Twin Research and Human Genetics最新文献

{"title":"Gene-Breastfeeding Interaction on Body Mass Index Among Chinese Twins Aged 2-18 Years.","authors":"Hui Cao, Wenjing Gao, Weihua Cao, Jun Lv, Canqing Yu, Shengfeng Wang, Tao Huang, Dianjianyi Sun, Chunxiao Liao, Yuanjie Pang, Min Yu, Jinyi Zhou, Xianping Wu, Zhong Dong, Fan Wu, Dezheng Wang, Jie Yin, Shengli Yin, Liming Li","doi":"10.1017/thg.2026.10052","DOIUrl":"https://doi.org/10.1017/thg.2026.10052","url":null,"abstract":"<p><p>The objective of this study was to investigate the gene-breastfeeding interaction on BMI based on the Chinese National Twin Register (CNTR). The study included 4,573 pairs of same-sex twins aged 2-18 from CNTR. Data were collected using a self-reported questionnaire, and a structural equation model was used to analyze the gene-environment interaction of breastfeeding with BMI in six age groups. Our findings indicate that as age increases, the heritability of BMI shows an increasing trend, being the lowest (h²: 0.08; 95% CI [0.00, 0.19]) in the 6- to 8-year age group and the highest (h²: 0.57, 95% CI [0.44, 0.72]) in the 12- to 14-year age group. Additionally, breastfeeding significantly modified the additive genetic component of BMI in the 6- to 8-year age group and 12- to 14-year age group. In the 6- to 8-year age group, breastfeeding decreased the impact of genes on BMI, with a genetic effect modification coefficient (βa) of -0.19 (-0.25, -0.13). In the 12- to 14-year age group, breastfeeding increased the impact of genes on BMI, with a genetic effect modification coefficient (βa) of 0.08 (0.02, 0.15). In conclusion, as age increases, the genetic influence on children's BMI becomes more pronounced. Breastfeeding may modulate genetic effects at the ages of 6-8 and 12-14. Given the metabolic diversity of obesity, our findings offer insight into how breastfeeding interacts with genetic background, helping to unravel the complex gene-environment interplay influencing obesity.</p>","PeriodicalId":23446,"journal":{"name":"Twin Research and Human Genetics","volume":" ","pages":"1-6"},"PeriodicalIF":1.2,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692560","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":"Trends in Birth Rates, Sex Ratio, and Infant Mortality Rates Among Singletons, Twins, and Higher Order Multiples in Brazil Between 2010 and 2023.","authors":"Tania Kiehl Lucci, Bernardo Schonhorst de Oliveira, Claudia Monteiro Peixoto, Isabella Ribeiro Rodrigues, Claudio Possani, Ricardo Prist, Nancy L Segal, Edna Lúcia Tinoco Ponciano, Silvia Regina Dias Medici Saldiva, Mariana Azevedo Carvalho, Emma Otta","doi":"10.1017/thg.2026.10061","DOIUrl":"https://doi.org/10.1017/thg.2026.10061","url":null,"abstract":"<p><p>This study examines birth rates and infant mortality rates in Brazil among singletons, twins, and higher order multiples between 2010 and 2023. Data were obtained from the Brazilian Ministry of Health's Live Birth Information System and Infant Mortality Information System. The dataset comprised 39,663,928 live births and 464,843 infant deaths occurring within the first year of life. Twin birth rates increased steadily over time, while singleton birth rates declined. The highest twin birth rates were observed in the Southeast (11.64‰) and South (11.47‰), whereas the lowest were observed in the North (7.81‰) and Northeast (9.23‰). Infant mortality among twins was approximately five times higher than among singleton, and higher order multiples faced an approximately threefold greater risk compared to singletons. Infant mortality rates were highest in the North and Northeast and lowest in the Southeast and South. Sex ratios varied by gestation type, with singletons showing the expected male bias and twins a slightly reduced male proportion, reflecting biological and regional influences on birth rates in Brazil. The data reveal a marked demographic shift between 2010 and 2023, with birth rates declining among women in their teens and 20s and increasing among those in their late 30s and 40s. Using Weinberg's differential method, we identified divergent trends in zygosity: dizygotic birth rates increased significantly over time, whereas monozygotic rates remained stable. This contrast underscores the environmentally responsive nature of dizygotic twinning, particularly its association with advancing maternal age and assisted reproductive technologies, compared to the relatively biologically stable pattern of monozygotic twinning.</p>","PeriodicalId":23446,"journal":{"name":"Twin Research and Human Genetics","volume":" ","pages":"1-10"},"PeriodicalIF":1.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677239","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":"umx version 4.5: Extending Twin and Path-Based SEM in R with CLPM, MR-DoC, Definition Variables, Ωnyx Integration, and Censored Distributions.","authors":"Luis F S Castro-de-Araujo, Nathan A Gillespie, Michael C Neale, Timothy Charles Bates","doi":"10.1017/thg.2026.10056","DOIUrl":"https://doi.org/10.1017/thg.2026.10056","url":null,"abstract":"<p><p>Structural equation modeling (SEM) is a flexible statistical technique with multiple applications, including behavioral genetics and social sciences. Building on the original design of the umx package, which improved accessibility to OpenMx by specifying a concise syntax, umx v4.5 extends functionality for longitudinal and causal twin designs while improving interoperability with graphical modeling tools such as Onyx. New capabilities include: classic and modern cross-lagged panel models; Mendelian Randomization Direction-of-Causation (MR-DoC) twin models incorporating polygenic scores as instruments; support for definition variables directly in umxRAM(); a workflow for importing paths from Ωnyx; a dedicated function for incorporating censored variables' data into models, particularly valuable in biomarker research; improved covariate placeholder handling for definition variables; sex-limitation modeling across five twin groups, accommodating quantitative and qualitative sex differences; and covariate residualization in wide- or long-format data. These new functionalities accelerate reproducible, reliable, publication-ready twin and family modeling, and integrated journal-quality reporting, thereby lowering barriers to genetic epidemiological analyses.</p>","PeriodicalId":23446,"journal":{"name":"Twin Research and Human Genetics","volume":" ","pages":"1-6"},"PeriodicalIF":1.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628750","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":"How Genomic and Structural Context Could Shape JAK-STAT Variant Pathogenicity.","authors":"Markus Hoffmann, Hye Kyung Lee","doi":"10.1017/thg.2026.10054","DOIUrl":"10.1017/thg.2026.10054","url":null,"abstract":"<p><p>The Janus kinase (JAK)-Signal Transducer and Activator of Transcription (STAT) pathway is essential for cellular signal transduction, regulating immune responses, hematopoiesis, and cell proliferation. Dysregulation of JAK-STAT signaling due to genetic variations, particularly missense mutations, has been implicated in autoimmune disorders, cancers, and hematological malignancies. This study investigates missense mutations in JAK and STAT genes, focusing on disease-associated single nucleotide polymorphisms (SNPs) and ClinVar benign variants identified in the All of Us and COSMIC databases. We analyzed the distribution of these mutations across functional domains, their structural localization, and biochemical properties. We identified mutation hotspots within specific domains, highlighting their correlation with disease phenotypes. Structural mapping revealed that disease-associated SNPs predominantly localize in linker regions and at the boundaries of secondary structures, suggesting a significant impact on folding, stability, and function of JAK and STAT proteins. Additionally, we examined the genomic context of mutations and identified vulnerable sequences; for example, 'GATC'. Furthermore, our analysis found no predominant association between potential CRISPR-Cas9 target sites and ClinVar benign/disease-associated SNPs. The analysis of amino acid sequence patterns surrounding mutations uncovered an enrichment of hydrophobic residues leucine (Leu), isoleucine (Ile), methionine (Met), and phenylalanine (Phe) in close proximity to disease-associated mutations. Our findings emphasize the importance of structural and biochemical context in determining pathogenicity. In this study, we provide a bioinformatic strategy for refining variant classification and understanding the roles of JAK-STAT pathway mutations in disease.</p>","PeriodicalId":23446,"journal":{"name":"Twin Research and Human Genetics","volume":" ","pages":"1-13"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monozygotic Twins of Different Religions: Causes and Consequences/Twin Research Reviews: Language Development in Dizygotic Twins; MZ Twins with Hallermann-Streiff Syndrome; Digital Twins and Asthma Research; Zygosity Revealed/Human Interest: A Pen Turned Holocaust Children Into Twins; Identical Twin <i>Jeopardy</i> Winners; Twin Hostages Freed From Gaza; Loss of a Twin Son; Fraternal Twin Mountaineers; Twins in the Sydney to Hobart Yacht Race; Twin Patron Saints of Cobblers.","authors":"Nancy Segal","doi":"10.1017/thg.2026.10051","DOIUrl":"https://doi.org/10.1017/thg.2026.10051","url":null,"abstract":"<p><p>Monozyotic (MZ) twins reared together are typically raised in the same religion, as are all children in a family. However, a young pair of MZ male twins, raised together, but with different religions, was identified and raises interesting issues that warrant consideration. This case, as well as those of reared-apart MZ twins who adopt different religions due to their family background or other circumstances, are summarized. A review of recent and current twin research follows. The studies included here concern language development in a pair of dizygotic (DZ) female twins, the second case of MZ twins with presumed Hallermann-Streiff syndrome, and the use of digital twins to advance asthma research. The final entry in the research section describes parents' responses to their twin children's misdiagnosed zygosity. Human interest stories involving twins - some entertaining, but all informative - include a pen that saved nontwin Holocaust children by assigning them as twins, identical twin <i>Jeopardy</i> winners, twin hostages freed from Gaza, loss of a twin son, fraternal twin mountaineers, twin sailors in the Sydney to Hobart Yacht Race, and the twin Patron Saints of Cobblers.</p>","PeriodicalId":23446,"journal":{"name":"Twin Research and Human Genetics","volume":" ","pages":"1-6"},"PeriodicalIF":1.2,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515134","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":"India's Twin Paradox: Abundant Resource, Absent Research.","authors":"Ruby Dhar, Subhradip Karmakar","doi":"10.1017/thg.2026.10049","DOIUrl":"https://doi.org/10.1017/thg.2026.10049","url":null,"abstract":"<p><p>India's rising twin birth rate, driven by assisted reproductive technologies and delayed childbearing, generates approximately 30,000-40,000 twin pairs annually, yet this invaluable research resource remains systematically underutilized. While established twin registries in the United Kingdom, Australia, and Nordic countries have transformed understanding of disease heritability and gene-environment interactions, India, despite its 1.4 billion population and exceptional genetic diversity, lacks a coordinated infrastructure to capitalize on this scientific opportunity. Twin studies provide nature's ideal control experiment, enabling researchers to disentangle genetic predisposition from environmental influences through comparison of monozygotic and dizygotic pairs, with discordant twins offering particularly powerful insights into modifiable risk factors. India's extraordinary genetic heterogeneity, encompassing over 4600 distinct population groups, coupled with rapid environmental transitions including urbanization, dietary shifts, and pollution exposure, creates unparalleled natural experiments for investigating conditions demonstrating marked interpopulation variation such as type 2 diabetes, cardiovascular disease, and neuropsychiatric disorders. Establishing a National Twin Registry through a federated model linking existing birth registries with opt-in research participation, leveraging digital health infrastructure like Ayushman Bharat Digital Mission, would require modest investment while generating insights applicable across the disease spectrum. Initiating pilot registries in states with robust health systems such as Kerala, Tamil Nadu or Karnataka would enable iterative refinement before national expansion. International collaborations with established registries could accelerate development while preserving data sovereignty through robust governance frameworks. A National Twin Registry represents a strategic imperative for transitioning India from a research subject pool to a research leader in precision medicine, enabling Indian investigators to drive discovery addressing India-specific health priorities.</p>","PeriodicalId":23446,"journal":{"name":"Twin Research and Human Genetics","volume":" ","pages":"1-2"},"PeriodicalIF":1.2,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499828","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":"Association Between Gestational Weight Gain And Spontaneous Preterm Birth In Chinese Women With Twin Pregnancies.","authors":"Lesha Wang, Yibo Tang, Ying Hu, Uwimana Muhuza Marie Parfaite, Menglin Zhou, Danqing Chen, Zhaoxia Liang","doi":"10.1017/thg.2025.10038","DOIUrl":"https://doi.org/10.1017/thg.2025.10038","url":null,"abstract":"<p><p>The studies on the association between maternal gestational weight gain (GWG) and spontaneous preterm birth (SPTB) in twin pregnancies are limited and inconsistent. There are no standardized guidelines for GWG in twin pregnancies in China. This retrospective cohort study included 1510 women who delivered living twins from January 1, 2015 to December 31, 2019. The basic demographics and outcomes of mothers and neonates were listed, and logistic regression was used to analyze the relationship between GWG and SPTB in the total population and different subgroups. In the overall population, 464 (30.7%) women had inadequate GWG, and 316 (20.9%) women had excess GWG. Compared to women with adequate GWG, women with inadequate GWG had a significantly higher risk of SPTB (adjusted odds ratio [<i>aOR</i>]: 2.46, 95% CI [1.92, 3.15]), while women with excess GWG also had a significantly higher risk of SPTB (<i>aOR</i>: 1.48, 95% CI [1.12, 1.95]). Both inadequate GWG and excess GWG had a significantly higher risk of SPTB in normal-weight women and women with dichorionic diamniotic twins. Only IGWG was significantly associated with SPTB in women with monochorionic diamniotic twins and underweight women. Our findings indicate that inadequate GWG and excess GWG were significantly associated with a higher risk of SPTB, providing an empirical basis for establishing weight gain guidelines for women with twin pregnancies in China.</p>","PeriodicalId":23446,"journal":{"name":"Twin Research and Human Genetics","volume":" ","pages":"1-9"},"PeriodicalIF":1.2,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228745","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":"International Normative Charts for Twin Weight, Length, and Head Circumference at Birth, By Gestational Age and Sex: The Twin Neonatal Cross-Sectional Study of the INTERGROWTH-21st Project.","authors":"Francesca Giuliani, Sonia Deantoni, Enrico Bertino, Yasmin A Jaffer, Manorama Purwar, Fernando C Barros, Leila Cheikh Ismail, Wu Qingqing, Ilaria Stura, Maria Carvalho, Serena Gandino, Adele Winsey, Michael G Gravett, Zulfiqar A Bhutta, Aris T Papageorghiou, Giuseppe Migliaretti, Stephen H Kennedy, Jose Villar","doi":"10.1017/thg.2025.10032","DOIUrl":"https://doi.org/10.1017/thg.2025.10032","url":null,"abstract":"<p><p>Assessing the size of twins at birth using charts developed for singletons may over diagnose small for gestational age in this sub-population. The study aimed to produce international, twin-specific, newborn size normative charts by gestational age and sex. This longitudinal observational study in eight geographically diverse settings prospectively collected data between May 2009 and August 2013 from healthy pregnant women and their newborn twins. The participants were enrolled as part of the INTERGROWTH-21st study, and recruited based on World Health Organization recommendations for evaluation of anthropometric measures. All the women met, in addition to the underlying population characteristics of low perinatal risk, strict individual criteria for a population at low risk of impaired fetal growth. Newborn weight, length and head circumference measures were collected independently in duplicate by two trained anthropometrists within 12 hours of birth using identical equipment and protocols at all sites. From 1034 multiple pregnancies, after exclusions of condition such as smoking, high maternal BMI, and congenital malformations, the final sample was 864 twin newborns. Most of the twins were below the 50th centile of the INTERGROWTH-21st standards for singletons. We present international newborn size normative charts for twins using the same methodological approach adopted to construct the singleton standards.</p>","PeriodicalId":23446,"journal":{"name":"Twin Research and Human Genetics","volume":" ","pages":"1-16"},"PeriodicalIF":1.2,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158532","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":"Catch-Up Growth in Twins: The Influence of Chorionicity and Zygosity from Birth to School Age.","authors":"Luis Correia, Tania Kiehl Lucci, Lucas Moura, Claudia Monteiro Peixoto, Maria de Lourdes Brizot, Mario Henrique Burlacchini de Carvalho, Vera Krebs, Mariana Azevedo Carvalho, Julia Gomes Freitas, Rafael Albuquerque, Timon Lebaron-Khérif, Isabella França Ferreira, Giovanna Arissi, Lilian C Luchesi, Ricardo Pris, Emma Otta","doi":"10.1017/thg.2025.10042","DOIUrl":"https://doi.org/10.1017/thg.2025.10042","url":null,"abstract":"<p><p>This study evaluated the growth trajectories of twins from birth to school age, focusing on weight and height <i>z</i> scores of children born in São Paulo. The longitudinal study comprised 188 healthy twins (<i>M</i> = 9.13 years; <i>SD</i> = 2.16). Weight data were obtained from birth records and reassessed at school age, and height at school age. Singleton birth weights and standard growth curves were used as reference points. Overall, the proportion of children with <i>z</i> scores below the median decreased significantly, from 98.3% at birth to 31.4% at school age. At birth, the dispersion of <i>z</i>-scores below the median was significantly greater among monochorionic compared to dichorionic twins (2.051 vs. 1.701), but this difference was no longer observed at school age (1.861 vs. 0.976). In total, 68.8% of the twins showed improved weight development, with no cases of deterioration. While monozygotic (MZ) and dizygotic (DZ) twin pairs exhibited comparable intertwin birth-weight differences, by school age MZ pairs exhibited more similar weights, whereas DZ pairs showed significantly greater weight discrepancies. For height at school age, mean height <i>z</i> scores were within the expected range for singletons. No significant differences were observed between monochorionic and dichorionic twins, whereas MZ pairs showed smaller within-pair height differences than DZ pairs. These findings suggest that although chorionicity plays an important role during the perinatal period - particularly due to the lower birth weights observed among monochorionic twins - its influence diminishes over time. By school age, weight and height differences are primarily determined by zygosity.</p>","PeriodicalId":23446,"journal":{"name":"Twin Research and Human Genetics","volume":" ","pages":"1-7"},"PeriodicalIF":1.2,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126502","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":"Reared-Apart Twins From the Philippines: New Views of Lingering Questions/Twin Research Reviews: Twin Discordance for Multisystem Inflammatory Syndrome; IVF Twins and Hearing Impairment; Writing Styles of MZ Twins; Update on Twins with Feingold Syndrome/Human Interest: Conjoined Twin Girls Born in Sri Lanka, Conjoined Twin Boys Born in Papua, New Guinea, Update on Conjoined Twins Abby and Brittany Hensel, Twin Sentenced for Criminal Activities, and Correct Identification of an Identical Twin Culprit by DNA Sequencing.","authors":"Nancy L Segal","doi":"10.1017/thg.2025.10041","DOIUrl":"https://doi.org/10.1017/thg.2025.10041","url":null,"abstract":"<p><p>This article presents an overview of the life histories of reared-apart twins from the Philippines. One twin always knew he was a twin, but for the other twin the discovery at age 15 came as a shock. This essay is followed by summaries of recent twin research of interest. Topics include twin discordance for multisystem inflammatory syndrome, in vitro fertilization (IVF) twins and possible associations with impaired hearing, the writings of monozygotic (MZ) twins, and an update on MZ twins with Feingold syndrome whom I have covered in a previous issue of this journal. This essay concludes with several twin-related human interest stories, namely conjoined twin girls from Sri Lanka, conjoined twin boys from Papua, New Guinea, recent information concerning conjoined twins Abby and Brittany Hensel, a twin sentenced for criminal activities, and accurate identification of an identical twin culprit by DNA sequencing.</p>","PeriodicalId":23446,"journal":{"name":"Twin Research and Human Genetics","volume":" ","pages":"1-5"},"PeriodicalIF":1.2,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047197","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}