Transfusion最新文献

{"title":"Tranexamic acid is associated with post-injury mortality in a resource-limited trauma system: Findings from the epidemiology and outcomes of prolonged trauma care cohort study.","authors":"Adane F Wogu, Julia M Dixon, Mengli Xiao, Hendrick J Lategan, George Oosthuizen, Steven G Schauer, Elmin Steyn, Smitha Bhaumik, Janette Verster, Craig Wylie, Shaheem de Vries, Mohammad Mayet, Lesley Hodsdon, Leigh Wagner, L' Oreal Snyders, Karlien Doubell, Denise Lourens, Willem Stassen, Christiaan Rees, Jessica Young, Ernest E Moore, Nee-Kofi Mould-Millman","doi":"10.1111/trf.18171","DOIUrl":"https://doi.org/10.1111/trf.18171","url":null,"abstract":"<p><strong>Background: </strong>Injury-related deaths claim millions of lives annually, with severe hemorrhage a leading cause. This study assesses tranexamic acid (TXA) administered within 3 h post-injury on mortality in trauma patients.</p><p><strong>Study design and methods: </strong>We conducted secondary database analysis of EpiC, a multicenter, prospective cohort of trauma patients in South Africa. We compared mortality between severely injured patients at risk for traumatic hemorrhage receiving TXA within 3 h post-injury versus untreated patients. Inverse probability of treatment weighting adjusted for confounders, and multivariate logistic regression assessed 24-h mortality, with extended secondary outcome analyses.</p><p><strong>Results: </strong>Of 3607 analyzed patients, 502 received TXA within 3 h. TXA reduced 24-h mortality by 38% (marginal odds ratio [mOR], 0.62; 95% confidence interval [CI], 0.49-0.78) versus untreated patients. Similar reductions were observed for longer-term mortality. Subgroup analyses revealed reduced mortality when TXA was given within 2 h post-injury (mOR, 0.57; 95% CI, 0.45-0.73), doses of 1 g of TXA within 3 h (mOR, 0.73; 95% CI, 0.56-0.94), and those with the highest risk of hemorrhage (mOR, 0.40; 95% CI, 0.30-0.53). The 24-h mortality reduction was significant for patients with penetrating injury (mOR, 0.58; 95% CI, 0.43-0.78) but not for blunt injury patients. Sensitivity analyses confirmed the robustness of these findings, with TXA consistently reducing mortality odds by 28%-39% across subgroups.</p><p><strong>Discussion: </strong>Early TXA administration significantly reduced mortality in trauma patients, especially with penetrating injuries and those with the highest risk of hemorrhage. One-gram dosing was as effective as higher doses, and mortality reduction was notable when TXA was given within 2 h post-injury. These findings support TXA use in resource-limited trauma protocols.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An assessment of laboratory changes during autologous whole blood transfusion training: A prospective, observational study.","authors":"Steven G Schauer, Juliette M Conte, Ian L Hudson, Jessica Mendez, Dayana Sifuentes, Fabiola Mancha, Melody A Martinez, Rocio J Huaman, Allyson A Arana, Jason B Corley, Andrew D Fisher, Michael A Meledeo, Brian J Kirkwood, Michael D April","doi":"10.1111/trf.18178","DOIUrl":"https://doi.org/10.1111/trf.18178","url":null,"abstract":"<p><strong>Introduction: </strong>Hemorrhage is the leading cause of death after trauma. Blood transfusions are used to restore physiology but are stored in citrate preservative which can bind electrolytes, particularly calcium, leading to hypocalcemia. Few data exist on the changes that occur in humans because of whole blood donation/transfusion. We sought to determine the electrolyte changes that occur during whole blood donation/reinfusion.</p><p><strong>Methods: </strong>We conducted a prospective observational study of military personnel that served as donor/recipient for personnel performing autologous whole blood transfusion training. Trained research staff analyzed whole blood samples collected pre-donation, post-donation, and post-reinfusion of one autologous unit of whole blood. We used the i-STAT laboratory analyzer. Laboratory data are reported using means and standard deviations.</p><p><strong>Results: </strong>We prospectively enrolled 40 participants. The median age was 22 years (interquartile range [IQR] 20-26), and 95% were male. The median body mass index was 25.3 (IQR 23.0-29.1). There were four participants that reported use of dietary supplements: three reported taking creatine, and the other one reported taking fish oil, magnesium, multivitamin, creatine, caffeine, and beetroot powder. Mean iCa was 1.25 mmol/L (standard deviation [SD] 0.04) pre-donation, 1.26 (SD 0.04) post-donation, and 1.12 (SD 0.14) post-reinfusion. Comparatively, the mean potassium values were 3.90 mEq/L (SD 0.36), 4.10 (SD 0.62), and 4.09 (SD 0.72). Hemoglobin levels decreased by 0.34 g/dL (p < .001) from post-donation to post-reinfusion. Other labs had no significant changes.</p><p><strong>Conclusions: </strong>We noted a decrease in ionized calcium measurements post-reinfusion. Future studies should assess changes after larger volume transfusions and assess repletion methods.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood donor SARS-CoV-2 infection or vaccination and adverse outcomes in plasma and platelet transfusion recipients.","authors":"Nareg H Roubinian, John Greene, Bryan R Spencer, Marjorie Bravo, Roberta Bruhn, Paula Saa, Mars Stone, Brian Custer, Steve Kleinman, Vincent X Liu, Philip J Norris, Michael P Busch","doi":"10.1111/trf.18159","DOIUrl":"https://doi.org/10.1111/trf.18159","url":null,"abstract":"<p><strong>Background: </strong>Despite data supporting the safety of SARS-CoV-2 vaccination, concerns regarding the receipt of blood products from donors previously infected or vaccinated against SARS-CoV-2 persist. We assessed whether transfusions of plasma or platelet products from donors with prior SARS-CoV-2 infection or vaccination were associated with adverse outcomes in patients without COVID-19.</p><p><strong>Methods: </strong>We linked donor SARS-CoV-2 spike and nucleocapsid antibody data and vaccination history to blood products transfused between June 1, 2020 and March 31, 2022. We used logistic regression, adjusting for demographics and comorbidities, to calculate odds ratios and 95% confidence intervals (CI) for posttransfusion thrombosis, increased respiratory requirement, and hospital mortality. Outcomes were assessed as per transfused unit from previously infected or vaccinated donors compared to units from uninfected or unvaccinated donors.</p><p><strong>Results: </strong>Among 8715 hospitalizations of 7773 transfusion recipients linked to donor SARS-CoV-2 antibody data, there were 251 thromboses, 700 hospitalizations with increased respiratory requirements, and 1443 deaths. Among 15,167 transfused plasma units, 4993 and 1106 were from vaccinated donors and previously infected donors, respectively. Among 19,295 transfused platelet units, 8530 and 1368 were from vaccinated and previously infected donors, respectively. There were no associations between the transfusion of blood products from vaccinated or previously infected donors and thrombosis, increased respiratory requirements, or hospital mortality (all CI including 1). Nor were there associations between the receipt of blood products from recently infected or vaccinated donors or high SARS-CoV-2 antibody titers and adverse outcomes.</p><p><strong>Discussion: </strong>Donor SARS-Cov-2 infection and vaccination were not associated with adverse patient outcomes and do not need to be considered in blood allocation.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expected outcomes of stratified post-donation testing in whole blood donation in England: A discrete event simulation modeling study.","authors":"Hongchao Qi, Angela M Wood, Stephen Kaptoge, Amy McMahon, Susan Mehenny, Nathalie Kingston, Willem H Ouwehand, John Danesh, David J Roberts, Emanuele Di Angelantonio, Lois G Kim","doi":"10.1111/trf.18165","DOIUrl":"https://doi.org/10.1111/trf.18165","url":null,"abstract":"<p><strong>Background: </strong>In England, blood donors with low hemoglobin concentration are deferred following on-session testing to prevent donations below regulatory thresholds, thereby protecting donors' health and blood supply quality. However, deferrals are costly, time-consuming and may discourage donors. Post-donation testing (PDT), where hemoglobin levels are measured after donation, offer potential alternatives as used in some European countries.</p><p><strong>Study design and methods: </strong>We compared four PDT strategies to the current approach: (A) no on-session testing, (B) on-session testing if low hemoglobin at previous visit, (C) on-session testing if low/medium hemoglobin at previous visit, all with delayed reinvitation if low hemoglobin at previous donation, and (D) on-session testing if low/medium hemoglobin at previous visit without delayed reinvitations. We employed discrete event simulation modeling, informed by data collected from 16,941 donors returning under the current strategy in England, to simulate and compare total donations, under-threshold donations, and deferrals for each strategy over 18 months.</p><p><strong>Results: </strong>Strategy A eliminated deferrals but led to increased under-threshold donations compared to the current strategy in men (6.5% vs. 2.3%) and women (11.8% vs. 4.5%). Strategies B-D reduced deferrals rates for men (1.0%-3.7% vs. 5.5%) and women (2.2%-6.3% vs. 8.9%) but showed slightly higher under-threshold donations in men (3.0%-5.1% vs. 2.3%) and women (5.3%-8.8% vs. 4.5%). Strategies with more on-session testing had lower under-threshold donations.</p><p><strong>Discussion: </strong>PDT strategies incorporating on-session testing for low/medium hemoglobin at previous visits could reduce deferrals while maintaining a low proportion of under-threshold donations, thereby balancing donor safety with operational efficiency.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel molecular mechanism underlying the In(Lu) phenotype in Brazilians.","authors":"C P Arnoni, C S R Araújo, B A Machado, A Pasqualotti, N M Silva, A Cortez, F R M Latini, L Castilho","doi":"10.1111/trf.18169","DOIUrl":"https://doi.org/10.1111/trf.18169","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended storage of leukoreduced whole blood for transfusion stored in CPD from 21 to 35 days to improve prehospital blood supply logistics in rural areas.","authors":"Hanne Braathen, Turid Helen Felli Lunde, Geir Strandenes, Torunn Oveland Apelseth","doi":"10.1111/trf.18170","DOIUrl":"https://doi.org/10.1111/trf.18170","url":null,"abstract":"<p><strong>Background: </strong>Rural blood services with limited access to blood donors face challenges in supplying helicopter emergency medical services and local hospitals with leukoreduced whole blood. Extending the shelf life of whole blood can improve emergency preparedness during crises and conflicts and address critical transfusion needs and blood supply challenges. This study investigated whether the in vitro quality of stored leukoreduced whole blood in citrate-phosphate-dextrose (CPD) declined with extended storage for up to 35 days.</p><p><strong>Study design and methods: </strong>Twenty units of whole blood were collected in CPD (Imuflex, BB*LGQ456E6, Terumo BCT), leukoreduced with a platelet-sparing filter, and stored (2-6°C) for 35 days. The units were sampled on days 1, 21, 28, and 35, and hematology parameters, hemolysis, blood gas, glucose, coagulation, and thromboelastography were analyzed. Results were compared to historical controls (n = 26).</p><p><strong>Results: </strong>All units complied with European requirements throughout storage for 35 days, except one, which showed hemolysis of 0.9% on day 35. There was a decline in platelet count, hemostatic function, and plasma quality during storage. Comparisons with historical controls indicated few in vitro quality differences between CPD and CPDA-1 whole blood. Leukoreduction had a favorable effect on factor VIII concentration during storage.</p><p><strong>Conclusion: </strong>When comparing to European requirements, our results indicate that the shelf life of whole blood in CPD can be extended beyond 21 days. A risk-benefit analysis should be done to evaluate if shelf life can be extended to improve the availability of blood products for patients with severe bleeding in remote regions, crises, and war.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing HIV trends among blood donors in five Brazilian blood centers: The impact of individual donor assessment.","authors":"Renata Buccheri, Donald E Warden, Marcio Oikawa, Eduard Grebe, Carolina Miranda, Luiz Amorim, Paula Loureiro, Maisa Ribeiro, Nelson Fraji, Cesar de Almeida-Neto, Ester Sabino, Brian Custer","doi":"10.1111/trf.18168","DOIUrl":"https://doi.org/10.1111/trf.18168","url":null,"abstract":"<p><strong>Background: </strong>In many countries, including Brazil, time-based blood donation deferral policies for gay, bisexual, and other men who have sex with men (gbMSM) have been replaced by individual donor assessment (IDA). We examined HIV prevalence and incidence among first-time (FTD) and repeat donors (RD), comparing data from ~3.5 years before and after the IDA policy implementation in 2020.</p><p><strong>Study design and methods: </strong>The Recipient Epidemiology and Donor Evaluation Study-IV-Pediatric (REDS-IV-P) Brazil component collects blood donor screening data from five public centers. From January 2017 to December 2023, we report frequencies, rates, and 95% confidence interval (CI) of confirmed HIV-positive donations among FTD, HIV NAT-yield rates for FTD and RD, and the incidence of confirmed HIV among RD before and after the policy change. We also report multivariable regression analysis results.</p><p><strong>Results: </strong>Confirmed HIV prevalence in FTD was 79 per 100,000 (95% CI 72-87) before and 100 per 100,000 (95% CI 90-109) after the policy change, with differences between centers. HIV NAT-yield rates decreased for RD (p = .0025), with no change for FTD (p = .3). HIV incidence in RD did not increase (12.4 [95% CI: 11.1-13.9] vs. 10.3 [95% CI: 9-11.7] per 100,000 person-years).</p><p><strong>Discussion: </strong>Our findings showed no significant difference in HIV incidence among RD. Although HIV prevalence among FTD increased, there was no rise in HIV NAT-yield donations. The analysis highlights challenges in interpreting changes within specific groups and blood centers, underscoring the importance of multicenter monitoring of transfusion-transmitted infections.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of a novel missense variant (c.567G>A, p. Met189Ile) in ABO*B.01 allele.","authors":"Hua Wang, Fei Wang, Zhicheng Li, Yajun Liang, Yi Xu, Jiangtao Zuo, Qing Li, Ruiqing Guo, Yunxiang Wu, Demei Zhang","doi":"10.1111/trf.18175","DOIUrl":"https://doi.org/10.1111/trf.18175","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrative review: Resuscitation of older adults with hemorrhagic shock.","authors":"Mohammad Al Ma'ani, Adam Nelson, Francisco Castillo Diaz, Audrey L Specner, Muhammad Haris Khurshid, Tanya Anand, Omar Hejazi, Michael Ditillo, Louis J Magnotti, Bellal Joseph","doi":"10.1111/trf.18173","DOIUrl":"https://doi.org/10.1111/trf.18173","url":null,"abstract":"<p><strong>Background: </strong>The increasing population of older adults presents unique challenges in trauma care due to their reduced physiologic reserve compared to younger patients. Trauma-induced hemorrhage remains a leading cause of mortality, yet there is a significant gap in the optimal management of hemodynamically unstable older adults. This review aims to synthesize current literature on resuscitation strategies, coagulopathy, triage, and the impact of timely interventions in older adult trauma patients experiencing hemorrhagic shock.</p><p><strong>Study design and methods: </strong>A comprehensive narrative review was conducted following PRISMA-Scr guidelines. A systematic literature search was performed using PubMed, Scopus, and Web of Science databases, yielding 380 titles. After removing duplicates, 287 unique articles were screened, of which 120 full-text articles were reviewed. A total of 45 studies met the inclusion criteria and were analyzed. Studies were categorized based on resuscitation protocols (14 studies), coagulopathy management (7 studies), frailty and aging physiology (10 studies), and timing/triage in trauma care (14 studies).</p><p><strong>Results: </strong>Studies highlight the effectiveness of the shock index (SI) over traditional vital signs for identifying hemodynamic instability in older adults. Balanced transfusion ratios and whole blood resuscitation show potential benefits, though data specific to older adults remain limited. Goal-directed resuscitation protocols improve outcomes by addressing the unique physiological needs of this population. While trauma-induced coagulopathy rates are similar across age groups, older adults frequently present with pre-existing anticoagulation, complicating management. Standardized care pathways, early activation of massive transfusion protocols (MTP), and tailored resuscitation approaches are critical for optimizing care.</p><p><strong>Discussion: </strong>The growing geriatric trauma population necessitates improved resuscitation strategies tailored to their unique physiological responses. While balanced transfusions and goal-directed protocols have demonstrated efficacy, further research is required to refine these interventions specifically for older adults. Establishing standardized resuscitation guidelines and defining futility criteria will enhance decision-making and improve outcomes for this vulnerable population.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transfusion quantities associated with 24-h mortality in trauma patients.","authors":"Mary L Wallace, Ryan A Kingrey, Julie A Rizzo, Michael D April, Andrew D Fisher, Maxwell A Braverman, Mark H Yazer, Steven G Schauer","doi":"10.1111/trf.18172","DOIUrl":"https://doi.org/10.1111/trf.18172","url":null,"abstract":"<p><strong>Introduction: </strong>Data on the correlation between transfusion volumes and trauma mortality are limited. The association between the total number of red blood cell (RBC) and low titer group O whole blood (LTOWB) units, as well as the total volume of all transfused products that were administered up to 4-h after admission and 24-h mortality was determined.</p><p><strong>Methods: </strong>The Trauma Quality Improvement Program (TQIP) datasets from 2020 to 2022 were reviewed to identify patients aged ≥15 who received any volume of blood products. Receiver operating characteristic (ROC) were constructed along with the calculated area under the ROC curve (AUROC) to determine the association between the quantity of transfusion and 24-h mortality.</p><p><strong>Results: </strong>There were 144,379 encounters that met inclusion, with 22,467 patients who died within the first 24 h. There was a 90% probability of 24-h mortality following the transfusion of 56 RBC/LTOWB units (AUROC 0.673), with the 90% specificity, Youden's index, and 90% sensitivity surrounding this probability occurring after the transfusion of 8, 4, and 2 units, respectively. In terms of the volume of transfusion, there was a 90% probability of 24-h mortality following the transfusion of 36,000 mL of all blood products combined (AUROC 0.662), with the 90% specificity, Youden's index, and 90% sensitivity surrounding this probability occurring after the transfusion of 4400, 2000, and 500 mL, respectively.</p><p><strong>Conclusions: </strong>Both the total number of RBC and LTOWB units transfused and the total volume of all blood products transfused demonstrated poor predictive association with the risk of 24-h mortality in the civilian trauma population.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}