Journal of Clinical Sleep Medicine最新文献

{"title":"Adherence to unilateral hypoglossal nerve stimulation and changes in Epworth Sleepiness Scale scores.","authors":"Emily A Commesso, Cyrus Haghighian, Eric J Kezirian","doi":"10.5664/jcsm.11620","DOIUrl":"10.5664/jcsm.11620","url":null,"abstract":"<p><strong>Study objectives: </strong>Effective treatment of obstructive sleep apnea depends on efficacy and adherence. The objective of this analysis was to examine the association between adherence to unilateral hypoglossal nerve stimulation (Inspire upper airway stimulation) and changes in daytime sleepiness.</p><p><strong>Methods: </strong>Participants were adults treated with unilateral hypoglossal nerve stimulation enrolled in the ADHERE Registry. All participants included in the analysis completed a final visit 1-2 years following implantation. Outcomes were the change in Epworth Sleepiness Scale (ESS) score and normalization of a baseline abnormal ESS score (baseline ESS > 10 and final ESS ≤ 10). Statistical analyses examined the association between objective therapy adherence and ESS outcomes, with multiple regression including adjustment for age, sex, race, ethnicity, body mass index, and apnea-hypopnea index-defined responder status.</p><p><strong>Results: </strong>The analysis included 1,147 participants who were primarily middle-aged (59.7 ± 10.5 years), overweight (body mass index: 29.1 ± 3.7), White (95.8%), male (76.8%), and with severe obstructive sleep apnea (apnea-hypopnea index: 35.12 ± 14.81). ESS scores decreased from 11.3 ± 5.5 at baseline to 6.9 ± 4.6 at the final visit. Of those with baseline ESS > 10, 68% (441/644) achieved normalized ESS scores at the final visit. Multiple regression analyses showed that each additional hour/night of therapy use was associated with a decrease in ESS score (0.17, <i>P</i> = .045) and increased odds of normalized ESS (odds ratio: 1.13; 95% confidence interval: 1.03-1.25). Apnea-hypopnea index response was also associated with a decrease in ESS score (1.29, <i>P</i> < .001) and increased odds of a normalized ESS (odds ratio: 2.29; 95% confidence interval: 1.55-3.4).</p><p><strong>Conclusions: </strong>Adherence to hypoglossal nerve stimulation is associated with improvement in daytime sleepiness symptoms and increased odds of achieving normalization of daytime sleepiness.</p><p><strong>Citation: </strong>Commesso EA, Haghighian C, Kezirian EJ. Adherence to unilateral hypoglossal nerve stimulation and changes in Epworth Sleepiness Scale scores. <i>J Clin Sleep Med</i>. 2025;21(7):1175-1183.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1175-1183"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An approach to improving efficiency of actigraphy data in research: use of statistical software to facilitate batch import.","authors":"Onyekachi S Ezeokeke, Janelle M Fine, Jennifer L Martin, Prerna Gupta, Atul Malhotra, Melissa P Knauert, Erica B Feldman, Biren B Kamdar","doi":"10.5664/jcsm.11612","DOIUrl":"10.5664/jcsm.11612","url":null,"abstract":"<p><p>Despite the recent discontinuation of Philips Actiwatch devices, volumes of actigraphy data remain unanalyzed, and these and similar devices continue to be used for clinical and research applications. In this report, we present a Stata \"do\"-file that automates the process of importing and appending raw data files downloaded from Philips Actiware software. For example, in less than 60 seconds, our do-file imported, appended, and cleaned 189,596 epochs of data from raw 48-hour actigraphy data files of 35 critically ill patients, yielding a single unified dataset with usable variables ready for analysis. Portable and scalable, this approach can facilitate error-free generation of single- or multi-day actigraphy datasets from an unlimited number of patients. Although designed for Stata, this simple executable file can be adapted for other data platforms and applied to new and existing actigraphy data files and modified as needed for other actigraphy-based efforts.</p><p><strong>Citation: </strong>Ezeokeke OS, Fine JM, Martin JL, et al. An approach to improving efficiency of actigraphy data in research: use of statistical software to facilitate batch import. <i>J Clin Sleep Med</i>. 2025;21(7):1293-1296.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1293-1296"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of sleep-disordered breathing in opioid users with adaptive servo-ventilation: a subgroup analysis of the European READ-ASV registry.","authors":"Jean-Louis Pepin, Adam V Benjafield, Oliver Munt, Holger Woehrle, Raphael Heinzer, Michael Arzt","doi":"10.5664/jcsm.11652","DOIUrl":"10.5664/jcsm.11652","url":null,"abstract":"<p><strong>Study objectives: </strong>Central sleep-disordered breathing (SDB) is associated with negative health outcomes. Intake of opioids influences stability of breathing and can cause central apneas. Screening for and treatment of SDB is recommended for individuals who use opioids. This subanalysis of the READ-ASV (Registry on the Treatment of Central and Complex Sleep-Disordered Breathing with Adaptive Servo-Ventilation) investigated the effects of adaptive servo-ventilation therapy (ASV) on SDB symptoms in people using opioids.</p><p><strong>Methods: </strong>Patients initiated on ASV who reported intake of opioids at baseline were included in this analysis of real-world registry data. Patients were prospectively followed-up for 12 months. Disease-specific quality of life was assessed with the Functional Outcomes of Sleep Questionnaire. Sleepiness was measured with the Epworth Sleepiness Scale. Symptomatic patients were defined as having a Functional Outcomes of Sleep Questionnaire score of < 17.9 and an Epworth Sleepiness Scale score of > 10.</p><p><strong>Results: </strong>Eighty-six patients who reported opioid use were included. The population had severe SDB (median apnea-hypopnea index: 55 events/h), the majority (n = 75 [87%]) had comorbidities, and 81.6% (40/49 with follow-up available questionnaires) were symptomatic at baseline. ASV effectively treated SDB (residual median apnea-hypopnea index from device data [apnea-hypopnea index flow]: 1.5 events/h). The Functional Outcomes of Sleep Questionnaire (+1.4 points; <i>P</i> = .003) and Epworth Sleepiness Scale (-3 points; <i>P</i> = .029) scores improved significantly at follow-up compared with baseline, and improvements in disease-specific quality of life were more pronounced in symptomatic patients.</p><p><strong>Conclusions: </strong>ASV treatment of central breathing disorders in individuals using opioids resolved SDB and was associated with significant improvements in disease-specific quality of life and sleepiness. ASV treatment may therefore be an actionable intervention to counteract the negative effects of opioids on SDB and quality of life.</p><p><strong>Clinical trial registration: </strong>Registry: ClinicalTrials.gov; Name: Registry on the Treatment of Central and Complex Sleep-Disordered Breathing With Adaptive Servo-Ventilation (READ-ASV); URL: https://www.clinicaltrials.gov/study/NCT03032029; Identifier: NCT03032029.</p><p><strong>Citation: </strong>Pepin J-L, Benjafield AV, Munt O, Woehrle H, Heinzer R, Arzt M; for the READ-ASV Investigators. Treatment of sleep-disordered breathing in opioid users with adaptive servo-ventilation: a subgroup analysis of the European READ-ASV registry. <i>J Clin Sleep Med</i>. 2025;21(7):1227-1232.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1227-1232"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between sleep fragmentation and incident atrial fibrillation: a prospective cohort study in a community population.","authors":"Lixia Wang, Xinjie Hui, Rong Huang, Yi Xiao","doi":"10.5664/jcsm.11614","DOIUrl":"10.5664/jcsm.11614","url":null,"abstract":"<p><strong>Study objectives: </strong>Sleep fragmentation (SF) has been recognized as a risk factor for cardiovascular disease. This study aims to investigate the impact of SF on atrial fibrillation (AF).</p><p><strong>Methods: </strong>A total of 2,377 participants without pre-existing AF from the Sleep Heart Health Study were enrolled in this study. Wake after sleep onset (WASO), SF index, arousal index, and sleep efficiency were used to describe SF objectively. Multivariate logistic regression and restricted cubic spline analysis were conducted to investigate the association between SF and AF.</p><p><strong>Results: </strong>During a mean follow-up of 5.3 years, we observed 221 (9.30%) participants developed AF. Participants with incident AF had significantly worse WASO, arousal index, and sleep efficiency compared with those without incident AF. Multivariate logistic regression revealed that WASO was associated with incident AF in both overall sample and participants without obstructive sleep apnea, with odds ratios of 1.61 (95% confidence interval: 1.04, 2.49; <i>P</i> = .033) and 5.89 (95% confidence interval: 2.18, 19.16; <i>P</i> = .001) for the fourth quartile of WASO, respectively. The first quartile of sleep efficiency (odds ratio, 3.51; 95% confidence interval: 1.28, 10.49; <i>P</i> = .019) and the fourth quartile of arousal index (odds ratio, 3.16; 95% confidence interval: 1.23, 9.01; <i>P</i> = .021) were associated with incident AF in participants without obstructive sleep apnea.</p><p><strong>Conclusions: </strong>This study demonstrated that worsening SF, as assessed by WASO, sleep efficiency, and arousal index, was associated with an increased odds of incident AF in participants without obstructive sleep apnea. Thus, improving SF may contribute to decreasing the odds of incident AF.</p><p><strong>Citation: </strong>Wang L, Hui X, Huang R, Xiao Y. The association between sleep fragmentation and incident atrial fibrillation: a prospective cohort study in a community population. <i>J Clin Sleep Med</i>. 2025;21(7):1191-1200.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1191-1200"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of cognitive behavioral therapy for insomnia in patients with cardiovascular disease: a systematic review and meta-analysis.","authors":"Silje Glenna Andersen, Henrik Sæterhagen, André Pekkola Pacheco, Are Hugo Pripp, Harald Hrubos-Strøm, Costas Papageorgiou, John Munkhaugen, Toril Dammen","doi":"10.5664/jcsm.11656","DOIUrl":"10.5664/jcsm.11656","url":null,"abstract":"<p><strong>Study objectives: </strong>Insomnia affects up to 50% of patients with cardiovascular disease and is associated with poor clinical outcomes. Cognitive behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for insomnia, but little is known about the effects of CBT-I in patients with established cardiovascular disease. We aimed to investigate the effects of CBT-I on insomnia symptom severity, sleep parameters, and daytime symptoms in patients with cardiovascular disease and comorbid insomnia.</p><p><strong>Methods: </strong>Medline, Embase, PsycINFO, and ClinicalTrials.gov were searched for randomized controlled and open trials up to December 2023. Study selection, data extraction, and risk of bias assessment (Cochrane's Risk of Bias 2 tool) were independently conducted by the authors. Data were meta-analyzed using random-effects models.</p><p><strong>Results: </strong>In all, 1,275 records with 5 studies fulfilled the inclusion criteria (n = 352 patients). Compared with active control groups, CBT-I significantly reduced insomnia severity posttreatment (standardized mean difference  = -0.90, 95% confidence interval: -1.43, -0.37; <i>P</i> < .001), sleep onset latency, anxiety, and fatigue. Moreover, CBT-I significantly improved sleep quality (standardized mean difference = -0.77, 95% confidence interval: -1.10, -0.45; <i>P</i> < .001) and sleep efficiency (standardized mean difference = 0.68, 95% confidence interval: 0.12-1.25; <i>P</i> < .001). We regarded 3 randomized controlled trials as having low risk of bias and had some concerns with another.</p><p><strong>Conclusions: </strong>Evidence from our analyses indicated that CBT-I seems to be effective for alleviating insomnia symptoms among patients with cardiovascular disease, largely in line with the results of previous meta-analyses in patients with insomnia. The limited sample size encourages more robust evidence from high-quality, large-scale trials with long-term follow-up.</p><p><strong>Citation: </strong>Andersen SG, Sæterhagen H, Pacheco AP, et al. The effects of cognitive behavioral therapy for insomnia in patients with cardiovascular disease: a systematic review and meta-analysis. <i>J Clin Sleep Med.</i> 2025;21(7):1273-1284.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1273-1284"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 study of acceptance and commitment therapy for central disorders of hypersomnolence: opportunities to improve patient-centered and comprehensive treatment approaches.","authors":"Alicia J Roth, Nancy Foldvary-Schaefer","doi":"10.5664/jcsm.11634","DOIUrl":"10.5664/jcsm.11634","url":null,"abstract":"<p><p>Beyond daytime sleepiness, central disorders of hypersomnolence (including narcolepsy types 1 and 2 and idiopathic hypersomnia) affect the fundamental aspects of everyday life, including mental health, negative self-esteem, relationships, social stigma, and occupational/school problems, all of which can lead to disability. Limited scientifically tested behavioral treatments designed to address the psychological, social, and economic devastation associated with hypersomnia exist. This case report reviews 1 patient's experience with 2 adjuvant interventions for central disorders of hypersomnolence: group cognitive behavioral therapy for hypersomnia and individual acceptance and commitment therapy intervention for central disorders of hypersomnolence.</p><p><strong>Citation: </strong>Roth AJ, Foldvary-Schaefer N. A case study of acceptance and commitment therapy for central disorders of hypersomnolence: opportunities to improve patient-centered and comprehensive treatment approaches. <i>J Clin Sleep Med</i>. 2025;21(7):1301-1304.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1301-1304"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of cannabinoid therapy in treatment-refractory isolated REM sleep behavior disorder: a case report.","authors":"Sahej Samra, Hrayr Attarian, Roneil Malkani","doi":"10.5664/jcsm.11704","DOIUrl":"10.5664/jcsm.11704","url":null,"abstract":"<p><p>Current treatments for rapid eye movement sleep behavior disorder are not always effective and can lead to dose-limited adverse events, and new treatments are needed for this condition. We present a case of a patient with treatment-refractory isolated rapid eye movement sleep behavior disorder who had a dramatic and sustained improvement in dream enactment behaviors using oral tinctures containing cannabidiol and tetrahydrocannabinol without adverse events over 5 years of follow-up.</p><p><strong>Citation: </strong>Samra S, Attarian H, Malkani R. The use of cannabinoid therapy in treatment-refractory isolated REM sleep behavior disorder: a case report. <i>J Clin Sleep Med</i>. 2025;21(7):1311-1313.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1311-1313"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized endpoints in Prader-Willi syndrome: a case study with goal attainment scaling.","authors":"Amee Revana, Gunes Sevinc, Michelle George, Taylor Dunn, Kari Pope, Justin Stanley, Kenneth Rockwood","doi":"10.5664/jcsm.11664","DOIUrl":"10.5664/jcsm.11664","url":null,"abstract":"<p><p>This case report examines the implementation of goal attainment scaling for a 9-year-old female with Prader-Willi syndrome and narcolepsy-like features who began treatment with Pitolisant, a medication designed to alleviate excessive daytime sleepiness. The individualized goal attainment scaling framework enabled the patient and her caregivers to establish specific treatment goals across cognitive, motor, and physiological domains. Although validated outcome measures for this population are limited, goal attainment scaling effectively captured crucial aspects of the patient's experience, revealing overall improvements in most symptoms during a 6-month follow-up. This method provided an unbiased assessment of treatment effectiveness, underscoring the importance of integrating patient-centered measures in the management of rare diseases like Prader-Willi syndrome. The findings suggest that goal attainment scaling can yield valuable insights into patient priorities and treatment outcomes, highlighting the need for further research into its application in clinical settings for Prader-Willi syndrome and similar conditions.</p><p><strong>Citation: </strong>Revana A, Sevinc G, George M, et al. Personalized endpoints in Prader-Willi syndrome: a case study with goal attainment scaling. <i>J Clin Sleep Med</i>. 2025;21(7):1305-1309.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1305-1309"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new frontier for positional therapy: obstetrics.","authors":"Allan J Kember, Noa Gilad, Jerry Coleman, Jane Warland, Sebastian R Hobson","doi":"10.5664/jcsm.11616","DOIUrl":"10.5664/jcsm.11616","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"1319-1320"},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polysomnographic findings of multiple system atrophy: evidence from case-control studies.","authors":"Meiou Wang, Ye Zhang, Rong Ren, Jiaxue Huang, Xujun Feng, Michael V Vitiello, Larry D Sanford, Xiangdong Tang","doi":"10.5664/jcsm.11758","DOIUrl":"https://doi.org/10.5664/jcsm.11758","url":null,"abstract":"<p><strong>Study objectives: </strong>This study examines the polysomnographic (PSG) differences between multiple system atrophy (MSA) patients and healthy controls.</p><p><strong>Methods: </strong>An electronic literature search was performed in MEDLINE, EMBASE, All EBM databases and the Web of Science database from inception to August 2024.</p><p><strong>Results: </strong>Meta-analysis found significant reductions in percent rapid eye movement (REM) sleep, sleep efficiency, and total sleep time, and increases in the apnea-hypopnea index, percent N1, periodic limb movement index and sleep latency in MSA patients compared with healthy controls.</p><p><strong>Conclusions: </strong>Our meta-analysis found PSG abnormalities in MSA patients compared with controls. Future studies should include methodological considerations (i.e., REM sleep without atonia criteria) to evaluate the contributions of potential heterogeneous factors (i.e., disease duration, presence of stridor, comorbidity of rapid eye movement (REM) sleep behavior disorder) to PSG changes in MSA.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}