Brazilian Journal of Otorhinolaryngology最新文献

{"title":"Validation and reproducibility of the International Study of Asthma and Allergies in Childhood (ISAAC) Written Allergic Rhinitis Questionnaire for phone survey in children aged 6‒7 years","authors":"Priscilla Campos ,&nbsp;Solange O.R. Valle ,&nbsp;Antônio José Ledo Alves da Cunha ,&nbsp;Fábio Chigres Kuschnir ,&nbsp;Dirceu Solé","doi":"10.1016/j.bjorl.2024.101531","DOIUrl":"10.1016/j.bjorl.2024.101531","url":null,"abstract":"<div><h3>Objective</h3><div>To validate and assess the reproducibility of the ISAAC Written Allergic Rhinitis Questionnaire (WARQ) for children aged between 6 and 7 years by telephone contact.</div></div><div><h3>Methods</h3><div>Observational study through interviews with guardians of children aged 6–7 years using the ISAAC Allergic Rhinitis (AR) module questionnaire in three different phases separated by 2 weeks each: telephone interviews in the first and third contacts and face-to-face interviews, with the same guardian of telephone interviews, in the second contact. Reproducibility was estimated using the Kappa index and validation using the sensitivity and specificity coefficients.</div></div><div><h3>Results</h3><div>Data from 94 children (48 from the allergic rhinitis Control Group ‒ CG) were analyzed. Reproducibility showed perfect agreement (100%) for the question number 1 – Which refers to the symptoms of AR, ever: “Has your child ever had a problem with sneezing or a runny or a blocked nose when he/she did not have a cold or the flu?” and for the question number 2 – Which refers to current symptoms of AR: “In the past 12 months, has your child had a problem with sneezing or a runny or a blocked nose when he/she did not have a cold or the flu?” A strong agreement was also observed for the question number 3 (κ = 0.871) – it defines the presence of comorbidity of allergic rhinoconjuntivitis “In the past 12 months, has this nose problem been accompanied by itchy-watery eyes?” The validation showed high specificity (≥76.7%) and sensitivity (≥98%) for all questions, except for the ones related to seasonality and intensity of symptoms.</div></div><div><h3>Conclusions</h3><div>Our results showed that the ISAAC AR module questionnaire by telephone interviews has good reproducibility and high agreement with the clinical diagnosis of AR. It may be an appropriate alternative tool in epidemiological studies of childhood AR, especially in periods of social isolation, such as Coronavirus pandemic.</div></div><div><h3>Level of evidence</h3><div>Cohort Study. Level IV</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 2","pages":"Article 101531"},"PeriodicalIF":1.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683037","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":"Can anatomy-based fitting improve musical perception in adult cochlear implant users?","authors":"Luis Lassaletta ,&nbsp;Miryam Calvino ,&nbsp;Isabel Sánchez-Cuadrado ,&nbsp;Elena Muñoz ,&nbsp;Javier Gavilán","doi":"10.1016/j.bjorl.2024.101533","DOIUrl":"10.1016/j.bjorl.2024.101533","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare Anatomy-Based Fitting (ABF) vs. Default Fitting (DF) in terms of music perception and music enjoyment in CI users.</div></div><div><h3>Methods</h3><div>CI users ≥ 18 years implanted with a Synchrony ST Flex28 (MEDEL) with at least 12 months of experience with either ABF or DF, with good speech tests outcomes (≥ 65% disyllables) were enrolled. Music tasks were assessed with “Discovery” level of Meludia online interactive music tool, which includes Rhythm (beat count), Spatialization (differentiating between lower and higher notes), Stable/unstable (perception of stability or instability), Melody (ascendant or descendant), and Density (presence of one or multiple simultaneous sounds). Each task consists of five levels of difficulty. Participants were allowed a maximum of 4 attempts to complete a level. The Music-Related Quality of Life (MuRQoL) and the Munich Music (MUMU) questionnaires evaluated music background.</div></div><div><h3>Results</h3><div>Twenty CI users took part: 10 using ABF and 10 DF. There were no significant differences in age at implantation (53.2 ± 15.0 vs. 53.8 ± 14.5y), time since surgery (1.8 ± 0.5 vs. 2.4 ± 1.5y), or the percentage of disyllables in silence (68.0 ± 8.0 vs. 77.3 ± 11.5%) between groups. Regarding Meludia scores, differences were observed between both groups in Density: ABF had better mean scores when completing the level in only one attempt (8.7 ± 2.5 vs. 4.6 ± 3.1, <em>p</em> = 0.016) and required fewer restarts to complete the five levels (6.6 ± 1.6 vs. 9.3 ± 2.3; <em>p</em> = 0.009). Furthermore, the fifth level of Density was successfully completed by 60% of patients with ABF, while none of the patients with DF achieved this (<em>p</em> = 0.003). The scores obtained in MuRQoL were similar between ABF and DF groups. In a similar way, the MUMU showed no differences in terms of frequency and music importance.</div></div><div><h3>Conclusions</h3><div>ABF demonstrates specific advantages in certain musical tasks, specifically in processing multiple sounds simultaneously. Further studies are necessary to explore additional benefits of ABF in musical skills in CI users. NCT05319678.</div></div><div><h3>Level of evidence</h3><div>Level 3.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 2","pages":"Article 101533"},"PeriodicalIF":1.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683114","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":"Development and internal validation of risk stratification tool for lymph node metastasis in pT3-4 laryngeal squamous cell carcinoma patients","authors":"Changding He ,&nbsp;Yu Heng ,&nbsp;Xiaoke Zhu,&nbsp;Jian Zhou,&nbsp;Lei Tao","doi":"10.1016/j.bjorl.2024.101535","DOIUrl":"10.1016/j.bjorl.2024.101535","url":null,"abstract":"<div><h3>Objective</h3><div>To identify risk factors for Lymph Node Metastasis (LNM) in pT3-4 Laryngeal Squamous Cell Carcinoma (LSCC) patients with negative margins, and develop a nomogram to predict LNM risk.</div></div><div><h3>Methods</h3><div>872 patients were divided into training (2010–2014) and validation (2015–2016) cohorts. Univariate and multivariate analyses identified LNM risk factors. A nomogram incorporating significant factors was developed in the training cohort.</div></div><div><h3>Results</h3><div>Smoking history, maximal tumor diameter ≥3.0 cm, depth of tumor invasion &gt;1.0 cm, and supraglottic tumor location were significantly associated with LNM on multivariate analysis. A predictive nomogram incorporating these factors showed good discrimination (C-index &gt; 0.7) in both cohorts. Patients were stratified into low, moderate and high-risk subgroups based on total risk scores.</div></div><div><h3>Conclusions</h3><div>A LNM risk prediction model and risk grouping system was established, which may aid treatment selection for pT3-4 LSCC patients. The model and algorithm could help optimize neck management for this high-risk patient population.</div></div><div><h3>Level of evidence</h3><div>2.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 2","pages":"Article 101535"},"PeriodicalIF":1.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677569","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":"Risk factors for cervical lymph node metastasis in oropharyngeal cancer and its impact on prognosis","authors":"Li Zhang ,&nbsp;Zhilin Li ,&nbsp;Jing Wang ,&nbsp;Chen Wang ,&nbsp;Shuxin Wen","doi":"10.1016/j.bjorl.2024.101520","DOIUrl":"10.1016/j.bjorl.2024.101520","url":null,"abstract":"<div><h3>Objective</h3><div>To understand the characteristics of cervical lymph node metastasis in Oropharyngeal Squamous Cell Carcinoma (OPSCC) patients, explore the risk factors for lymph node metastasis, and its impact on prognosis.</div></div><div><h3>Methods</h3><div>Retrospective cohort study. Statistical analysis of the relationship between various clinicopathological factors and lymph node involvement, as well as the independent risk factors affecting lymph node metastasis and their impact on prognosis.</div></div><div><h3>Results</h3><div>The cervical lymph node metastasis rate in this group was 89.2%, with the palatine tonsils and base of the tongue more prone to cervical lymph node metastasis (<em>p</em> <!-->=<!--> <!-->0.007); lower pathological differentiation of OPSCC was more likely to develop cervical lymph node metastasis (<em>p</em> <!-->=<!--> <!-->0.017). The P16 protein positive rate in this group was 58.8%. P16 protein expression did not affect the incidence rate of cervical lymph node metastasis in OPSCC (<em>p</em> <!-->=<!--> <!-->1.000) but influenced the risk of multiple lymph node metastases (<em>p</em> <!-->=<!--> <!-->0.011) and was a risk factor affecting the prognosis of OPSCC (<em>p</em> <!-->=<!--> <!-->0.003). However, the lymph node metastasis status did not affect the survival time of OPSCC patients.</div></div><div><h3>Conclusion</h3><div>In the Shanxi region of China, HPV-related OPSCC accounts for a higher proportion; OPSCC has a high rate of cervical lymph node metastasis, but lymph node metastasis does not significantly increase the mortality risk of OPSCC patients, which may be related to the unique characteristics of HPV-related OPSCC.</div></div><div><h3>Level of Evidence Ⅳ</h3><div>Retrospective cohort study.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 2","pages":"Article 101520"},"PeriodicalIF":1.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591859","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":"Effectiveness of hypertonic saline irrigation following functional endoscopic sinus surgery: a systematic review and meta-analysis","authors":"Adriano Damasceno Lima ,&nbsp;Rodolfo Baptista Giffoni ,&nbsp;Julieta Arguelles-Hernandez ,&nbsp;Gabriele Santos ,&nbsp;Victor L.J.C. Sena ,&nbsp;Ricardo S. Aguiar ,&nbsp;Marcelo L.S. Cruz ,&nbsp;Maria E.P. Dalmaschio ,&nbsp;Marcio Nakanishi","doi":"10.1016/j.bjorl.2024.101517","DOIUrl":"10.1016/j.bjorl.2024.101517","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to clarify the impact of hypertonic solutions on various outcomes, including persistence or reduction of nasal crusts, polypoid edema, and postoperative inflammatory symptoms.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, and Cochrane Central Register of Controlled Trials for studies comparing hypertonic with isotonic saline irrigation after FESS in adult patients with Chronic Rhinosinusitis (CRS). Outcomes were polypoid mucosa, nasal crusts, and variation from the baseline of Sino-Nasal Outcome Test (SNOT) 20/22 and Visual Analog Scale (VAS). For statistical analysis, we used RevMan 5.4.1, and assessed heterogeneity with I² statistics.</div></div><div><h3>Results</h3><div>We included a total of 479 patients from 7 studies. In the hypertonic saline group, there was a reduction in the nasal crust Risk Ratio (RR) (RR = 0.65; 95% CI 0.49 to 0.87; <em>p</em> = 0.004; I² = 0%) after 30–45 days and severe crusts at 14–21 days (RR = 0.59; 95% CI 0.38 to 0.91; <em>p</em> = 0.02; I² = 0%). Additionally, the persistence of polypoid mucosa was lower in the intervention arm (RR = 0.53; 95% CI 0.43 to 0.65; <em>p</em> &lt; 0.00001; I² = 0%) after 14–21 days. In the symptomatic evaluation hypertonic saline group showed an improvement in postoperative symptoms by a VAS Mean Difference (MD) (MD = −5; 95% CI −5.77 to −4.24; <em>p</em> &lt; 0.00001; I² = 0%) and a SNOT 20/22 Standard Mean Difference (SMD) (SMD = −1.65; 95% CI −2.7 to −0.61; <em>p</em> = 0.002; I² = 93%) reduction from baseline in 30–45 days after the surgery.</div></div><div><h3>Conclusion</h3><div>Hypertonic saline showed a superior improvement in postoperative evaluation by means of nasal crusting, mucosal healing aspect, and nasal inflammatory symptoms compared with isotonic saline irrigation.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101517"},"PeriodicalIF":1.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587186","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":"Impact of hearing impairment on cognitive performance","authors":"Pedro Ivo Machado Pires de Araújo ,&nbsp;Pauliana Lamounier e Silva Duarte ,&nbsp;Hugo Valter Lisboa Ramos ,&nbsp;Claudiney Cândido Costa ,&nbsp;Isabela Gomes Maldi ,&nbsp;Lucas da Silva Braz ,&nbsp;Norma de Oliveira Penido","doi":"10.1016/j.bjorl.2024.101521","DOIUrl":"10.1016/j.bjorl.2024.101521","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to evaluate the cognitive performance in adults with hearing loss and to identify associations between clinical characteristics of hearing loss and cognitive outcomes.</div></div><div><h3>Methods</h3><div>In this cross-sectional analytical observational study, adults with hearing loss underwent the Mini-Mental State Examination (MMSE), following the collection of their clinical and audiometric data.</div></div><div><h3>Results</h3><div>Among 134 evaluated individuals, a majority reported a progressive onset (91.04%) and bilateral nature (87.31%) of hearing loss, with moderate hearing loss being the most common (41.04%). Sensorineural hearing loss was prevalent in 76.12% of cases, with presbycusis identified as a primary etiology in 37.31%. Comorbidities were reported in 61.19% of participants, with 16.42% using benzodiazepines or antidepressants regularly. Symptoms included imbalance (33.58%), vertigo (42.54%), and tinnitus (73.88%). Notably, a sudden onset of hearing loss and imbalance complaints were linked to a higher likelihood of subnormal MMSE performance. Analysis revealed varied cognitive domain performances associated with different clinical characteristics of hearing loss.</div></div><div><h3>Conclusion</h3><div>Various aspects of hearing loss, such as bilateral and sensorineural types, and the presence of symptoms like tinnitus and vertigo, significantly influence cognitive performance. Specifically, sudden onset hearing loss and imbalance complaints are associated with poorer overall cognitive outcomes in the MMSE. These findings underscore the importance of considering the diverse impacts of hearing loss characteristics on cognitive functions.</div></div><div><h3>Level of evidence</h3><div>Level 4.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 2","pages":"Article 101521"},"PeriodicalIF":1.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591851","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":"Perineural invasion and laryngeal squamous cell carcinoma: a systematic review","authors":"Debora Modelli Vianna Ocampo Quintana ,&nbsp;Rogerio Aparecido Dedivitis ,&nbsp;Luiz Paulo Kowalski","doi":"10.1016/j.bjorl.2024.101519","DOIUrl":"10.1016/j.bjorl.2024.101519","url":null,"abstract":"<div><h3>Objectives</h3><div>Several studies have evaluated the prognostic significance of Perineural Invasion (IPN) in laryngeal cancer; however, the results are non-conclusive. Therefore, we conducted a meta-analysis aiming to identify the prognostic value of IPN in laryngeal cancer.</div></div><div><h3>Methods</h3><div>A literature review was performed, searching MedLine via PubMed, Scielo, Lilacs, Cochrane and Websco. RevMan 5.4 was used for the statistical analysis.</div></div><div><h3>Results</h3><div>A total of 19 laryngeal cancer studies were included. The results indicate that IPN in laryngeal cancer shows 2-year survival with RR 0.71 (0.59‒0.86); disease-free survival RR 0.51 (0.14–1.95); and locoregional recurrence RR 1.71 (1.25–2.35).</div></div><div><h3>Conclusion</h3><div>IPN is a negative prognostic factor in laryngeal cancer.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101519"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565192","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":"Robotic-assisted cochlear implant surgery","authors":"Vagner Antonio Rodrigues Silva,&nbsp;Arthur Menino Castilho","doi":"10.1016/j.bjorl.2024.101530","DOIUrl":"10.1016/j.bjorl.2024.101530","url":null,"abstract":"","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"90 6","pages":"Article 101530"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142579099","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":"Enlarged vestibular aqueduct with bilateral sensorineural hearing loss following cranial trauma: a case report","authors":"Alexandre Camilotti Gasperin ,&nbsp;Bruna Timm Monteiro ,&nbsp;Ellen Paula Schetz Zawierucha ,&nbsp;Enrico Guido Oliveira Minniti ,&nbsp;Matheus Roberto Schetz Alves ,&nbsp;Pedro Henrique Vicari Passos","doi":"10.1016/j.bjorl.2024.101518","DOIUrl":"10.1016/j.bjorl.2024.101518","url":null,"abstract":"","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101518"},"PeriodicalIF":1.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552287","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":"Pre-clinical training, technical adjustment and human case experience of transoral robotic surgery using Versius System","authors":"Guilherme Reimann Agne ,&nbsp;Gustavo Nunes Bento ,&nbsp;Marcelo Belli ,&nbsp;Gustavo Becker Pereira ,&nbsp;Renan Bezerra Lira ,&nbsp;Leandro Luongo Matos ,&nbsp;Luiz Paulo Kowalski","doi":"10.1016/j.bjorl.2024.101515","DOIUrl":"10.1016/j.bjorl.2024.101515","url":null,"abstract":"<div><h3>Objective</h3><div>This study describes the training experience with the Versius Robotic System (CMR Surgical) for Transoral Robotic Surgery (TORS), the setup of the robot and its applicability in a human case.</div></div><div><h3>Methods</h3><div>A model mannequin with anatomical characteristics simulating the TORS working space was used for training purposes. Optimal docking, positioning of robotic arms and placement of instruments were defined using the mannequin. A human patient was selected based on the inclusion criteria, and a standardized protocol for robotic techniques was developed. The surgical procedure was conducted in accordance with ethical guidelines.</div></div><div><h3>Results</h3><div>The synthetic polymer mannequin mimicking human tissues and anatomy was used to define the robot set up for TORS. The patient was indicated for bilateral tonsillectomy due to recurrent episodes of tonsillitis. Bipolar Maryland and monopolar scissors were used. The procedure was uneventful. The patient remained hospitalized for 1 day and returned to work activities within 6-days, with no complications.</div></div><div><h3>Conclusion</h3><div>The specialized mannequin proved to be effective in the simulation, training proposal and set up standardization. Furthermore, the Versius robot was found to be safe and achieved excellent results during surgery. Despite being very promising, the Versius system is still in its developmental phase and requires larger-scale samples for a more comprehensive evaluation.</div></div><div><h3>Level of evidence</h3><div>4.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 1","pages":"Article 101515"},"PeriodicalIF":1.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606927","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}