Cleft Palate-Craniofacial Journal最新文献

{"title":"Evaluating SWAG and Its Validity When Compared to 3D Imagery of Secondarily Grafted Cleft Sites.","authors":"David S Briss, Ross E Long, John B Peterman, Jean Charles Doucet, John Daskalogiannakis, Ron R Hathaway, Ana M Mercado, Kathy Russell, Lexi Stauffer","doi":"10.1177/10556656231207570","DOIUrl":"10.1177/10556656231207570","url":null,"abstract":"<p><p>ObjectiveTo test validity of 2D Standardized Way to Assess Grafts (SWAG) ratings to assess 3D outcomes of bone grafting (ABG).Patients43 patients (34 UCLP, 9 BCLP) with non-syndromic complete clefts, bone-grafted at mean age 9yrs/3mos, with available post-graft occlusal radiographs and cone beam computed tomography (CBCT) (taken mean 4yrs/9mos post-ABG).Main Outcome Measures2D occlusal radiographs rated twice using SWAG by 6 calibrated raters. 12 scores were averaged and converted to a percentage reflecting bone-fill. Weighted Kappas were assessed for SWAG reliability. 3D cleft-site bone volume was calculated by 1 rater using ITK-SNAP. 13 cleft sites were re-measured by the 'one rater' for 3D reliability using Intraclass Correlation Coefficient (ICC). 2D versus 3D ratings were compared using paired t-test, independent samples t-test, Bland-Altman and Linear Regression. Significance level was <i>P</i> = .5.Results2D reliability was 0.724 (intra-rater) and 0.546 (inter-rater). 3D reliability was 0.986. Bland-Altman plot comparing 2D vs 3D showed for 45 of 47 graft-sites were within 2 SD's. Mean % bone-fill was 64.11% with 2D and 69.06% with 3D (mean difference = 4.95%) that was a non-significant difference in both t-tests. Regression showed a statistically significant relation between the two methods (r²= 0.46; <i>P</i> = .0001).Conclusion2D SWAG systematically and non-significantly underestimated bone-fill. There was a significant correlation between 2D/3D methods. Bland-Altman analysis illustrated the similarity of the two methods. For comparisons of group (cleft treatment Centers') bone grafting outcomes, the 2D method may suffice as a proxy for the 3D method. However, with individual variation up to 40% in 2D estimates of actual 3D volume, 2D SWAG method cannot be used in place of 3D images.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"430-438"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240191","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":"Craniometric and Aesthetic Outcomes in Craniosynostosis Surgery: A Systematic Review and Meta-Analysis.","authors":"Akriti Choudhary, Michael Edgar, Shreya Raman, Lee W Alkureishi, Chad A Purnell","doi":"10.1177/10556656231204506","DOIUrl":"10.1177/10556656231204506","url":null,"abstract":"<p><p>ObjectiveTo systematically review the published comparative aesthetic outcomes, and its determinants, for craniosynostoses surgically treated by minimally-invasive cranial procedures and open cranial vault remodeling (CVR).DesignPRISMA-compliant systematic review.SettingNot-applicable.Patients/ParticipantsArticles were included if they compared spring cranioplasty, strip minimally-invasive craniectomy or CVR for outcomes related to aesthetics or head shape. Forty-two studies were included, comprising 2402 patients.InterventionsNone.Main Outcome Measure(s)The craniometric and PROM used to determine surgical outcomes.ResultsTwenty-five studies (59%) evaluated sagittal craniosynostosis, with metopic (7;17%) and unicoronal (4;10%) the next most prevalent. Thirty-eight studies (90%) included CVR, 24 (57%) included strip craniectomy with helmeting, 9 (22%) included strip craniectomy without helmeting, 11 (26%) included spring cranioplasty, and 3 (7%) included vault distraction. A majority of studies only used 1 (43%) or 2 (14%) craniometric measures to compare techniques. In sagittal synostosis, 13 (59%) studies showed no difference in craniometric outcomes, 5 (23%) showed better results with CVR, 3 (14%) with strip craniectomy, and 1 (5%) with springs. In studies describing other synostoses, 10/14 (71%) were equivocal. Subjective outcome measures followed similar trends. Meta-analysis shows no significant difference in cranial index (CI) outcomes between CVR and less invasive procedures in patients with sagittal synostosis.ConclusionsThere is no difference in CI outcomes between CVR and less invasive procedures. The majority of literature comparing craniometric and aesthetic outcomes between CVR and less invasive procedures shows equivocal results for sagittal synostosis. However, the heterogeneity of data for other craniosynostoses did not allow meta-analysis.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"401-422"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684134","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":"Parents' Perception of the Benefit of Receiving a Patient Information Leaflet Prior to Attending a Craniofacial Multidisciplinary Team Appointment.","authors":"Moa Millgård, Anita Myhre, Bernt J Due-Tønnessen, Kristin J Billaud Feragen","doi":"10.1177/10556656231219579","DOIUrl":"10.1177/10556656231219579","url":null,"abstract":"<p><p>ObjectiveTo investigate how a patient information leaflet describing what to expect during a craniofacial multidisciplinary team (MDT) appointment is experienced by parents of children with craniofacial anomalies (CFAs) and whether it helps with preparation for the appointment.DesignCombination of qualitative and quantitative design.SettingNorwegian National Unit for Craniofacial Surgery.ParticipantsThirty-three parents of children with CFAs completed the questionnaire and fourteen were subsequently interviewed.InterventionsA patient information leaflet, sent to all parents before their MDT appointment.Main Outcome MeasuresDescriptive questionnaire data and interview data.ResultsAll parents (<i>N</i>  =  33, 100%) found the leaflet easy to understand, while 31 (93.9%) found it provided helpful information. However, many first-time attendees still found the MDT setting overwhelming.ConclusionsA leaflet may be helpful for parents when preparing for their child's MDT appointment. However, some parents may need additional support and information related to their child's treatment pathway.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"527-533"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811980","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":"Multidisciplinary Aesthetic Management of a Dentition in a Patient with Cleft Lip and Palate with a High Smile Line: A Clinical Report.","authors":"Daniel Dilworth, Emily Lordan, Sittana Elfadil, Aisling O'Mahony","doi":"10.1177/10556656231219581","DOIUrl":"10.1177/10556656231219581","url":null,"abstract":"<p><p>The aesthetic management of a case involving a high smile line in a patient with a cleft lip and palate can be difficult. In this report, we look at a complex case of a patient with a unilateral cleft lip and palate which required a multidisciplinary approach involving crown lengthening, extraction of a maxillary right central incisor and fabrication of a 4-unit fixed partial denture to replace this tooth and the adjacent absent maxillary right lateral incisor with use of gingival porcelain in order to improve the aesthetics of the patient's smile.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"534-539"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811978","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":"Is the Future of Cleft Care Financially Sustainable? An Economic Analysis of Inflation-Adjusted Reimbursements.","authors":"Jasmine M Chaij, Jacob B Hammond, Skyler K Palmer, Anna D Lee, Diego A Gomez, Brooke M French, Phuong D Nguyen, David W Mathes, David Y Khechoyan","doi":"10.1177/10556656251322608","DOIUrl":"https://doi.org/10.1177/10556656251322608","url":null,"abstract":"<p><strong>Objective: </strong>As Medicaid continues to expand, it remains unclear if reimbursement rates for cleft care are keeping up with the national economy. The purpose of this study is to determine how financial trends in cleft lip and palate repair reimbursements compare to annual changes in the U.S. economy.</p><p><strong>Design: </strong>Current Procedural Terminology (CPT) codes for cleft lip and palate repair were retrospectively reviewed between 2018 and 2023. Reimbursements were adjusted for inflation to 2023 U.S. dollars using Medicaid physician fee schedules. Annual percentage changes in inflation-adjusted reimbursements, and reimbursement Compounded Annual Growth Rate (CAGR) were compared to the annual change in the U.S. Consumer Price Index (CPI).</p><p><strong>Setting: </strong>Multi-state, Medicaid.</p><p><strong>Participants: </strong>Medicaid reimbursements of 6 U.S. states, 5 with highest birthrates: California, Texas, Florida, New York, and Pennsylvania. Colorado, the study institution, was evaluated.</p><p><strong>Main outcome(s): </strong>Primary outcomes included annual changes in overall and inflation-adjusted reimbursement rates for cleft lip and palate surgical procedures as compared to annual changes in CPI.</p><p><strong>Results: </strong>The U.S. CPI increased by 20.9% from 2018 to 2023, while the overall total percentage change in reimbursement rates for all cleft lip and palate procedures increased by 7.23%. The inflation-adjusted overall percent change in reimbursements for all procedures decreased by -12.81%. For all procedures, the average CAGR was -2.66%.</p><p><strong>Conclusions: </strong>Inflation-adjusted reimbursement rates for cleft lip and palate repair have significantly decreased in contrast to the annual growth in U.S. CPI. These findings show a potential lack of financial sustainability for surgical cleft care, indicating the need for healthcare policy reform.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251322608"},"PeriodicalIF":1.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525112","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":"Predicting the Feasibility of Local Tissues in Recurrent Palate Fistula Repair: A New Scoring System.","authors":"Seyda Guray, Uğur Kaan Kalem","doi":"10.1177/10556656251323043","DOIUrl":"https://doi.org/10.1177/10556656251323043","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the impact of structural changes from repeated failed surgeries on outcomes and develop a scoring system to evaluate local palatal tissue usability in recurrent fistula repairs.</p><p><strong>Design: </strong>A retrospective study of 51 patients with prior failed fistula surgeries using a novel scoring system for palatal tissue evaluation.</p><p><strong>Setting: </strong>The study was conducted at a tertiary care center for craniofacial surgery.</p><p><strong>Patients, participants: </strong>51 patients with recurrent palatal fistulas and at least 1prior failed surgery were included. Standardized preoperative photographs were taken.</p><p><strong>Interventions: </strong>Patients underwent palatal fistula repair. Outcomes were assessed 12 months postoperatively, and patients were grouped by success. Two surgeons applied the scoring system to assess scar condition (evaluated by color), rugae presence, remnant flap (RF), and number of failed surgeries (NFSs).</p><p><strong>Main outcome measure(s): </strong>The primary measure was the correlation between scoring system criteria and surgical outcomes, with statistical analysis determining predictive value.</p><p><strong>Results: </strong>All criteria correlated with NFS and recurrence (<i>P</i> < 0.001), but only rugae, RF, and NFS showed strong associations with recurrence. Scar condition evaluated by color had lower correlations with rugae (<i>r</i> = 0.461), RF (<i>r</i> = 0.458), and NFS (<i>r</i> = 0.239). The final scoring system was simplified to 3 variables: rugae, RF, and NFS.</p><p><strong>Conclusions: </strong>The revised scoring system effectively predicts success in recurrent palatal fistula repairs. Scores above 2 indicate a high risk of recurrence, suggesting alternative approaches when using local tissues.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251323043"},"PeriodicalIF":1.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525127","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":"Development of a Core Outcome Set for the Audit of Cleft Care in Malaysia.","authors":"Al Imran Shahrul, Nik Mukhriz Nik Mustapha, Mas Suryalis Ahmad, O P Kharbanda, Aida Nur Ashikin Abd Rahman","doi":"10.1177/10556656241285808","DOIUrl":"https://doi.org/10.1177/10556656241285808","url":null,"abstract":"<p><strong>Objective: </strong>To develop a core outcome set for the audit of cleft care in Malaysia.</p><p><strong>Design: </strong>To generate a core outcome set for patients dealing with cleft lip and/or palate within Malaysia, a combination of scholarly research reviews and consensus-driven methodologies, such as questionnaires and collaborative discussions, were utilized to guide the development process.</p><p><strong>Setting: </strong>Multicenter study. Feedback obtains via face-to-face and online interaction.</p><p><strong>Participants: </strong>Cleft Clinicians, Cleft Lip and Palate Association of Malaysia members, hospitals, and government bodies personal.</p><p><strong>Main outcome measure: </strong>Participants provide their feedback and suggestions of each outcome measure.</p><p><strong>Results: </strong>Through a deliberative process, agreement was established on a uniform set of outcome measures selected from an initial list of 108 potential outcomes. These agreed-upon measures were classified into 12 primary domains: demographic, cleft detail, pregnancy, general pediatric, otolaryngology/audiology, speech, surgical, orthodontics, pediatric dentistry, radiology, photographs, and study models.</p><p><strong>Conclusion: </strong>A specialized core outcome set has been successfully developed for patients with cleft lip and/or palate, aiming to facilitate its implementation within the Malaysian healthcare system.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656241285808"},"PeriodicalIF":1.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525108","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":"Anthropometric Difference of Unilateral Microtia Reconstructed Auricle.","authors":"Aqilah Mumtazah, Rizka Uswatun Hasanah, Faizal Rezky Dhafin, Imaniar Fitri Aisyah, Rosa Falerina, Muhtarum Yusuf, Indri Lakhsmi Putri","doi":"10.1177/10556656251320757","DOIUrl":"https://doi.org/10.1177/10556656251320757","url":null,"abstract":"<p><p>This study aimed to evaluate the surgical outcomes of auricular reconstruction by comparing the anthropometric differences between the reconstructed and normal auricles.</p><p><p>Cross-sectional study.</p><p><p>All microtia patients who underwent surgery at Airlangga University Hospital, Indonesia.</p><p><p>Patients with unilateral microtia who had completed auricular reconstruction using autologous costal cartilage at Airlangga University Hospital, with a more than 3 months follow-up between 2019 and 2022.</p><p><p>Primary data were obtained through auricle photographs, and a medical engineer performed anthropometric measurements. The data were analyzed using a paired <i>t</i> test.</p><p><p>The primary parameters measured were the ratios of auricle width to lobular width and auricle height to lobular height for each subject's right and left auricles. The differences between the reconstructed auricle and the normal contralateral side were assessed.</p><p><p>In a sample of 20 patients, no significant difference was observed in the ratio of auricle width to lobular width (<i>P</i> > .05). However, a significant difference was found in the ratio of auricle height to lobular height between the reconstructed auricle and the normal contralateral side (<i>P</i> < .05).</p><p><p>Future studies should consider utilizing the ratio of auricle width to lobular width as an objective indicator of success in microtia reconstruction.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251320757"},"PeriodicalIF":1.1,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484509","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":"Optimizing the Host Niche to Fuel Cleft Lip Muscle Regeneration.","authors":"Pinting He, Xu Cheng, Qian Shi, Chenghao Li, Bing Shi","doi":"10.1177/10556656251320758","DOIUrl":"https://doi.org/10.1177/10556656251320758","url":null,"abstract":"<p><strong>Objective: </strong>Lip muscle reconstruction is a key strategy for cleft lip repair, but the outcome of muscle regeneration is suboptimal. The lack of relevant models restricts studies on cleft lip muscle regeneration.</p><p><strong>Design: </strong>In this study, we developed an animal xenograft model by transplanting muscle samples from patients with cleft lip into different host sites in immunodeficient mice. The grafted muscles were harvested after 1, 2, and 5 months to investigate the temporal dynamics of myofiber growth and maturation. Comparisons were made among muscle biopsies, xenografts in the masseter (MAS) muscle of the mice, and xenografts in the tibialis anterior (TA) muscle of the mice to determine the optimal host niche.</p><p><p>Histological analysis of myofiber number and size, fiber type switching, innervation, and blood supply was performed to evaluate the cleft lip muscle regeneration process.</p><p><strong>Results: </strong>The muscles from cleft lip patients underwent an active degeneration-regeneration cycle. The fiber diameter in the MAS niche was significantly larger than that in the TA niche and was comparable to the fiber diameter of the donor biopsy from which it originated. The innervation and blood supply of the muscle grafts at the MAS host site were also superior to those of the grafts at the TA host site.</p><p><strong>Conclusions: </strong>The MAS muscles of mice provided the most favorable microenvironment for cleft lip muscle regeneration. This patient-centered xenograft model offers a platform for cleft lip muscle regeneration studies.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251320758"},"PeriodicalIF":1.1,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484529","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":"Care Pathways for Undocumented Migrant Children Seeking Cleft Lip and Palate Care: Institutional Experience, Current State Policies, and Opportunities.","authors":"Diego A Gomez, Skyler K Palmer, Maureen Andrews, Antonio R Porras, Jason W Yu, David Y Khechoyan, Brooke French, Phuong D Nguyen","doi":"10.1177/10556656251318860","DOIUrl":"https://doi.org/10.1177/10556656251318860","url":null,"abstract":"<p><p>Timely medical care is crucial for optimal outcomes in children with cleft lip and palate. Undocumented migrant children face significant healthcare barriers. This study assesses the demographic characteristics and unmet surgical needs of undocumented children at our institution and analyzes state-level policies affecting their care.</p><p><p>A retrospective review was conducted at a single institution between 2023 and 2024. Medicaid and Children's Health Insurance Program policies were reviewed as of August 2024, categorizing states by immigrant child healthcare coverage.</p><p><p>Multidisciplinary cleft clinic in a pediatric referral center.</p><p><p>Ten undocumented children were included, with clinical data and immigration status collected from social work and insurance records.</p><p><p>Timing of initial cleft surgery, additional surgical needs, and surgical completion were assessed.</p><p><p>Ten undocumented children were identified, with a mean age of 7 (range 1-10) years. Eight received primary cleft surgery in their home countries, but many had unmet surgical needs, including alveolar bone grafting (n = 4), oronasal fistula closure (n = 5), and dental care (n = 3). Twelve states provide comprehensive coverage regardless of immigration status, with 2 more expected by 2025. Twenty-three states cover only certain noncitizens without a waiting period, while 14 impose a 5-year delay. Broad coverage was concentrated in the Northeast and West (<i>P</i> = .002), with only one US-Mexico border state included.</p><p><p>This study highlights barriers undocumented migrant children face in accessing cleft care, with disparities in state-funded policies potentially delaying critical interventions. Addressing these disparities is essential for equitable healthcare access.</p>","PeriodicalId":49220,"journal":{"name":"Cleft Palate-Craniofacial Journal","volume":" ","pages":"10556656251318860"},"PeriodicalIF":1.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469797","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}