</p><p><strong>Methods: </strong>Certified hand therapists in Alabama were identified through the Hand Therapy Certification Commission directory. Practice addresses were geocoded and paired with county center coordinates to calculate travel distances from each county center to the nearest certified hand therapist. These distances were then converted into one-way travel costs using Internal Revenue Service standard mileage rates. Counties were categorized by rurality using Rural-Urban Continuum Codes (RUCC) and assessed for social vulnerability using the Social Vulnerability Index (SVI), which considers socioeconomic, housing, and transportation factors. Statistical analyses, including <i>t</i> tests, χ² tests, and multivariate regression, were used to evaluate patterns and predictors of travel costs.</p><p><strong>Results: </strong>Alabama counties had a mean SVI of 0.67 ± 0.195-significantly higher than the national mean of 0.50 (<i>P</i><0.0001). More than 80% of Alabama counties rank in the most vulnerable 50% of US counties, with Shelby County being the only county in the least vulnerable quartile (SVI 0.116). In addition, 36 counties (53.7%) are classified as rural (RUCC 4-9). Both SVI and RUCC independently correlated with increased travel costs. Multivariate regression modeling revealed that each unit increase in RUCC was associated with a $3.43 increase in travel costs (<i>P</i><0.0001), and each 10% increase in SVI corresponded to a $1.64 increase in travel costs (<i>P</i>=0.006). These factors explained 56.4% of the variability in travel costs. Heatmaps visually highlighted higher travel costs in rural, socially vulnerable areas.</p><p><strong>Conclusions: </strong>Rural and socially vulnerable populations in Alabama face significant travel barriers to accessing certified hand therapy. The combined impact of geographic isolation and social vulnerability underscores the need for targeted interventions to ensure equitable access to postoperative care.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"208-213"},"PeriodicalIF":0.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718206","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":"Impact of Medical School-Mandated Step 2 Deadlines on Student Well‑Being and Match Outcomes: A Medical Student's Perspective.","authors":"James R Burmeister","doi":"10.14423/SMJ.0000000000001948","DOIUrl":"10.14423/SMJ.0000000000001948","url":null,"abstract":"<p><p>Because the US Medical Licensing Examination Step 1 (Step 1) has transitioned to pass/fail scoring, US Medical Licensing Examination Step 2 has emerged as a primary standardized metric in residency selection. In response, many medical schools have implemented hard deadlines for Step 2 completion before Electronic Residency Application Service (ERAS) submission. Although intended to streamline the application process and ensure timely examination completion, such mandates may unintentionally heighten student stress, jeopardize academic performance, and impair Match outcomes. This perspective offers a medical student's insight into the psychological and professional consequences of Step 2 deadlines and suggests policy recommendations to better align institutional goals with student wellness and success.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"195-196"},"PeriodicalIF":0.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718082","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":"Reimagining Medical Educator Development: A Mixed-Methods Evaluation of KinetiC3, A Longitudinal, Character-Integrated Teaching Academy.","authors":"Kristina Kaljo, Austin Tubbs, Alexandra M Harrington, Vivian Dondlinger, Devarati Syam, Amy H Farkas","doi":"10.14423/SMJ.0000000000001958","DOIUrl":"10.14423/SMJ.0000000000001958","url":null,"abstract":"<p><strong>Objectives: </strong>Medical educators often navigate professional isolation, identity dissonance, and limited institutional support, despite strong motivation for growth. KinetiC3 is a year-long cohort-based educator enrichment program that integrates character education with pedagogical development, informed by theories of transformative learning, self-determination, and social identity.</p><p><strong>Methods: </strong>We conducted a mixed-methods evaluation of 173 participants from 2018 to 2024. Quantitative data were drawn from retrospective review of demographic and professional milestones. Semistructured group interviews (n=16) explored participants' experiences and perceptions of program impact.</p><p><strong>Results: </strong>Quantitative career mapping revealed professional advancement, including promotion and entry into educator leadership roles. Thematic analysis of interview data identified five themes: role evolution through transformative educator identity development; recognition and application of character strengths reinforcing professional values and purpose; advancement into formal and informal leadership roles; cohort-based, cross-disciplinary collaboration supporting peer mentorship and sustained engagement; and benefit of longitudinal character-integrated enrichment in fostering professional fulfillment.</p><p><strong>Conclusions: </strong>This study captures the need to reimagine educator development beyond traditional skill-based programs. KinetiC3's longitudinal, values-driven model supports motivation, confidence, and a strengthened sense of belonging within the educational community. Institutions aiming to retain and empower educators should invest in structured, character-integrated development programs.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"179-184"},"PeriodicalIF":0.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718177","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":"Obesity, Body Fat Distribution, and Blood Pressure in Hispanic and Non-Hispanic Whites in a National Survey.","authors":"Deba Ede-Imafidon, Justyna Sienkaniec, Fady Tawfik, Richard F Gillum","doi":"10.14423/SMJ.0000000000001951","DOIUrl":"10.14423/SMJ.0000000000001951","url":null,"abstract":"<p><strong>Objectives: </strong>Recent data from the National Health and Nutrition Examination Survey (NHANES) indicated that despite a higher prevalence of obesity in Hispanic women than non-Hispanic White women, their hypertension prevalence did not differ. Obesity and large upper arm (UA) circumference can affect the accuracy of BP readings. Anthropometric data were used to test the hypothesis that UA circumference was related to systolic blood pressure (BP), indicating possible inaccuracy of readings in either group.</p><p><strong>Methods: </strong>The data analysis was conducted using the NHANES 2017-March 2020 pre-coronavirus disease 2019 pandemic cycle. After excluding individuals under age 20 years, non-Hispanic Black participants, and others, the final analytic sample included (4092) non-Hispanic and Hispanic White adult females. Trained technicians measured height, weight, waist circumference, UA length and circumference, and three oscillometric systolic BP readings using four cuff sizes. Analyses accounted for the complex sampling design and weighting of the NHANES.</p><p><strong>Results: </strong>Compared with non-Hispanic White women, Hispanic women had lesser median height and UA length but a greater body mass index and UA circumference. Among women assigned to large cuffs, there were more Hispanics (21%), but among those assigned to extra-large cuffs, there were fewer Hispanics (10%) compared with White women. This was consistent with a more central distribution of body fat in Hispanic women. In regression analyses controlling for age, height, and weight, UA circumference was significantly associated with Hispanic ethnicity but was not associated with BP in Hispanics or Whites. Similar trends were seen in men.</p><p><strong>Conclusions: </strong>Despite having a higher body mass index, fewer Hispanics than non-Hispanic White women and men required extra-large BP cuffs. There was no evidence that bias in BP readings explained the lack of excess prevalence of hypertension in Hispanic women or men.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"157-160"},"PeriodicalIF":0.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718053","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":"Personal Philosophies of Practice: Purposeful Guides for Patient Engagement.","authors":"William Ventres","doi":"10.14423/SMJ.0000000000001949","DOIUrl":"10.14423/SMJ.0000000000001949","url":null,"abstract":"<p><p>At a time when many physicians feel frustrated and burned out, the author invites them to create their own personal philosophies of practice, statements that clarify the purposeful meanings they choose to instill in their work beyond the exigencies of their daily endeavors. Three tasks frame the process of creating a personal philosophy of practice: thinking about what purpose individual physicians attribute to the work of medicine; considering what core concepts steer their professional activities such that they, their patients, and the health of the public at large all benefit; and documenting their own personal philosophy of practice, with an eye toward the future. The author includes three example personal philosophies of practice to help guide readers' creative efforts.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"203-206"},"PeriodicalIF":0.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718190","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":"Publication Bias in Coronary Artery Disease Clinical Trials: A Bibliometric Review.","authors":"Anchal Shukla, Tejasvi Paturu, Shreya Shivan, Trenton Lippert, Vic Velanovich","doi":"10.14423/SMJ.0000000000001955","DOIUrl":"10.14423/SMJ.0000000000001955","url":null,"abstract":"<p><strong>Objective: </strong>The objective of our study was to determine the extent of publication bias of clinical trials pertaining to the treatment of coronary artery disease. Specifically, studies are more likely to be published if the results are positive and have a higher citation rate.</p><p><strong>Methods: </strong>The US National Library of Medicine Clinical Trials database was used to identify a total of 242 terminated and completed clinical trials with reported results since 2017. Studies were excluded if they had fewer than two treatment arms, fewer than five participants in any of the treatment arms, or no data analysis to determine significance. A trial was deemed \"positive\" if there was a statistically significant difference between the treatment arms that agreed with the hypothesis. A \"negative\" was not statistically significant and/or did not agree with the hypothesis of the trial. Data were collected on intervention, treatment arms, funding type, publication rates, citation rate, impact factor and H index of the journal.</p><p><strong>Results: </strong>Of the 144 trials analyzed, 86 had positive results and 58 had negative results. There was a statistically significant difference in the length of study and publication rate. The publication rate for positive studies was 92%, whereas for negative studies it was 50% (<i>P</i><0.001).</p><p><strong>Conclusions: </strong>Positive outcomes had a higher publication rate compared with the negative results. Identification of this bias is critical in addressing the impact it could have on the practice of evidence-based medicine. If negative results are not being published, then this pushes physicians to rely on positive results more heavily, thereby skewing evidence-based decision making. This in turn impacts decisions that affect the quality of care.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"169-172"},"PeriodicalIF":0.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718185","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":"Incidence and Impact of Atrial Fibrillation after Open Thoracotomy and VATS Pulmonary Lobectomy: A Single-Center Experience.","authors":"Amie Woolard, Daniel Davenport, Sibu Saha","doi":"10.14423/SMJ.0000000000001957","DOIUrl":"10.14423/SMJ.0000000000001957","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to measure the incidence and impact of atrial fibrillation (AF) after open thoracotomy versus video-assisted thoracoscopic surgery (VATS) lobectomy at an academic medical center.</p><p><strong>Methods: </strong>With institutional review board approval, 899 patients who underwent a pulmonary lobectomy from January 2005 to December 2021 were included in this study. Postoperative AF (POAF) was defined by electrocardiography. Patients with a preoperative diagnosis of AF were excluded. Univariate analyses were conducted to identify risk factors and outcomes of POAF. Multivariate analyses were conducted to identify independent predictors and associated complications of POAF.</p><p><strong>Results: </strong>The overall incidence of AF was 9.2%. This incidence after open thoracotomy (13.0%) and VATS procedures (6.5%) was significantly different (<i>P</i>=0.001). An independent risk factor for POAF was age (odds ratio [OR] 1.05, <i>P</i><0.001). POAF significantly increased the average number of other complications (<i>P</i><0.001). Multivariate analysis revealed that postoperative acute respiratory distress syndrome (OR 3.94, <i>P</i>≤0.001) and atelectasis (OR 3.89, <i>P</i>=0.004) were independently associated with POAF. POAF did not affect in-hospital mortality (<i>P</i>=0.341). Patients with POAF had a significantly longer average hospital length of stay compared with those without (8.80 vs 5.84, <i>P</i><0.001). The same is true for the first (3.52 vs 2.54, <i>P</i>=0.014) and the total length of stay in the intensive care unit (4.68 vs 3.10, <i>P</i>=0.009). POAF significantly increased the rate of postoperative mechanical ventilation (<i>P</i>=0.004), reintubation (<i>P</i><0.001), and return to the operating room (<i>P</i>=0.003).</p><p><strong>Conclusions: </strong>The incidence of POAF in patients who underwent an open lobectomy was significantly higher than those who underwent a VATS lobectomy. An independent risk factor for developing POAF was age. In the end, POAF greatly increased a patient's rate of postoperative complications, length of hospital and intensive care unit stay, and postoperative procedures.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"173-178"},"PeriodicalIF":0.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Study of Perceptions of Equity, Diversity, and Inclusion Work at University of Utah Health.","authors":"Edén Cortés López, Julie E Lucero, Donna Baluchi, Valerie J Flattes, Clare Lemke, Heather Nyman, Paloma Cariello, José E Rodríguez","doi":"10.14423/SMJ.0000000000001954","DOIUrl":"10.14423/SMJ.0000000000001954","url":null,"abstract":"<p><strong>Objectives: </strong>The Diversity Engagement Survey (DES) was administered at University of Utah Health (UUHealth) in 2015 and 2023. In 2023, leaders provided an opportunity for participants to express their opinions on equity, diversity, and inclusion work at UUHealth as part of the DES.</p><p><strong>Methods: </strong>E-mails were sent with a survey link to all employees and learners at UUHealth (N = 23,945). This article focuses on the responses to the question, \"If you wish, please provide additional comments on the diversity and inclusion efforts at University of Utah Health.\" The responses were entered into NVivo. Data were then coded inductively into parent codes. Parent codes were grouped and merged to create themes that captured recurring experiences.</p><p><strong>Results: </strong>Twenty percent of those surveyed (n = 4879) completed the survey. Of these, 882 (18%) answered the open-ended question, and 779 distinct responses were coded after the elimination of duplicates and blanks. The following eight themes were revealed by the analysis: experiences of discrimination and equity; lack of accountability for perceived discrimination; perceived change resulting from equity, diversity, and inclusion efforts (EDI); EDI initiatives perceived as discriminatory and exclusionary; implementing and improving EDI outcomes; political views and tensions with EDI; diversity within executive levels; and overall recommendations.</p><p><strong>Conclusions: </strong>In response to the above themes, UUHealth EDI has expanded to include veterans and older adults, changed its communication strategy to ensure that employees and students know about both reporting and accountability structures, implemented a religious diversity program, and incorporated the equity diversity and inclusion surveys in the unified Better U survey.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"197-202"},"PeriodicalIF":0.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718024","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":"Performance of Large Language Models on Diagnostic Radiology Board-Style Questions: A Comparative Evaluation of GPT-4o, Perplexity AI, and OpenEvidence.","authors":"Randall Aziz, Sydney Stewart, Rebecca Liscomb, Beecher Baldwin, Katie Bailey, Karim Hanna","doi":"10.14423/SMJ.0000000000001950","DOIUrl":"10.14423/SMJ.0000000000001950","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to compare the diagnostic accuracy and internal consistency of GPT-4o (Generative Pre-Trained Transformer-4 omni), Perplexity AI (artificial intelligence), and OpenEvidence when applied to text-based, specialty-level radiology board questions.</p><p><strong>Methods: </strong>A total of 161 text-based multiple-choice questions from the American College of Radiology (ACR) Diagnostic Radiology In-Training Examination were administered across three independent runs for each large language model (LLM). Questions containing images were excluded. All three models were accessed through their respective public Web interfaces. A final answer was assigned to each model based on majority vote across the three runs (two out of three). If all three responses differed, the third (last) response was selected. Our selected answer was then compared with the ACR reference key. Internal consistency as well as agreement between each model's final answer and the ACR reference key was assessed using Cohen's kappa. In addition, descriptive statistics were used to analyze performance by radiology subspecialty. SPSS version 30 was used for all statistical analyses, and <i>P</i><0.05 were considered statistically significant.</p><p><strong>Results: </strong>Perplexity AI demonstrated the highest agreement with the ACR reference key (κ=0.883, <i>P</i><0.001), followed by OpenEvidence (κ=0.858, <i>P</i><0.001), and GPT-4o (κ=0.709, <i>P</i><0.001). All models showed high internal consistency; however OpenEvidence was the only LLM to demonstrate absolute internal consistency (κ=1.00 for all three runs). Perplexity AI showed the least variability across the 14 radiology subspecialties.</p><p><strong>Conclusion: </strong>Emerging LLMs such as Perplexity AI and OpenEvidence may offer greater diagnostic reliability than general-purpose models in radiology-specific contexts.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"191-194"},"PeriodicalIF":0.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718112","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":"Pilot Cross-Sectional Study Assessing the Correlation between Marijuana Use and Rheumatoid Arthritis and Systemic Lupus Erythematosus Exacerbations.","authors":"Ujjwal Madan, Emily Puthawala, Roshni Thomas, Onyi Oligbo, Aatif Syed, Evelyn Peng, Sarah Ifteqar","doi":"10.14423/SMJ.0000000000001956","DOIUrl":"10.14423/SMJ.0000000000001956","url":null,"abstract":"<p><strong>Objective: </strong>Cannabis use is increasing among patients with autoimmune rheumatic diseases, often for symptom relief; however, its impact on disease activity remains unclear. This pilot study assessed whether cannabis use was associated with differences in flare frequency or duration among patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or both.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at a university-based rheumatology clinic in a US state where medical and recreational cannabis is legal. Adults (≥18 years) with confirmed RA, SLE, or both, receiving disease-modifying antirheumatic drug therapy for ≥3 months were included. Participants (N = 85) completed structured interviews assessing cannabis use, flare characteristics, and patient-reported outcomes. Demographics, comorbidities, substance use, and inflammatory markers also were collected.</p><p><strong>Results: </strong>Among 85 participants (mean age 54 years; 89.4% female), 74.1% had RA, 17.6% SLE, and 8.2% had both. Cannabis use was reported by 30% of RA participants, 47% of SLE participants, and 71.4% of participants with both diagnoses. In the RA subgroup (n = 60), cannabis users had a greater odds of experiencing flares lasting longer than 3 days (odds ratio 4.4, 95% confidence interval 1.4-14.3). No association was found with RA flare frequency. Due to small sample sizes, no statistical analysis was conducted in the SLE or RA/SLE subgroups.</p><p><strong>Conclusions: </strong>Cannabis use was associated with prolonged RA flares but not increased flare frequency. As cannabis becomes more accessible, further research is needed to clarify its immunologic effects. Clinicians should counsel patients regarding the potential risks of cannabis use in autoimmune disease management.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"161-168"},"PeriodicalIF":0.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718154","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}