Cleft Palate-Craniofacial Journal最新文献

{"title":"Rehabilitation of Combined Hard and Soft Palate Defects with a Soft Relining Prosthesis: A Clinical Report.","authors":"Zhi Yuan, Jingman Yuan, Ziyuan Wang, Qiong Rong","doi":"10.1177/10556656241272481","DOIUrl":"10.1177/10556656241272481","url":null,"abstract":"<p><p>It remains a significant challenge in prosthetic rehabilitation for combined hard and soft palate defects on account of two primary reasons. At first, conventional impressions can hardly get an accurate analogue and usually bring about a terrible experience for the patients. Secondly, conventional hard denture base resins used in obturator prostheses exhibit limitations in marginal sealing, undercut retention, and elastic buffering when in contact with the soft palate. This article presents a case where combined hard and soft palate defects were successfully and rapidly reconstructed by using digital intraoral impression technology and denture soft reline material.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1802-1807"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894754","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":"DNA Methylation Effects on Van der Woude Syndrome Phenotypic Variability.","authors":"Amanda Seaberg, Waheed Awotoye, Fang Qian, Ligiane A Machado-Paula, Lindsey Dunlay, Azeez Butali, Jeff Murray, Lina Moreno-Uribe, Aline L Petrin","doi":"10.1177/10556656241269495","DOIUrl":"10.1177/10556656241269495","url":null,"abstract":"<p><p>ObjectiveVan der Woude Syndrome (VWS) presents with combinations of lip pits (LP) and cleft lip and/or cleft palate (CL/P, CPO). VWS phenotypic heterogeneity even amongst relatives, suggests that epigenetic factors may act as modifiers. <i>IRF6,</i> causal for 70% of VWS cases, and <i>TP63</i> interact in a regulatory loop coordinating epithelial proliferation and differentiation in palatogenesis. We hypothesize that differential DNA methylation within <i>IRF6</i> and <i>TP63</i> regulatory regions underlie VWS phenotypic discordance.MethodsDNA methylation of CpG sites in <i>IRF6</i> and <i>TP63</i> promoters and in an <i>IRF6</i> enhancer element was compared amongst blood or saliva DNA samples of 78 unrelated cases. Analyses were done separately for blood and saliva, within each sex and in combination, and to address cleft type (CL/P ± LP vs. CPO ± LP) and phenotypic severity (any cleft + LP vs. any cleft only).ResultsFor cleft type, blood samples showed higher <i>IRF6</i> and <i>TP63</i> promoter methylation on males with CPO ± LP compared to CL/P ± LP and on individuals with CPO ± LP compared to those with CL/P ± LP, respectively. Saliva samples showed higher <i>IRF6</i> enhancer methylation on individuals with CPO ± LP compared to CL/P ± LP and contrary to above, lower <i>TP63</i> promoter methylation on CPO ± LP compared to CL/P ± LP. For phenotypic severity, blood samples showed no differences; however, saliva samples showed higher <i>IRF6</i> promoter methylation in individuals with any cleft + LP compared to those without lip pits.ConclusionWe observed differential methylation in <i>IRF6</i> and <i>TP63</i> regulatory regions associated with cleft type and phenotypic severity, indicating that epigenetic changes in <i>IRF6</i> and <i>TP63</i> can contribute to phenotypic heterogeneity in VWS.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1641-1650"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898708","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":"Facial Expressions of Emotion in Children with Cleft Lip and Palate.","authors":"Robert Brinton Fujiki, Fangyun Zhao, Paula M Niedenthal, Susan L Thibeault","doi":"10.1177/10556656241271650","DOIUrl":"10.1177/10556656241271650","url":null,"abstract":"<p><p>ObjectiveTo examine the facial movements children with cleft lip and palate (CLP) employ to express basic emotions. Ability of observers to interpret facial expressions of children with CLP was also considered.DesignProspective case-control design.SettingOutpatient craniofacial anomalies clinic.PatientsTwenty-five children with CLP (age 8 to 12) and 25 age/sex-matched controls.Outcome MeasuresChildren were video recorded making facial expressions representing anger, disgust, fear, happiness, sadness, and surprise. Magnitude of children's facial movements was quantified and compared using OpenFace. Subsequently, emotion videos were presented to 19 adults who were asked to identify the emotion conveyed in each facial expression. Accuracy of emotion recognition was compared across groups.ResultsCompared with controls, children with CLP employed significantly (<i>P </i>< .05) smaller magnitude superior and lateral perioral movements to express disgust (Cohen's d = .50), happiness (Cohen's d = 1.1), and fear (Cohen's d = .93). For disgust and sadness, children with CLP employed significantly greater magnitude movements of the nose and chin, presumably to compensate for reduced perioral range of motion. For anger, happiness, and sadness, children with CLP employed smaller magnitude movements of the upper face when compared with controls. Observers identified disgust (OR = 1.26), and fear (OR = 2.44) significantly less accurately in children with CLP when compared with controls.ConclusionsChildren with CLP employed different facial movements to express certain emotions. Observers less accurately identified some emotions conveyed by facial expressions in children with CLP when compared with controls, likely due in part to differences in facial movements. Future research should explore the implications of these differences for social communication.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1695-1704"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082409","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 Effect of Barrel-Stave Osteotomy Length in Sagittal Strip Craniectomy.","authors":"Lucas M Harrison, Kayla Prezelski, Rami R Hallac, Paymon Sanati-Mehrizy","doi":"10.1177/10556656241275964","DOIUrl":"10.1177/10556656241275964","url":null,"abstract":"<p><p>ObjectiveIn managing sagittal craniosynostosis, strip craniectomy of the affected suture is commonly paired with barrel-stave osteotomies to allow for additional cranial remodeling. However, the effect of these osteotomies is not well-established. This study aimed to evaluate the effect of the length of barrel-stave osteotomies on outcomes in patients with sagittal craniosynostosis.DesignA retrospective review of operative records and pre-operative and one-year post-operative three-dimensional images.SettingTertiary care pediatric institution.PatientsForty-five patients with sagittal craniosynostosisInterventionsSagittal strip craniectomy and either long, medium, or short barrel-stave osteotomy lengths followed by helmet therapyMain Outcome MeasuresOperative and three-dimensional craniometric outcomes.ResultsOperative time, estimated blood loss, and hospital length of stay were significantly decreased in the short group (<i>P</i> = .003; 0.002; 0.027). The cranial index was normalized in all groups, but the long group was significantly lower (<i>P</i> = .007; 0.025). Head circumference was similar between groups. All indexes were within the normal percentiles in all groups. The medium group had a significantly decreased scaphocephalic index (<i>P</i> = .031; .035). The short group had significantly greater occipital bulleting than the medium group (<i>P</i> = .001). The long group had significantly greater narrowing than the short group (<i>P</i> = .036).ConclusionsStrip craniectomy with the addition of long, medium, or short barrel staves all resulted in clinically successful outcomes. Our findings suggest that increased barrel-stave osteotomy length may not be necessary for a successful outcome while avoiding more extensive dissection, potential risk, increased operative time, and hospital length of stay.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1750-1756"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972139","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":"Autogenous Bilateral Cleft Alveolar Bone Grafting with rhBMP-2 and Cellular Bone Matrix.","authors":"Lucas M Harrison, Rami R Hallac, James Seaward, Alex A Kane, Yong-Jong Park","doi":"10.1177/10556656241271672","DOIUrl":"10.1177/10556656241271672","url":null,"abstract":"<p><p>Alveolar bone grafting (ABG) in bilateral cleft lip and palate (BCLP) patients provides a reconstructive challenge. We present a novel technique of combining autologous iliac crest bone graft (ICBG) with recombinant human bone morphogenic protein 2 (rhBMP-2) and cellular bone matrix (CBM) for ABG in BCLP patients. Complete bone fill occurred in 90% of patients, with 100% having bilateral canine eruption. No patients required repeat ABG, and no significant complications were reported. The alveolar cleft gap volume significantly decreased with an improvement of 75.87%. ABG with autologous ICBG with rhBMP-2 and CBM is an effective technique for patients with BCLP.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1816-1819"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894753","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 Comparative Effectiveness Study of Speech and Surgical Outcomes: Study Overview.","authors":"Kathy L Chapman, Thomas Sitzman, Adriane Baylis, Mary Hardin-Jones, Richard Kirschner, M'hamed Hamy Temkit","doi":"10.1177/10556656241274242","DOIUrl":"10.1177/10556656241274242","url":null,"abstract":"<p><p>AimsTo provide an overview of the Cleft Outcomes Research NETwork (CORNET) and the CORNET Speech and Surgery study. The study is (1) comparing speech outcomes and fistula rate between two common palate repair techniques, straight-line closure with intra-velar veloplasty (IVVP) and Furlow Double-Opposing Z-palatoplasty (Furlow Z-plasty); (2) summarizing practice variation in the utilization of early intervention speech-language (EI-SL) services; and (3) exploring the association between EI-SL services and speech outcomes.DesignProspective, longitudinal, observational, comparative effectiveness, multi-center.SitesTwenty sites across the United States.ParticipantsOne thousand two hundred forty-seven children with cleft palate with or without cleft lip (CP ± L). Children with submucous cleft palate or bilateral sensorineural severe to profound hearing loss were excluded from participation.InterventionsStraight-line closure with IVVP or Furlow Z-plasty based on each surgeon's standard clinical protocol.Main Outcome Measure(s)The primary study outcome is perceptual ratings of hypernasality judged from speech samples collected at 3 years of age. Secondary outcomes are fistula rate, measures of speech production, and quality of life. The statistical analyses will include generalized estimating equations with propensity score weighting to address potential confounders.Current ProgressRecruitment was completed in February 2023; 80% of children have been retained to date. Five hundred sixty two children have completed their final 3-year speech assessment. Final study activities will end in early 2025.ConclusionsThis study addresses long-standing questions related to the effectiveness of the two most common palatoplasty approaches and describes CORNET which provides an infrastructure that will streamline future studies in all areas of cleft care.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1660-1675"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373331","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":"Using the SCAR-Q to Evaluate Morbidity of Scars in Craniosynostosis Repair.","authors":"Neil Parikh, Kevin G Hu, Omar Allam, Katelyn Lewis, Jacqueline M Ihnat, Albert L Rancu, Sam Boroumand, John A Persing, Michael Alperovich","doi":"10.1177/10556656241272473","DOIUrl":"10.1177/10556656241272473","url":null,"abstract":"<p><p>ObjectiveWhile previous literature has investigated the psychosocial impact and aesthetic satisfaction associated with post-operative scarring for certain pediatric craniofacial conditions, the impact of the scar burden resulting from craniosynostosis surgery has not been adequately studied.ParticipantsSCAR-Q was shared with patients ages 8 and older. Thirty-two complete patient responses were recorded.InterventionsSCAR-Q is a PROM that consists of three independent scales - appearance, symptoms, and psychosocial impact - associated with a scar.Main Outcome MeasuresMann-Whitney U, linear regression, and Pearson correlation tests were used to evaluate associations between the scales, in addition to patient characteristics such as sex and suture involvement.ResultsMean ages at time of surgery and survey completion were 9.65 ± 10.10 months and 12.10 ± 3.92 years, respectively. Mean scale scores were 81.5 ± 17.9 for appearance, 86.8 ± 12.4 for symptoms, and 79.3 ± 25.7 for psychosocial impact. Higher patient dissatisfaction with scar appearance correlated with more scar-related symptoms (r = 0.389; p = 0.028) and a greater psychosocial impact (r = 0.725; p < 0.001). SCAR-Q scales did not significantly correlate with age at surgery, age at survey completion, type of synostosis, or type of surgery; however, female patients reported lower mean appearance (65.4 vs. 86.0; p = 0.012) and psychosocial impact (57.3 vs. 85.5; p = 0.010) scores when compared to their male counterparts.ConclusionsIt is vital that surgeons discuss patients' aesthetic satisfaction following craniosynostosis surgery in order to appropriately address and limit deleterious, long-term physical and psychosocial outcomes.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1713-1717"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977013","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":"Publication Trends and Surgeon Perceptions: A Comprehensive Analysis of Gender Disparities in Craniofacial Surgery.","authors":"Molly F MacIsaac, Iman F Khan, Rafael Felix P Tiongco, Joshua M Wright, Fatima Qamar, Carisa M Cooney, Richard J Redett, Jordan N Halsey","doi":"10.1177/10556656241274020","DOIUrl":"10.1177/10556656241274020","url":null,"abstract":"<p><p><i>Objective</i>In academic craniofacial surgery, gender disparities exist across various metrics including faculty positions, leadership roles, and conference representation. This study benchmarks the academic productivity of craniofacial surgeons in 2022 and surveys their perspectives regarding diversity, equity, and inclusion (DEI).<i>Design</i>Total, first author, and senior author PubMed publications in 2022 were recorded for 193 craniofacial attendings and fellows. Craniofacial surgeons were also surveyed regarding academic experience, leadership roles, and DEI perceptions.<i>Setting</i>Electronic<i>Survey Participants</i>26 craniofacial attendings<i>Main outcome measures</i>Total, first author, and senior author publication counts in 2022<i>Results</i>Women comprised 27% (n = 53) of the craniofacial surgeon cohort. Men led total publications (81% vs 19%, p < 0.001), senior-author publications (84% vs 16%, p < 0.001), average total publications (6.6 vs 4.0, p = 0.043), and average senior-author publications (3.1 vs 1.5, p = 0.02). Sub-analysis of craniofacial fellows showed a higher proportion of women (65%) with no statistical difference in total or average publication counts. Survey responses (n = 26) included a perceived lack of female representation in academic and leadership roles. Barriers included inadequate support from current leadership, systemic issues, and biases. Recommendations for improvement included mentorship programs, targeted recruitment, and equitable conference speaker selection.<i>Conclusion</i>Ongoing gender disparities are evident in craniofacial surgery, particularly in academic metrics. However, trends in younger cohorts exhibit more balanced gender representation, publication records, and leadership positions, indicating potential improvements. Further studies are needed to examine these cohorts more comprehensively and longitudinally. Sustained commitment, including mentorship programs and enhanced DEI efforts, is needed to continue this progress.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1742-1749"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142086388","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":"TeleCleft: Development and Evaluation of a Mobile Application for Monitoring Cleft Patients.","authors":"Livian Isabel de Medeiros Carvalho, Eduarda Gomes Onofre de Araújo, Breno Estevam Silva de Souza, Hélder Domiciano Dantas Martins, Daniela Yukie Sakai Tanikawa, Ana Maria Gondim Valença, Cláudia Batista Mélo, Edson Hilan Gomes de Lucena, Rosa Helena Wanderley Lacerda, Paulo Rogério Ferreti Bonan","doi":"10.1177/10556656241271721","DOIUrl":"10.1177/10556656241271721","url":null,"abstract":"<p><p>ObjectiveDevelopment and evaluation of a mobile application for remote monitoring and guidance of pediatric patients diagnosed with cleft lip and/or palate (CL ± P) and their caregivers.DesignThis is a pilot cross-sectional, applied, and quantitative study.SettingThe study was conducted in two tertiary care treatment centers in Brazil.ParticipantsThe participants included 20 caregivers and infants undergoing treatment with nasoalveolar molding (NAM) for CL ± P.InterventionsThe intervention involved using the TeleCleft mobile application for remote monitoring and guidance of caregivers and infants during NAM treatment.Main Outcome Measure(s)The main outcome measures included usability and satisfaction of users with the <i>TeleCleft</i> application.ResultsThe results showed high usability and satisfaction ratings among users of the TeleCleft application. Most participants found remote monitoring to be effective and expressed positive opinions about its convenience and usefulness.Conclusion<i>TeleCleft</i> could be a viable tool for remote monitoring and guidance, reducing the need for patients and caregivers to travel to treatment centers, which could potentially alleviate the burden of care faced by families during the journey of CL ± P treatment.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1676-1683"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894755","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":"Effect of Age and Gender on Nasalance Across the Lifespan: A Systematic Review.","authors":"Valerie J Pereira, Emily See-Man Ching, Joanna Hoi-Man She, Wilson Shing Yu, Kendy Lau, Michael Chi-Fai Tong, Kathy Yuet-Sheung Lee","doi":"10.1177/10556656241276675","DOIUrl":"10.1177/10556656241276675","url":null,"abstract":"<p><p><i>Objective</i>The Nasometer^® is a widely used clinical and research tool with diagnosis and outcome measurement utility. The objective of this study was to systematically examine the effect of age and gender on nasalance across the lifespan.<i>Design</i>A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews (PRISMA 2020).<i>Setting</i>University.<i>Participants</i>Children, adolescents, adults, and older adults.<i>Interventions</i>Covidence Better Systematic Review Management; Scottish Intercollegiate Guidelines Network Methodology (SIGN) Checklist 3 for risk of bias; Levels of evidence, Oxford Centre for Evidence-Based Medicine Levels of Evidence hierarchy; and effect size calculations using G*Power 3.<i>Main outcome measures</i>Nasalance (%) from the Nasometer™.<i>Results</i>50 studies (from N = 1884) were included in the review. All were Level 3 (non-randomized controlled cohort) observational-analytic type studies. Only 10 (20%) of studies met a High Quality (low risk of bias) rating. Effect sizes were moderate for adults versus children (<i>d </i>= 0.717) and adults versus adolescents (<i>d </i>= 0.521) for oral text/passage. Gender differences were clinically significant for adolescent males and females with a moderate effect size (<i>d </i>= 0.545) for oronasal text/passage.<i>Conclusion</i>The systematic review provides objective and defined evidence as to the effects of age and gender on nasalance. Separate normative databases are implicated for specific age subgroups across the lifespan and for gender, particularly in adolescence. Review findings are applicable to other clinical groups where acquisition and/or progression occurs in adulthood/older adulthood.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"1774-1801"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156458","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}