Journal of Rheumatology最新文献

{"title":"Associations Between Mental Health Diagnoses and Recurrent Acute Care Use Among Individuals With Systemic Lupus Erythematosus in the All of Us Research Program.","authors":"Karen H Costenbader, Jeong Yee, Hongshu Guan, Emily G Oakes, Jing Cui, Leah Santacroce, Elizabeth W Karlson, Karestan Koenen, Laura Kubzansky, Candace H Feldman","doi":"10.3899/jrheum.2026-0335","DOIUrl":"10.3899/jrheum.2026-0335","url":null,"abstract":"<p><strong>Objective: </strong>We investigated prospective associations between mental health conditions (depression, anxiety, and posttraumatic stress disorder [PTSD]) and recurrent acute care use among patients with systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>Within the All of Us Research Program (version 8), a US-wide cohort of adults who enrolled and consented for linkage to electronic health records, we identified those with SLE by International Classification of Diseases, 10th Revision (ICD-10) or Systematized Nomenclature of Medicine (SNOMED) codes before enrollment. We assessed baseline depression, anxiety, and/or PTSD using ICD-10 or SNOMED codes. Outcomes included emergency department (ED) visits and hospitalizations after enrollment. Incidence rates for acute care events among patients with vs without mental health diagnoses were calculated. Multivariable negative binomial regression models estimated incidence rate ratios (IRRs) with 95% CIs, adjusting for sociodemographic factors and comorbidities.</p><p><strong>Results: </strong>Of 2160 patients with SLE, 973 had depression, anxiety, and/or PTSD (mean age 49.4 [SD 13.5] years; 92.8% female); 1187 did not (mean age 50.4 [SD 14.9] years; 88.1% female). Those with ≥ 1 mental health condition had lower education levels and income and more smoking and comorbidities. Patients were followed up for a mean of 3.02 (SD 1.73) years. One or more mental health diagnosis was strongly associated with higher rates of ED visits (adjusted IRR [aIRR] 1.90, 95% CI 1.60-2.27) and hospitalizations (aIRR 1.33, 95% CI 1.08-1.65). This was true for ED visits and hospitalizations for SLE (aIRR 1.42, 95% CI 1.19-1.69) and for non-SLE conditions (aIRR 1.42, 95% CI 1.17-1.74).</p><p><strong>Conclusion: </strong>In this nationwide SLE cohort, those with vs without mental health diagnoses had increased acute care use for SLE and other causes. Further studies are needed to understand whether effective treatment for mental health diagnoses alters care patterns.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of NT-proBNP in Systemic Lupus Erythematosus.","authors":"Lucia Zhu, Evelyne Vinet, Arielle Mendel, Christian A Pineau, Fares Kalache, Louis-Pierre Grenier, Thao Huynh, Karim Sacre, Sasha Bernatsky","doi":"10.3899/jrheum.2026-0384","DOIUrl":"https://doi.org/10.3899/jrheum.2026-0384","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated patterns of N-terminal prohormone of n-terminal brain natriuretic peptide (NT-proBNP, a biomarker of cardiac disease) in SLE, and associations with demographic and clinical characteristics.</p><p><strong>Methods: </strong>We analyzed data from the McGill SLE Research Cohort, including yearly serum NTproBNP. We assessed prevalence of baseline elevated NT-proBNP (≥133 ng/L) , and associations with baseline variables: age, sex, race/ethnicity, age at SLE diagnosis, SLE duration, smoking, and SLE International Collaborating Clinics Damage Index. Patients were classified into four NT-proBNP patterns: abnormal at baseline and remaining abnormal; abnormal and normalizing; normal and becoming abnormal; normal and remaining normal. We compared baseline characteristics across patterns using multivariate logistic regressions.</p><p><strong>Results: </strong>We studied 294 patients with ≥2 measurements. At baseline, 101 (34.4%) had elevated NT-proBNP. Higher levels were associated with older age at SLE diagnosis, longer SLE duration, cardiovascular damage, pulmonary hypertension, and renal damage. Of 101 individuals with abnormal baseline NT-proBNP, 79 (78.2%) remained abnormal. Of the 193 with normal baseline levels, 30 (15.5%) became abnormal. No patient with a baseline level ≥350 normalized to <133. High-risk patterns (abnormal-remaining-abnormal and normal-becoming-abnormal) were more likely to have cardiovascular damage (OR 3.90, 95% CI 1.49-12.5, renal damage (OR 2.87, 95% CI 1.61-5.51), and pulmonary hypertension (OR 32.0, 95% CI 4.59-651.1).</p><p><strong>Conclusion: </strong>Over one-third of SLE patients had abnormal baseline NT-proBNP; most (78%) remained abnormal. Over 15% of those with an initially normal value became abnormal. Higher levels were associated with age, SLE duration, and organ damage. Levels ≥350 ng/L did not normalize over our evaluation.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jaw Claudication Progressing to Scalp and Tongue Necrosis in Giant Cell Arteritis.","authors":"Monica Ghebrial, Costa Papasotiriou, Mohamad-Hasan Kadhim, Christine A Peschken","doi":"10.3899/jrheum.2026-0614","DOIUrl":"https://doi.org/10.3899/jrheum.2026-0614","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening Spondyloarthritis Care in the Americas: A Joint Position Statement of the Pan American League of Associations for Rheumatology and the Spondyloarthritis Research and Treatment Network on Education, Collaborative Research, and Mentorship.","authors":"Mohamad Bittar, Antonio Cachafeiro Villar, Ignacio Garcia-Valladares, Rodrigo García Salinas, Carla Gonçalves Schahin Saad, Nigil Haroon, Sebastián Ibañez Vodnizza, Marina Magrey, Rodolfo Pérez Alamino, Hernán Maldonado Ficco, John D Reveille, Fernando Sommerfleck, Matthew L Stoll, Carlos E Toro Gutiérrez, Wilson Bautista-Molano","doi":"10.3899/jrheum.2026-0390","DOIUrl":"https://doi.org/10.3899/jrheum.2026-0390","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The spectrum of cardiovascular disease in systemic lupus erythematosus and rheumatoid arthritis: a nationwide case-control postmortem study.","authors":"Jessica L Fairley, Laura Ross, Elizabeth Paratz, Penelope McKelvie, Simin Daneshvar, Shereen Oon, Dylan Hansen, Wendy Stevens, Andre La Gerche, Mandana Nikpour","doi":"10.3899/jrheum.2026-0337","DOIUrl":"https://doi.org/10.3899/jrheum.2026-0337","url":null,"abstract":"<p><strong>Objective: </strong>To examine cardiovascular pathology in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) vs. population-based controls, and its association with cause of death.</p><p><strong>Methods: </strong>A case-control postmortem study was performed in Australia using the National Coronial Information System (2000-2025). SLE/RA cases were identified via keyword/ICD-10 code search. Controls were selected from motor vehicle accident deaths (3:1 ratio). Cardiovascular findings/histology were extracted from autopsy reports. Associations between SLE/RA and cardiovascular findings/outcomes using logistic regression (odds ratios (OR), 95% confidence intervals (CI)).</p><p><strong>Results: </strong>363 cases (240 RA&123 SLE) and 123 controls of similar age (cases 63y (IQR 53-72), vs. controls 59y (47-73), p=0.166) and sex (female 69% vs. controls 75%, p=0.235) were included. Adjusting for age, sex and BMI, myocardial fibrosis (SLE OR3.66, 95%CI2.00-6.72, p<0.001; RA OR3.96, 95%CI2.37-6.60, p<0.001), myocardial inflammation (SLE OR14.79, 95%CI3.35-65.37, p<0.001; RA OR6.35, 95%CI1.44-28.09, p=0.015) and cardiomegaly (SLE OR5.70, 95%CI2.99-10.86, p<0.001; RA OR3.50, 95%CI2.02-6.08, p<0.001) were more frequent in SLE and RA, as were coronary artery disease (CAD; SLE OR2.46, 95%CI1.34-4.51, p=0.004; RA OR2.56, 95%CI1.54-4.27, p<0.001) and microvascular disease (SLE OR10.28, 95%CI2.28- 46.31; RA OR6.74, 95%CI1.53-29.57, p=0.012). Associations between cardiovascular findings and SLE/RA status were strongest in under-60s, and persisted after adjusting for CAD. Cardiovascular death was associated with myocardial fibrosis (SLE OR2.35, 95%CI1.02-5.43, p=0.045; RA OR3.62, 95%CI1.81-7.27, p<0.001), cardiomegaly (SLE OR3.77, 95%CI1.71-8.27, p=0.001; RA OR2.52, 95%CI1.44-4.43, p=0.001) and CAD (SLE OR4.12, 95%CI1.76-9.66, p=0.001; RA OR12.71, 95%CI6.59-24.49, p<0.001); and microvascular disease (OR5.26, 95%CI1.40-19.77, p=0.014) and valvular pathology (OR2.68, 95%CI1.11-6.43, p=0.028) in SLE only.</p><p><strong>Conclusion: </strong>This unique dataset identified increased atherosclerotic, inflammatory and fibrotic cardiovascular disease in SLE and RA, particularly in younger individuals. These pathologies were frequently associated with cardiovascular death.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent Opioid Exposure in Older Adults with Rheumatic Disease: National Patterns, Disparities, and Cross-Specialty Prescribing.","authors":"Christine Anastasiou, Eric Roberts, Daniel Ciccarone, Karen Costenbader, Gabriela Schmajuk, Jinoos Yazdany","doi":"10.3899/jrheum.2026-0220","DOIUrl":"10.3899/jrheum.2026-0220","url":null,"abstract":"<p><strong>Objective: </strong>Estimate national prevalence of opioid use, including chronic and high-risk use, among older adults with rheumatic diseases; identify sociodemographic and clinical factors associated with chronic opioid use; and characterize prescribing patterns by clinician specialty in a contemporary Medicare-linked national registry cohort.</p><p><strong>Methods: </strong>Cross-sectional analysis of the Rheumatology Informatics System for Effectiveness (RISE) registry linked to Medicare Part D (2016-2021). Patients were ≥65 years with qualifying rheumatic diagnoses and continuous Medicare enrollment in 2021. Opioid use was identified from Part D claims. Chronic use was defined as ≥90 days' supply in 2021. High-risk use was assessed using Office of Inspector General indicators. Generalized estimating equations modeled factors associated with chronic opioid use.</p><p><strong>Results: </strong>Among 45,455 patients (mean age 75.8 years; 76.88% women), 43.13% filled ≥1 opioid prescription and 17.93% met criteria for chronic use in 2021. Very high-risk prescribing was rare (<1%). Chronic use was most prevalent in axial spondyloarthritis (axSpA; 26.19%) and least in polymyalgia rheumatica (11.58%). In adjusted analyses, axSpA (OR 1.63, 95% CI 1.35-1.98), fibromyalgia (OR 2.68, 95% CI 2.39-3.00), mood and anxiety disorders, higher comorbidity burden, American Indian/Alaska Native race, and greater socioeconomic deprivation were independently associated with chronic use. Non-rheumatology clinicians wrote most opioid prescriptions (62.60%) and more high-dose prescriptions (≥50 morphine milligram equivalents/day).</p><p><strong>Conclusion: </strong>Opioid exposure remains common among Medicare-insured older adults with rheumatic disease, although very high-risk prescribing is rare. Coordinated, guideline-concordant pain management across specialties may help preserve appropriate opioid use for patients who may benefit while reducing avoidable long-term exposure.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Concurrent Antiacetylcholine Receptor-Positive Myasthenia Gravis and Anti-HMGCR-Positive Myositis Following Statin Exposure.","authors":"Candie Jammal, David W Newton, Calvin Chen, Andrew L Mammen","doi":"10.3899/jrheum.2025-0711","DOIUrl":"10.3899/jrheum.2025-0711","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Endobronchial Plasmacytoma in a Patient With Rheumatoid Arthritis Taking Methotrexate.","authors":"Shuyun Wang, Binglin Lai","doi":"10.3899/jrheum.2026-0749","DOIUrl":"https://doi.org/10.3899/jrheum.2026-0749","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Comparison of Treat-to-Target States and Clinical Outcomes in Patients With Late-Onset Versus Early-Onset Systemic Lupus Erythematosus.","authors":"Worawit Louthrenoo, Alberta Hoi, Vera Golder, Yi-Hsing Chen, Jiacai Cho, Aisha Lateef, Laniyati Hamijoyo, Shue-Fen Luo, Yeong-Jian Jan Wu, Sandra V Navarra, Leonid Zamora, Zhanguo Li, Sargunan Sockalingam, Yasuhiro Katsumata, Yanjie Hao, Zhuoli Zhang, B M D B Basnayake, Madelynn Chan, Jun Kikuchi, Yuko Kaneko, Tsutomu Takeuchi, Shereen Oon, Sang-Cheol Bae, Kristine Pek Ling Ng, Sean O'Neill, Geraldine Hassett, Fiona Goldblatt, Tze-Chin Tan, Nicola Tugnet, Cherica Tee, Michael Tee, Mark Sapsford, Chiu Wai Shirley Chan, Chak Sing Lau, Naoaki Ohkubo, Yusuke Miyazaki, Yoshiya Tanaka, Mandana Nikpour, Eric F Morand, Rangi Kandane-Rathnayake","doi":"10.3899/jrheum.2026-0047","DOIUrl":"10.3899/jrheum.2026-0047","url":null,"abstract":"<p><strong>Objective: </strong>We compared demographic and clinical characteristics between patients with late-onset (LO) and early-onset (EO) systemic lupus erythematosus (SLE) and examined their longitudinal associations with treatment targets and long-term outcomes, irreversible organ damage accrual, and health-related quality of life (HRQOL).</p><p><strong>Methods: </strong>We analyzed prospectively collected data from patients enrolled in the Asia Pacific Lupus Collaboration cohort. Patients diagnosed with SLE at age > 50 years were classified as having LO-SLE, whereas those diagnosed at age ≤ 50 years were classified as having EO-SLE. Longitudinal associations with treatment targets (Low Lupus Disease Activity State [LLDAS] and Definition of Remission in SLE [DORIS] remission), organ damage accrual (Systemic Lupus International Collaborating Clinics/American College of Rheumatology [SLICC/ACR] Damage Index), and HRQOL (36-item Short Form Health Survey v2 physical and mental component summary [PCS and MCS] scores) were examined using multivariable multilevel logistic, recurrent event survival, and linear mixed-effects models, respectively. Disease activity, flares, medication exposure, and other clinical characteristics were also compared between groups.</p><p><strong>Results: </strong>Among 3917 patients studied, 346 (8.8%) had LO-SLE and 3571 (91.2%) had EO-SLE. Compared to patients with EO-SLE, those with LO-SLE had lower disease activity, lower glucocorticoid and immunosuppressant exposure, and higher attainment of treatment targets. LO-SLE was associated with higher odds of attaining LLDAS (odds ratio [OR] 2.33, 95% CI 1.66-3.28) and DORIS remission (OR 2.22, 95% CI 1.45-3.38). However, patients in this group were at a greater risk of damage accrual (hazard ratio 1.82, 95% CI 1.50-2.21) and lower PCS scores, meaning poorer physical health (regression coefficient [RC] -3.63, 95% CI -4.58 to -2.68), but not MCS scores (RC 0.68, 95% CI -0.50 to 1.86).</p><p><strong>Conclusion: </strong>Despite higher attainment of treatment targets, patients with LO-SLE experienced greater damage accrual and poorer physical health, suggesting that disease activity targets alone may not fully identify outcome risk in LO-SLE.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in clinical need, willingness, and surgeon recommendations for total knee arthroplasty: a cross-sectional study.","authors":"Gillian A Hawker, Eric R Bohm, Philippa J A Nicolson, Lissa Pacheco-Brousseau, Lauren K King, Cornelia M Borkhoff","doi":"10.3899/jrheum.2026-0257","DOIUrl":"https://doi.org/10.3899/jrheum.2026-0257","url":null,"abstract":"<p><strong>Objective: </strong>Females experience greater severity of knee osteoarthritis (OA) than males, but are disproportionately less likely to receive total knee arthroplasty (TKA). We examined whether sex differences in willingness to undergo TKA at surgeon consultation contributed to sex disparities.</p><p><strong>Methods: </strong>This cross-sectional study was nested in a prospective cohort of knee OA patients referred to Alberta, Canada, hip/knee surgery clinics from 2014 to 2017. A pre-consult questionnaire assessed TKA appropriateness and contextual factors. TKA willingness was defined as responding 'yes' to \"I would definitely consider having TKA now\". Surgeon's reported their TKA recommendation (yes/no) postconsultation. Multivariable logistic regression models examined the association of patient sex with TKA willingness (yes/no) and multivariable log Poisson regression models assessed the association of willingness with receipt of a surgeon recommendation for TKA, stratified by sex. Models were adjusted for TKA appropriateness (need, psychological readiness, expectations, health status) and contextual factors.</p><p><strong>Results: </strong>2,035 participants were included (58.72% female; mean age 65.7 years [SD, 9.1]). Adjusting for TKA appropriateness and contextual factors, the odds ratio associated with a female versus a male being 'willing' was 0.67 (0.51 - 0.88). 1,518 (74.59%) participants were recommended TKA. The adjusted risk ratio associated with a 'definitely willing' individual being recommended TKA was 5.03 (95% CI 3.04 - 8.33) in males and 2.15 (95% CI 1.68 - 2.75) in females.</p><p><strong>Conclusion: </strong>Willingness to undergo TKA was associated with a higher likelihood of being recommended for TKA among males than females, raising concerns regarding bias.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}