Vox Sanguinis最新文献

{"title":"The efficacy and effectiveness of drinking interventions to reduce vasovagal reactions in blood donors: A systematic review and meta-analysis.","authors":"Hans Van Remoortel, Dieter Van de Sande, Dieter Maes, Jina Khoudary, Veerle Tavernier, Pierre Tiberghien, Emmy De Buck, Veerle Compernolle","doi":"10.1111/vox.13724","DOIUrl":"10.1111/vox.13724","url":null,"abstract":"<p><strong>Background and objectives: </strong>Blood establishments strive to ensure the safety and comfort of blood donors while minimizing adverse events. This review aims to assess the efficacy and effectiveness of eating and/or drinking interventions before, during and/or after blood donation in reducing vasovagal reactions (VVRs).</p><p><strong>Materials and methods: </strong>We analysed randomized and non-randomized controlled trials comparing eating and/or drinking interventions to no intervention, placebo or usual practice on (pre-)syncopal VVRs and related symptoms. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach was used to assess the risk of bias and overall certainty of the evidence.</p><p><strong>Results: </strong>Pre-donation water ingestion likely results in reduced on-site VVRs, compared to no water (2 fewer per 100 donors, moderate-certainty evidence). A pre-donation isotonic drink likely results in reduced VVRs, compared to usual practice (2 fewer per 100 donors, moderate-certainty evidence). Pre-donation salt-loaded sweetened lemon water may result in fewer off-site VVRs, compared to sweetened lemon water only (1 fewer per 100 donors, low-certainty evidence). Pre-donation water and a gel cap containing sucrose with 250 mg caffeine may result in fewer blood donor reaction ratings, compared to pre-donation water only (low-certainty evidence).</p><p><strong>Conclusions: </strong>Pre-donation plain water ingestion or isotonic drink probably results in a large reduction in on-site and off-site VVRs. Pre-donation water ingestion with caffeine consumption or salt supplementation may result in a VVR reduction, compared to water ingestion only. Future large trials are required to increase the certainty of the effect of these and other interventions in the prevention of VVRs.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1129-1140"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141245","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":"Use of preoperative erythropoietin-stimulating agents is associated with decreased thrombotic adverse events compared to red blood cell transfusion in surgical patients with anaemia.","authors":"Una E Choi, Ryan C Nicholson, Steven M Frank, Stephanie Cha, Brian C Cho, Jennifer S Lawton, Laeben C Lester, Nadia B Hensley","doi":"10.1111/vox.13729","DOIUrl":"10.1111/vox.13729","url":null,"abstract":"<p><strong>Background and objectives: </strong>Preoperative red blood cell (RBC) transfusions increase post-operative venous thromboembolic (VTE) events. Erythropoietin-stimulating agents (ESAs) increase VTE risk in cancer patients; we aimed to assess ESA versus RBC-associated VTE risks in a broad population of surgical patients.</p><p><strong>Materials and methods: </strong>We queried TriNetX Diamond Network from 2006 to 2023, comparing patients with anaemia within 3 months preoperatively who received preoperative ESAs with or without intravenous (IV) iron to patients who received preoperative RBCs. Sub-analyses included (1) all surgeries and (2) cardiovascular surgeries. We propensity score matched for demographics, comorbidities, medical services, post-treatment haemoglobin (g/dL) and, for all-surgery comparisons, surgery type. Outcomes included 30-day post-operative mortality, VTE, pulmonary embolism (PE), disseminated intravascular coagulation (DIC) and haemoglobin.</p><p><strong>Results: </strong>In our 19,548-patient cohorts, compared with preoperative RBC transfusion, ESAs without IV iron were associated with lower mortality (relative risk [RR] = 0.51 [95% confidence interval (CI), 0.45-0.59]), VTE (RR = 0.57 [0.50-0.65]) and PE (RR = 0.67 [0.54-0.84]). Post-operative haemoglobin was higher in the ESA without IV iron cohort compared with the transfusion cohort (10.0 ± 1.4 vs. 9.4 ± 1.8 g/dL, p = 0.002). Cardiac surgical patients receiving ESAs with or without IV iron had lower risk for post-operative mortality, VTE and PE (p < 0.001) than those receiving RBCs. Post-operative haemoglobin differed between patients receiving ESAs with IV iron versus RBCs (10.1 ± 1.5 vs. 9.4 ± 1.9 g/dL, p = 0.0009).</p><p><strong>Conclusion: </strong>Compared with surgical patients who were transfused RBCs, ESA recipients had reduced 30-day post-operative risk of mortality, VTE, PE and DIC and increased haemoglobin levels. IV iron given with ESAs improved mortality.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1174-1182"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018750","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":"Non-neutralizing antibody profiles against hepatitis B virus: A comparative study of Japanese- and US-donor-derived intramuscular human hepatitis B-specific immunoglobulin preparations.","authors":"Tatsuki Miyamoto, Hiroko Okamoto, Shoya Hori, Kei Sato, Katsushi Murai","doi":"10.1111/vox.13742","DOIUrl":"10.1111/vox.13742","url":null,"abstract":"","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1214-1216"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366723","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":"Repeated apheresis donations cause important iron deficiency in male Japanese donors.","authors":"Takeshi Odajima, Nelson H Tsuno, Junko Iwasaki, Koji Matsuzaki, Fumihiko Ishimaru, Rie Okubo, Junko Murakami, Kaori Kitsukawa, Katsuya Ikuta, Kazuo Muroi, Masahiro Satake, Shuichi Kino","doi":"10.1111/vox.13720","DOIUrl":"10.1111/vox.13720","url":null,"abstract":"<p><strong>Background and objectives: </strong>In Japan, apheresis donation of plasma is allowed to a maximum of 24 times a year, and plateletpheresis are counted as two plasmapheresis donations. Diversion of the initial blood flow is conducted for all donations, and additionally, blood remaining in apheresis machine circuit is lost. Here, we aimed to investigate on the health impact of frequent apheresis donations, as measured by the serum ferritin (sFer).</p><p><strong>Materials and methods: </strong>A total of 538 male apheresis donors and 538 age-matched whole blood (WB) donors, who gave informed consent to join the study, were enrolled. sFer were compared, according to age. Another group of 19 apheresis donors were followed during four consecutive donations.</p><p><strong>Results: </strong>About half (48%) of repeat male apheresis donors had iron deficiency (sFer < 26 ng/mL), compared with lower rates (13.9%) among male WB donors. It was evident in all age groups, except for teenagers, possibly because of the lower number of donations. Follow-up of the 19 donors for 4 months revealed a progressive decrease in sFer.</p><p><strong>Conclusion: </strong>Blood remaining in the apheresis machine circuit and diversion of the initial blood flow have been implicated in iron deficiency for many years. Taking the present results, the manufacturer of apheresis equipment was requested to improve it to allow rinseback of the remaining blood, which was achieved only for plateletpheresis. Until further improvement, plasmapheresis frequency was reduced to 12 times a year. Additional measures, such as oral supplementation of iron, need to be considered.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1141-1149"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971954","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":"Blood donor questionnaires and infectious disease screening in Latin American countries.","authors":"Gisela Marrero-Rivera, Michel-Andrés García-Otálora, Carlos Gonzalez, José Pérez-Carrillo, Paolo Rojas, Paula Castellanos, Melissa Granados, Guillermo Herrera, Celina Montemayor, Sara Bakhtary","doi":"10.1111/vox.13730","DOIUrl":"10.1111/vox.13730","url":null,"abstract":"<p><strong>Background and objectives: </strong>Blood donor questionnaires are tools used to screen prospective blood donors to determine their eligibility. There are limited data regarding blood donor questionnaires and infectious disease screening of the blood supply in Latin American countries. This study aimed to survey donor centres in Latin American countries to learn more about blood donor screening and infection assessment.</p><p><strong>Materials and methods: </strong>An international team of transfusion medicine professionals including medical directors and supervisors who work or collaborate with Latin American donor centres, called 'Comité de Investigación en Medicina Transfusional', designed a survey (16 questions) to characterize blood donor eligibility in Latin America.</p><p><strong>Results: </strong>Eighty-two institutions from 14 Latin American countries responded to the survey. Most donor centres (66%; 54 of 82) had a donor deferral percentage between 5% and 25%, and the most common causes of deferrals were low haemoglobin and high-risk behaviour. Most donors in blood centres were directed family donors compared with voluntary donors. Infection evaluation included mostly serologic assessment (81%; 30 of 37) for human immunodeficiency virus (HIV), Hepatitis B, Hepatitis C, Treponema pallidum and Trypanosoma cruzi rather than nucleic acid tests (5%; 2 of 37).</p><p><strong>Conclusion: </strong>Heterogeneity exists in donor selection and infectious disease screening in Latin American countries. This survey provides valuable information to understand Latin American blood centre practices.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1201-1206"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093923","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":"Navigating the Asia-Pacific region plasma therapies landscape: Insights from the 2023 Asia-Pacific Plasma Leaders' Network meetings.","authors":"Sonu Bhatnagar, Thierry Burnouf, Johan Prevot, Jean-Claude Faber, René Büechel, Yuyun Siti Maryuningsih, Bach Quoc Khanh, Nguyen Thi Mai, Hideo Nakanishi, Masako Kataoka","doi":"10.1111/vox.13725","DOIUrl":"10.1111/vox.13725","url":null,"abstract":"<p><p>The Asia-Pacific Plasma Leaders' Network (APPLN) plays a crucial role in addressing the regional shortage of plasma-derived medicinal products (PDMPs), particularly in low- and middle-income countries (LMICs). It provides a platform for experts to share their expertise and drive multi-stakeholder collaborations. While several PDMPs are acknowledged by the World Health Organization (WHO) as life-saving therapeutics on the Model List of Essential Medicine for treating various chronic and acute life-threatening diseases, there are still many inadequacies in the availability and affordability of PDMPs. These challenges arise from insufficient domestic supplies of plasma suitable for fractionation, as well as a lack of technical and financial capabilities to implement contract or domestic plasma fractionation programmes. At two separate dialogue forums organized by the APPLN in 2023, experts discussed the unmet needs of PDMPs for individuals living with haemophilia and immunodeficiencies in the region. They also highlighted the limited access to early diagnosis and patient-centred care in several LMICs. To address these issues, there is an urgent need to increase the availability of high-quality domestic plasma for fractionation. Adopting a stepwise approach to utilize unused recovered plasma and establishing contract fractionation programmes could be viable strategies to potentially enhance PDMP availability in LMICs. However, achieving this goal requires improving existing domestic infrastructures for blood collection, implementing adequate policy reforms and fostering competent local leadership. Ultimately, there is no 'one-size-fits-all' strategy for securing safe plasma proteins for all patients in need. Collaborative efforts are essential for achieving progressive self-sufficiency in PDMPs.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1207-1213"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005436","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":"Donor knowledge and perceptions regarding donation-induced iron depletion and iron supplementation as a blood service policy.","authors":"Jan H M Karregat, Franke A Quee, Jos W R Twisk, Katja van den Hurk","doi":"10.1111/vox.13712","DOIUrl":"10.1111/vox.13712","url":null,"abstract":"<p><strong>Background and objectives: </strong>Regular whole blood donations are associated with an increased risk of iron deficiency. Iron supplementation is an effective strategy to prevent donation-induced iron deficiency. However, research on donor perceptions towards such a policy is limited. Therefore, we aim to evaluate donors' knowledge on donation-induced iron depletion and their perceptions regarding iron supplementation as a blood service policy.</p><p><strong>Materials and methods: </strong>Three thousand Dutch whole blood donors were invited to complete a survey assessing their knowledge of donation-induced iron depletion and attitudes and perceptions towards iron supplementation as a policy. Linear regression modelling was used to evaluate associations between explanatory variables and perceptions.</p><p><strong>Results: </strong>In total, 1093 (77.1%) donors were included in the analysis. Donors had poor knowledge of current iron management policies, but a better understanding of iron metabolism and supplementation. Iron supplementation as a policy was perceived mainly positive by donors, and the majority were willing to use iron supplements if provided. Iron supplementation was not perceived as invasive or negatively affecting donors' motivation to continue donating. Additional iron monitoring, information and donor physician involvement were regarded as important conditions for implementation. Male sex, trust in the blood service, prior experience with iron supplements and openness towards dietary supplements were strongly positively associated with willingness to use iron supplementation.</p><p><strong>Conclusion: </strong>Donors' knowledge regarding donation-induced iron depletion is limited, but not associated with their perceptions regarding iron supplementation. Donors do not consider iron supplementation as invasive, deterring or demotivating, and a majority are willing to take supplements if offered.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1047-1057"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141580957","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":"Quantification of the contribution of individual coagulation factors to haemostasis using a microchip flow chamber system and reconstituted blood from deficient plasma.","authors":"Akihiro Fuchizaki, Kazuta Yasui, Tomoya Hayashi, Yoshihiro Fujimura, Chiaki Oyamada, Tomoko Ohnishi-Wada, Kazuya Hosokawa, Kazushige Shimogaki, Takafumi Kimura, Fumiya Hirayama, Yoshihiro Takihara","doi":"10.1111/vox.13709","DOIUrl":"10.1111/vox.13709","url":null,"abstract":"<p><strong>Background and objectives: </strong>Quantifying the contribution of individual coagulation factors to haemostasis may aid our understanding of the haemostatic function in patients with rare coagulation deficiencies (RCDs) and the exploration of suitable treatments.</p><p><strong>Materials and methods: </strong>Reconstituted blood prepared from specific coagulation factor-deficient plasma (factor [F]II; prothrombin, FV, FVII, FVIII, FIX, FX, FXI or FXII) and red blood cell/platelet products were used to simulate the whole blood of patients with RCD. We prepared in vitro treatment models for patients with prothrombin deficiency using coagulation factor agents and fresh frozen plasma. Haemostatic function was measured using a microchip flow chamber system at 600 s^-1.</p><p><strong>Results: </strong>The haemostatic function was low, especially in blood samples reconstituted with prothrombin- and FX-deficient plasma. In a plasma transfusion model of prothrombin deficiency, haemostatic function recovered after 10% replacement with normal plasma and reached a plateau at ≧60% replacement. A treatment model of prothrombin deficiency with prothrombin complex concentrates revealed dose-dependent therapeutic effects in the range of 0-50 IU/kg.</p><p><strong>Conclusion: </strong>Microchip flow chamber system-based quantification of haemostatic function using reconstituted blood could predict haemostasis and therapeutic effects of treatments in patients with prothrombin deficiency.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1065-1071"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477520","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":"The International Society of Blood Transfusion (ISBT) Public Health Research Toolkit: A report from the Surveillance, Risk Assessment and Policy Sub-group of the ISBT Transfusion Transmitted Infectious Diseases Working Party.","authors":"Jean Stanley, Michael P Busch, Christian Erikstrup, Susan A Galel, Jerry A Holmberg, Antoine Lewin, Sheila F O'Brien, Carla Osiowy, Gopal Patidar, W Alton Russell, Bryan R Spencer, Connie Higgs","doi":"10.1111/vox.13713","DOIUrl":"10.1111/vox.13713","url":null,"abstract":"<p><strong>Background and objectives: </strong>Data provided from blood donors have contributed to the understanding of public health epidemiology and policy decisions. A recent example was during the severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) pandemic when blood services monitored the seroprevalence in blood donors. Based on this experience, blood services have the opportunity to expand their role and participate in public health surveillance and research. The aim of this report is to share available resources to assist blood services in this area.</p><p><strong>Materials and methods: </strong>The Surveillance, Risk Assessment and Policy (SRAP) Sub-group of the International Society of Blood Transfusion (ISBT) Transfusion Transmitted Infectious Diseases (TTID) Working Party developed a Public Health Research Toolkit to assist blood services and researchers interested in expanding their role in public health research.</p><p><strong>Results: </strong>The ISBT Public Health Research Toolkit provides resources for what blood services can offer to public health, examples of donor research studies, the utility of donor data and website links to public health agencies. The toolkit includes a customizable template for those interested in establishing and managing a biobank.</p><p><strong>Conclusion: </strong>The ISBT Public Health Research Toolkit includes resources to increase the recognition of the role blood donors can play in public health and to help blood services gain commitment and funding from various agencies for new research and surveillance.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1122-1125"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761288","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":"Re-evaluating treatment thresholds in patient blood management: Female patients experience more perioperative anaemia and higher transfusion rates in major elective surgery.","authors":"Sumedha Arya, Alanna Howell, Lee Vernich, Yulia Lin, Katerina Pavenski, John Freedman","doi":"10.1111/vox.13717","DOIUrl":"10.1111/vox.13717","url":null,"abstract":"<p><strong>Background and objectives: </strong>By optimizing erythropoiesis, patient blood management (PBM) programmes can reduce transfusions, lower mortality and provide cost-effective care. While definitions of anaemia have historically varied by sex, for the purposes of PBM, anaemia is defined as a haemoglobin <130 g/L. Our objective was to describe whether perioperative anaemia and transfusion rates in the PBM setting vary by sex.</p><p><strong>Materials and methods: </strong>We conducted a retrospective study of the Ontario Nurse Transfusion Coordinators Program (ONTraC) database from 2018 to 2022. ONTraC collects data from 25 Ontario hospitals which together account for >70% of Ontario's provincial blood use (~400,000 units per year). We collected data on patients undergoing elective isolated coronary artery bypass graft surgery (CABG), open heart valve replacement, CABG plus valve replacement, single-knee arthroplasty and single-hip arthroplasty.</p><p><strong>Results: </strong>From 2018 to 2022, 17,700 patients were included in the ONTraC program; 47% were females (N = 8376). Across almost all years and procedures, females were found to have a significantly lower pre-operative, nadir and discharge haemoglobin as compared with males, irrespective of PBM interventions. Transfusion rates were significantly higher for females; this was most pronounced in cardiac surgery.</p><p><strong>Conclusion: </strong>Females experienced more perioperative anaemia and higher transfusion rates. Historic sex-specific definitions of anaemia may contribute to a greater tolerance of anaemia in females. Prioritizing females for multimodal PBM and consistently achieving a pre-operative haemoglobin >130 g/L may reduce the amount of red blood cell (RBC) transfusions that female patients receive.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"1090-1095"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761286","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}