Wiener Klinische Wochenschrift最新文献

{"title":"Healing chronic idiopathic eosinophilic pneumonia using mepolizumab alone without corticosteroids.","authors":"Katharina Moritz, Carolina Amelunxen, Michael Bergmann, Florian Vafai-Tabrizi, Georg-Christian Funk","doi":"10.1007/s00508-024-02406-5","DOIUrl":"10.1007/s00508-024-02406-5","url":null,"abstract":"<p><p>While glucocorticoids remain the standard first-line treatment for chronic idiopathic eosinophilic pneumonia (CIEP), the long-term use is marred by significant side effects. This case study explores the effectiveness of mepolizumab, an anti-interleukin‑5 (IL-5) monoclonal antibody, as a novel corticosteroid-free alternative in treating CIEP. A 50-year-old woman presented with a 3-week history of progressive shortness of breath, dry cough and night sweats. The blood tests showed eosinophilia, and chest radiography identified lung consolidations. The CIEP was confirmed, ruling out other conditions through a detailed clinical and bronchoscopic work-up. The patient declined to be treated with systemic glucocorticoids. Treatment with mepolizumab was remarkable for effectively resolving symptoms and improving radiological findings without any prior or concurrent glucocorticoid therapy. Notably, the patient remained relapse-free over a 2-year follow-up, underscoring mepolizumab's efficacy as a corticosteroid-free treatment for CIEP. This case study calls for further research into anti-IL‑5 treatment of rare respiratory conditions.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"453-456"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903070","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":"The impact of artificial intelligence on the adenoma detection rate : Comparison between experienced, intermediate and trainee endoscopists' adenoma detection rate.","authors":"Sebastian Bernhofer, Julian Prosenz, David Venturi, Andreas Maieron","doi":"10.1007/s00508-025-02561-3","DOIUrl":"https://doi.org/10.1007/s00508-025-02561-3","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is a promising tool to achieve a high adenoma detection rate (ADR). The aim of this study is to evaluate the impact of a computer-aided detection (CADe) device on the ADRs of endoscopists with different levels of expertise.</p><p><strong>Methods: </strong>Data were collected from patients who underwent colonoscopy with CADe within a 12-month period. Endoscopists were divided into three groups, a trainee group (< 500 colonoscopies), an intermediate group (500-1000 colonoscopies) and an expert group (> 2000 colonoscopies). Endoscopists with the same definition of experience without CADe support served as the control cohort. For the differences in ADR between the groups a 2-sided 95% confidence interval (CI) and odds ratios (OR) were calculated.</p><p><strong>Results: </strong>In this study 335 patients (155 females, 177 males) with a mean age 62.1 years (SD ± 16.2 years) were included in the CADe cohort. In this cohort 508 polyps were resected. The ADRs for the groups and control groups (without CADe) were as follows: 42.9% (95% CI: 28.5-57.2%) and 21.5% (95% CI: 11.3-31.8%) in the trainee group, 41.3% (95% CI: 33.5-49.0%) and 36.8% (95% CI: 27.9-45.6%) in the intermediate group and 39.8% (95% CI: 30.9-48.8%) and 33.3% (95% CI: 26.3-40.4%) in the expert group. There were no significant differences among the CADe groups when trainees were compared to experts (p = 0.72, OR 1.13, 95% CI: 0.58-2.16) or when intermediate endoscopists were compared to experts (p = 0.81, OR 1.06, 95% CI: 0.65-1.74).</p><p><strong>Conclusion: </strong>The use of AI appears to provide an opportunity to match the ADR-based quality of colonoscopy at an early stage of endoscopy training with experts.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486205","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":"Efficacy and safety of imatinib in patients with COVID-19: a systematic review and meta-analysis.","authors":"Le Li, Chengxiao Zhao, Siyuan Hou","doi":"10.1007/s00508-025-02552-4","DOIUrl":"https://doi.org/10.1007/s00508-025-02552-4","url":null,"abstract":"<p><strong>Objective: </strong>To inform treatment decisions in clinical practice, we conducted a meta-analysis to evaluate the efficacy and safety of imatinib in patients with COVID-19.</p><p><strong>Methods: </strong>A comprehensive systematic search was conducted across multiple electronic databases to identify relevant randomized controlled trials (RCTs) comparing imatinib with placebo in patients with COVID-19. A meta-analysis was performed using Review Manager software version 5.3 and followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.</p><p><strong>Results: </strong>The analysis included 4 studies with a total of 717 patients. The risk ratio (RR) for 28-day mortality in the imatinib group compared to the placebo group was 0.79 (95% confidence interval. CI 0.51-1.21; p = 0.28). There were no statistically significant differences in the duration of oxygen supplementation (MD = -0.13, 95% CI -2.57-2.31; p = 0.92) or the number of ventilator-free days (MD = 4.71, 95% CI -6.97-16.38; p = 0.43). Imatinib treatment did not significantly reduce the duration of hospital or intensive care unit (ICU) stay. Additionally, there was no significant difference between imatinib and placebo in the risk of any adverse events (AEs) or serious AEs.</p><p><strong>Conclusion: </strong>Imatinib did not significantly improve clinical outcomes in patients with COVID-19. Future research should consider subgroup analyses based on the biological heterogeneity of COVID-19-associated acute respiratory distress syndrome (ARDS) or the concurrent use of interleukin 6 (IL-6) receptor inhibitors to identify patient populations that may benefit from imatinib treatment.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327019","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":"Identifying patients' signs and symptoms to guide eHealth-directed diuretic therapy intensification in heart failure-Insights from the trial of intensified versus standard medical therapy in elderly patients with congestive heart failure (TIME-CHF).","authors":"Arno J Gingele, Casper Eurlings, Josiane J Boyne, Hans-Peter Brunner-La Rocca","doi":"10.1007/s00508-025-02551-5","DOIUrl":"https://doi.org/10.1007/s00508-025-02551-5","url":null,"abstract":"<p><p>Heart failure significantly burdens healthcare systems. eHealth products could alleviate this burden by providing patients with recommendations for intensifying diuretic therapy. As evidence on guiding diuretic therapy is scarce, our goal was to identify clinical parameters that eHealth products can use to support heart failure patients in intensifying their diuretic therapy. A post-hoc analysis of the trial of intensified versus standard medical therapy in elderly patients with congestive heart failure (TIME-CHF), comparing an NT-proBNP-guided management strategy with a symptom-guided strategy in elderly heart failure patients, was conducted. Clinical data were collected during patient evaluations at 1, 3, 6, and 12 months of follow-up. At each visit, any increase or new prescription of diuretic therapy was recorded as the outcome event. Mixed-effects logistic regression analyses were used to estimate odds ratios (OR) with 95% confidence intervals (CI), investigating the relationship between the patient data and the odds of diuretic therapy intensification. In this retrospective analysis, 568 heart failure patients were included. Over a 12-month period, 2013 follow-up visits were conducted, during which diuretics were initiated or increased in 370 visits (18.4%). Higher New York Heart Association (NYHA) classification (OR 2.60, 95%CI 1.94-3.50), presence of edema (OR 2.84, 95%CI 2.15-3.77), paroxysmal nocturnal dyspnea (OR 1.52, 95%CI 1.04-2.21), and orthopnea (OR 1.39, 95%CI 1.04-1.85) were significantly associated with the initiation or increase of diuretics. Dyspnea, edema, paroxysmal nocturnal dyspnea, and orthopnea are associated with the intensification of diuretic treatment in HF patients. These symptoms, which patients can easily report, should be integrated into eHealth devices that offer guidance on managing diuretic therapy.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318123","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":"Comment on \"Fake smoke, real fire: a retrospective single-center analysis of the underestimated risk of e-cigarette explosions and the typical burn patterns\".","authors":"Renu Sah, Ankita Mathur","doi":"10.1007/s00508-025-02562-2","DOIUrl":"https://doi.org/10.1007/s00508-025-02562-2","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295044","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":"Exploratory study on the self-perceived knowledge and care competence of general practitioners in managing patients with overweight and obesity in Austria.","authors":"Sabine Fritzenwallner, Maria Flamm, Hans-Peter Wiesinger, Dagmar Schaffler-Schaden","doi":"10.1007/s00508-025-02545-3","DOIUrl":"https://doi.org/10.1007/s00508-025-02545-3","url":null,"abstract":"<p><strong>Objectives: </strong>Obesity is a chronic, multifactorial disease that is often described as an epidemic or pandemic of the 21st century. General practitioners (GPs) play a crucial role in managing it, yet multiple barriers hinder effective care. This study explores Austrian GPs' experiences in obesity management, their self-assessed knowledge and care competencies, and the perceived barriers to optimal treatment.</p><p><strong>Methods: </strong>A quantitative online survey was conducted among GPs in October and November 2023. The questionnaire covered prevention, treatment, barriers, and experiences in managing overweight and obesity in primary care.</p><p><strong>Results: </strong>In all, 59 GPs (56% female) completed the survey. Nearly all recognized obesity as a chronic disease and felt responsible for its management, but almost half considered their training insufficient. While 80% acknowledged the need for multimodal therapy programs, awareness of available healthcare services was low. The most significant barrier to effective obesity care from the GP's point of view was a lack of patient motivation. Female GPs were more likely to screen for dietary habits and physical activity, refer patients to specialized care, and request additional resources, whereas male GPs were more likely to prescribe pharmacotherapy. More experienced GPs felt better trained but were less likely to seek treatment guidelines. Regional and practice-setting differences influenced attitudes and referral patterns. GPs with private insurance contracts felt best trained and were least likely to request additional support.</p><p><strong>Conclusion: </strong>The survey revealed considerable uncertainty among GPs regarding the management of overweight and obesity. These findings highlight the need for targeted interventions to improve patient care and enhance GPs' training in obesity management.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267409","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":"Evaluating physicians' knowledge of assisted suicide and palliative sedation therapy in Austria : An exploratory survey study.","authors":"Lukas Fischer, Nguyen-Son Le, Stefanie Kirchner, Angelika Feichtner, Angelina Falkner, Eva Katharina Masel, Jan Gärtner, Dietmar Weixler, Gudrun Kreye","doi":"10.1007/s00508-025-02509-7","DOIUrl":"10.1007/s00508-025-02509-7","url":null,"abstract":"<p><strong>Background: </strong>Since January 2022, assisted suicide (AS) has been legal in Austria under specific conditions, allowing medical AS for individuals with incurable, life-ending diseases or severe, enduring illnesses that significantly impact their lives. Palliative sedation therapy (PST) involves the controlled use of drugs to induce unconsciousness and alleviate otherwise untreatable suffering. This study evaluates Austrian physicians' knowledge of AS and PST, comparing the knowledge levels of palliative care (PC) and non-PC physicians.</p><p><strong>Methods: </strong>In this explorative study, an online survey was distributed primarily to physicians in Lower Austria through the State Healthcare Agency Lower Austria (Landesgesundheitsagentur Niederösterreich, LGA) and to PC physicians across Austria via the Austrian Association for Palliative Care (Österreichische Palliativgesellschaft, OPG). Questions in this survey focused on basic knowledge of the principles of AS and PST. Participants included physicians who have expertise in PC and physicians from other medical specialties.</p><p><strong>Results: </strong>In this study, 223 physicians completed the survey. The PC physicians displayed significantly more specialized training, with 74.2% holding a PC diploma compared to 17.9% of non-PC physicians (p < 0.001). Regarding PST, PC physicians were more likely to follow guidelines, using midazolam (97.8% vs. 77.6%, p < 0.001), propofol (56.2% vs. 38.1%, p = 0.009), and levomepromazine (23.6% vs. 11.2%, p = 0.016). In AS, PC physicians emphasized the decision-making capacity more frequently (p = 0.006) and were better informed about the legal requirements.</p><p><strong>Conclusion: </strong>Overall, Austrian physicians demonstrate insufficient knowledge of AS and PST, underlining the need for enhanced education on PC principles to ensure informed practice post-AS legalization. Nonetheless, PC physicians in Austria demonstrate superior adherence to guidelines in managing life-limiting conditions, PST and AS compared to non-PC physicians, highlighting the importance of specialized PC education.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"357-367"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543816","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":"Associations of malnutrition factors with dysphagia mediated by ADL among nursing home residents.","authors":"Kotomi Sakai, Shoji Kinoshita, Hidetaka Wakabayashi, Tokiko Isowa, Haruka Tohara, Ryosuke Yanagida, Ryo Momosaki","doi":"10.1007/s00508-024-02488-1","DOIUrl":"10.1007/s00508-024-02488-1","url":null,"abstract":"<p><strong>Objective: </strong>The potential link between malnutrition and dysphagia along with its underlying mechanisms remains unknown. This study aimed to investigate the association between malnutrition factors and dysphagia mediated by a decline in activities of daily living (ADL) among nursing home residents.</p><p><strong>Methods: </strong>This cross-sectional study used data from 705 nursing home residents. The primary factors were risk of malnutrition and dysphagia. A body mass index (BMI) of < 18.5 and insufficient energy and protein intakes were also collected as factors related to malnutrition. The causal mediation analysis was used with malnutrition factors as the exposure, dysphagia as the outcome, and ADL as the mediation factor.</p><p><strong>Results: </strong>In total, 391 residents (55.5%) were at risk of malnutrition and 451 residents (64.0%) had dysphagia. The average causal mediation effect (ACME) of risk of malnutrition on dysphagia was 0.07 (95% confidence interval, C, 0.07-0.08), and the ACME of BMI < 18.5 was 0.05 (95% CI 0.04-0.05, P < 0.001 for both). For insufficient nutritional intake, the ACME of low energy intake was 0.07 (95% CI 0.07-0.07), and the ACME of low protein intake was 0.03 (95% CI 0.02-0.04, P < 0.001 for both). The total effects of all these exposures on dysphagia were significant (P = 0.002 for low protein intake and P < 0.001 for the others).</p><p><strong>Conclusion: </strong>Malnutrition factors were associated with dysphagia, mediated by a decline in ADL among nursing home residents. The results of this study suggest the importance of nutritional management along with approaches to ADL to prevent dysphagia.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"377-383"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877710","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":"Addressing healthcare vulnerabilities in nursing homes : Insights from human rights monitoring in two Austrian provinces.","authors":"Arkadiusz Komorowski, Theresa Rahel Demmer, Marianne Auer, Marianne Schulze, Gabriele Fischer","doi":"10.1007/s00508-024-02409-2","DOIUrl":"10.1007/s00508-024-02409-2","url":null,"abstract":"<p><strong>Background: </strong>Current demographic changes bear challenges for national care systems due to higher life expectancy of older citizens. Largely cut off from society, nursing home residents are at risk for violence, neglect, and other potential human rights violations. This study aimed to investigate healthcare vulnerabilities in nursing homes and evaluate the Austrian National Preventive Mechanism (NPM).</p><p><strong>Methods: </strong>Between 2017 and 2019, 55 monitoring visits were conducted in 32 nursing homes. Study outcomes from two Austrian provinces included data on infrastructure, occupancy, staffing, resident's demographics and medical conditions, as well as measures related to the functioning of the NPM.</p><p><strong>Results: </strong>Accessibility with mobility aids was sufficient in 87%, but assistance for persons with visual or hearing impairments solely in 20-40% of the institutions. An understaffing with nursing assistants (-5.2 full-time equivalents in Carinthia) and home helpers (-1.6 in Carinthia and Styria) was present. Less than 20% of the personnel received advanced training related to dementia and neuropsychiatric care. While 50% of the residents were diagnosed with a psychiatric disorder, approximately 36% received support from an appointed legal guardian. Of the monitoring visits 58.1% were conducted due to anonymous complaints and urgent referrals. The median processing times of the NPM and the provincial governments exceeded 250 days.</p><p><strong>Conclusion: </strong>Human rights monitoring reveals critical aspects in nursing home care, including insufficient accessibility, understaffing and inadequate training. Although the authorities' handling times hinder prompt responses, the NPM may foster systemic improvements and accountability within nursing homes.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"368-376"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914142","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":"A comic that explains palliative care: how patients experience comic-based educational material.","authors":"Anna Kitta, Sarah Winsauer, Sal Marx, Lea Kum, Feroniki Adamidis, Franziska Ecker, Jessica Stöger, Eva Katharina Masel","doi":"10.1007/s00508-024-02480-9","DOIUrl":"10.1007/s00508-024-02480-9","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to create a patient-centered comic on palliative care with and for patients admitted to a palliative care unit and to examine their experiences of graphic educational material.</p><p><strong>Methods: </strong>This study employed a qualitative methodology using semi-structured interviews with advanced cancer patients admitted to the palliative care unit of the Medical University of Vienna. The data were analyzed using thematic analysis with the assistance of the MAXQDA software.</p><p><strong>Results: </strong>In the first phase of the comic creation 6 interviews were conducted and 15 additional interviews in the second phase, all of which examined patients' reactions to the comic. The findings revealed three themes: 1) patients' experiences with and understanding of graphics about palliative care, 2) patients' perceptions of the possibilities for use of the comic and 3) how the visual material facilitated access to the patients' shared imagination and interpretations. The medium generated curiosity, participation, and positive reactions. Patients were inclined to be involved in patient-centered educational material that enabled an entry into conversations and connection, giving access to feelings and associations of patients.</p><p><strong>Conclusion: </strong>The results of the present study offer insights into mostly positive reactions of patients when presented with a comic about palliative care. The study showed how illustrated educational information led to deepened conversation among the interviewer and the patients, offering insights into their experiences and imagination.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"325-334"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955950","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}