Clinical ImagingPub Date : 2025-07-26DOI: 10.1016/j.clinimag.2025.110566
Livja Mertiri , Eric Bih , Pamela Ketwaroo , Martha M. Munden , Zachary V. Zuniga , Nadia Mahmood , Esther Ngan , J. Herman Kan
{"title":"Differential epididymal enlargement and identification of the mediastinum testes: New proposed sonographic checklist in the acute assessment of pediatric testicular torsion","authors":"Livja Mertiri , Eric Bih , Pamela Ketwaroo , Martha M. Munden , Zachary V. Zuniga , Nadia Mahmood , Esther Ngan , J. Herman Kan","doi":"10.1016/j.clinimag.2025.110566","DOIUrl":"10.1016/j.clinimag.2025.110566","url":null,"abstract":"<div><h3>Background</h3><div>Testicular torsion is a surgical emergency. We have observed that mass-like epididymal enlargement and morphologic changes to the testicular parenchyma differentially represent testes that are viable versus non-viable at the time of scrotal exploration.</div></div><div><h3>Objective</h3><div>The purpose of this study is to assess sonographic findings that may help predict the viability of torsed testes at the time of scrotal exploration.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 128 scrotal ultrasound exams of surgically confirmed testicular torsions (88 salvageable, 40 non-salvageable) from July 2022 to July 2023 (mean age 13.1 years, range: 1–19 years). We assessed the visibility of the mediastinum testis, the ratio between affected and non-affected testes of the maximal cross-sectional area of the epididymis on a transverse plane, the ratio between affected and non-affected testes of the testicular volume, and subjective evidence of mass-like epididymal enlargement.</div></div><div><h3>Results</h3><div>Patients with global epididymal enlargement and those with a non-visible mediastinum testis were found to have a statistically higher likelihood of non-salvageable testes (<em>p</em> = 0.0123 and <em>p</em> = 0.0208, respectively). Additionally, a significant association was observed between testicular volume symmetry and the viability of torsed testes (<em>p</em> = 0.0013). Notably, when the volume of the torsed testis exceeded that of the normal contralateral testis by 40 %, it was significantly associated with a non-salvageable outcome (<em>p</em> = 0.0132).</div></div><div><h3>Conclusion</h3><div>Sonographically visible mediastinum testis, absence of epididymal tail enlargement, and similar volume between affected and non-affected testes are potential positive predictors of the viability of the pediatric torsed testes found during emergent testicular salvage surgery. In contrast, the absence of these predictors suggests a non-salvageable testis.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"125 ","pages":"Article 110566"},"PeriodicalIF":1.5,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724733","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}
Clinical ImagingPub Date : 2025-07-26DOI: 10.1016/j.clinimag.2025.110573
Eren Çamur , Turay Cesur , Yasin Celal Güneş , Yusuf Öztürk , Yunus Şerefettin , Ersin Doğanözü , Ayşegül Akçebe , Ahmet Kürşad Güneş , İbrahim Ethem Cakcak
{"title":"Evaluating Large Language Models for imaging modality selection: Potential to reduce unnecessary contrast agent use and radiation exposure","authors":"Eren Çamur , Turay Cesur , Yasin Celal Güneş , Yusuf Öztürk , Yunus Şerefettin , Ersin Doğanözü , Ayşegül Akçebe , Ahmet Kürşad Güneş , İbrahim Ethem Cakcak","doi":"10.1016/j.clinimag.2025.110573","DOIUrl":"10.1016/j.clinimag.2025.110573","url":null,"abstract":"<div><h3>Introduction</h3><div>Large Language Models (LLMs) represent a transformative leap in artificial intelligence with the potential to revolutionize radiologic decision-making. This study uniquely evaluates the performance of various LLMs from different vendors in selecting appropriate imaging modalities and comparing their responses with those of clinicians across different specialties and radiologists with different experience levels.</div></div><div><h3>Methods</h3><div>In a cross-sectional experimental design, 120 clinical scenarios derived from ACR AC and 120 “Multifaceted practice-oriented clinical scenarios” (including breast, cardiac, gastrointestinal, musculoskeletal, neuro, thoracic, genitourinary, vascular sections) were assessed using three different prompts. The performance of four LLMs from different vendors were evaluated and compared with four clinicians (emergency physician, cardiologist, internist and general surgeon) and four radiologists with different experience level. Also, the performances of LLMs contrast agent use and X-ray-containing imaging modality selection were evaluated. The responses were categorized according to ACR AC. Short and long-term reproducibility were assessed in the same clinical scenarios.</div></div><div><h3>Results</h3><div>All LLMs yielded identical modality recommendations across the three distinct prompts (κ = 1). In ACR clinical scenarios, DeepSeek-R1 identified the appropriate imaging modality in 98.3 % of cases, achieving superior accuracy without inter-model differences (p > 0.006). In realistic scenarios, DeepSeek-R1 again led, matching board-certified junior radiologist performance and exceeding clinician and resident performance. The short-term reproducibility ranged from κ = 0.773 to 0.886, with long-term reproducibility spanning κ = 0.507 to 0.787.</div></div><div><h3>Discussion</h3><div>This study underscores that LLMs have remarkable potential for selecting appropriate imaging modalities for different clinical scenarios related to various sections and their valuable contributions as supportive tools in clinical practice in this field.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"125 ","pages":"Article 110573"},"PeriodicalIF":1.5,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750668","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}
Clinical ImagingPub Date : 2025-07-24DOI: 10.1016/j.clinimag.2025.110564
Savvas Andronikou , Andressa Guariento , Antrea Zouvanni , Carlos Yaya , Linda Tebogo Hlabangana
{"title":"Relevance of spinal lesions in chronic non-bacterial osteomyelitis and imaging features on whole body MRI","authors":"Savvas Andronikou , Andressa Guariento , Antrea Zouvanni , Carlos Yaya , Linda Tebogo Hlabangana","doi":"10.1016/j.clinimag.2025.110564","DOIUrl":"10.1016/j.clinimag.2025.110564","url":null,"abstract":"<div><div>Chronic non-bacterial osteomyelitis (CNO) is an autoinflammatory bone disorder that usually involves long bone metaphyses of the lower extremities and can affect the clavicles, pelvis, mandible, sternum, and spine. The spine is recognized as a classic feature of CNO, but routine whole-body MRI with coronal-only STIR images may underreport its frequency. Dedicated sagittal spinal imaging is important not only in proving a multifocal process but also because vertebral height loss and vertebra plana in CNO can result in scoliosis and kyphosis. Aggressive treatment can prevent vertebral collapse and promote vertebral body height recovery. Spinal CNO typically involves the thoracic spine, is often multifocal, usually shows non-contiguous vertebral involvement, and demonstrates abnormal high T2W signal at the vertebral body and endplate destruction—sometimes as a spondylodiscitis. Importantly, in distinguishing it from other potential causes, CNO usually has no soft tissue mass. Treatment with pamidronate may result in a bone-in-bone appearance.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"125 ","pages":"Article 110564"},"PeriodicalIF":1.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724154","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}
Clinical ImagingPub Date : 2025-07-24DOI: 10.1016/j.clinimag.2025.110565
Liangyu Wu, Suying Wu, Qin Chen, Xiaoyan Yu
{"title":"Diagnostic value of low-dose CT pulmonary angiography combined with iterative reconstruction in suspected pulmonary embolism","authors":"Liangyu Wu, Suying Wu, Qin Chen, Xiaoyan Yu","doi":"10.1016/j.clinimag.2025.110565","DOIUrl":"10.1016/j.clinimag.2025.110565","url":null,"abstract":"<div><h3>Objective</h3><div>Assessing the utility of low-dose computed tomographic pulmonary angiography (CTPA) employing iterative reconstruction (IR) for the detection of pulmonary embolism (PE), we compared its image quality, and radiation exposure with standard-dose CTPA protocols.</div></div><div><h3>Methods</h3><div>Patients with suspected PE were prospectively and randomly allocated to either a low-dose CTPA with IR arm (study group, n = 80) or a standard-dose CTPA plus IR arm (control group, n = 80). The low-dose group used 70 kVp and automatic tube current modulation, while the standard-dose group used 120 kVp with conventional parameters. A 5-point scale was used to evaluate subjective image quality. Objective assessment of noise and contrast was performed by quantifying the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) within the pulmonary arteries. Radiation exposure was quantified via computed tomography dose index volume (CTDIvol) and dose-length product (DLP).</div></div><div><h3>Results</h3><div>Baseline characteristics were comparable between groups (P > 0.05). Subjective image quality was similar, with a non-significant trend towards lower scores in the low-dose group (median 4 [IQR 3–4]) compared to the standard-dose group (P > 0.05). Objective measures showed a non-significant 4.0 % and 5.5 % reduction in SNR and CNR, respectively, in the low-dose group (P > 0.05). Noise levels (SD) were comparable. The low-dose group demonstrated notable reduced radiation exposure: CTDIvol (P < 0.001), DLP (P < 0.001), and effective dose (P < 0.001).</div></div><div><h3>Conclusion</h3><div>Low-dose CTPA employing IR presents a viable option for PE diagnosis, providing similar diagnostic quality with significantly reduced radiation exposure.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"125 ","pages":"Article 110565"},"PeriodicalIF":1.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724156","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}
Clinical ImagingPub Date : 2025-07-19DOI: 10.1016/j.clinimag.2025.110561
Melissa Reichman , Ava Tsapatsaris , David Jaramillo Gil , Lisa Americo , Kemi Babagbemi , Katerina Dodelzon
{"title":"Evaluating provider knowledge and practices in breast cancer screening: Identifying gaps and barriers to informed referrals","authors":"Melissa Reichman , Ava Tsapatsaris , David Jaramillo Gil , Lisa Americo , Kemi Babagbemi , Katerina Dodelzon","doi":"10.1016/j.clinimag.2025.110561","DOIUrl":"10.1016/j.clinimag.2025.110561","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate knowledge and practices of primary care providers on high-risk breast cancer screening imaging recommendations.</div></div><div><h3>Methods</h3><div>A 10-question anonymous survey was distributed via e-mail to primary care providers. The survey assessed provider knowledge of screening guidelines, current referral practices, perceived barriers to timely screening implementation, and preferences in screening methodologies. Responses were aggregated and results reported descriptively.</div></div><div><h3>Results</h3><div>Response rate was 23.3 % (49/210). Majority 55 % (27/49) were obstetricians or gynecologists, 35 % (17/49) were internal medicine or primary care physicians, and 10 % (5/49) were advanced practice providers from the obstetrics and gynecology and internal medicine departments. Nearly all the respondents reported that they routinely assess patients for breast cancer risk. However, more than a quarter (28 %, 14/49) of respondents disagreed that all women should have their lifetime risk of breast cancer assessed by age 25–30, with those remote from their training more likely to disagree (<em>p</em> < 0.001). There was variability in knowledge of appropriate breast imaging screening exam for those identified as high-risk for developing breast cancer, with MRI (69 %, 34/49), mammography (65 %, 32/49), ultrasound (59 %, 29/49), and genetic testing (55 %, 27/49) all being recommended in close proportions. Multiple barriers to routine cancer risk assessment were identified, with time constraints (20 %, 8/40), cost (18 %, 7/40) and lack of knowledge (18 %, 7/40) of assessment tools most frequently reported.</div></div><div><h3>Conclusion</h3><div>High-risk breast cancer screening recommendations practice patterns vary among different specialty primary care providers. Lack of time and knowledge were the main barriers for breast cancer risk assessment evaluation. Future interventions should focus on provider education to optimize imaging recommendations.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"125 ","pages":"Article 110561"},"PeriodicalIF":1.8,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686530","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}
Clinical ImagingPub Date : 2025-07-15DOI: 10.1016/j.clinimag.2025.110563
Olga Laur , Alan Wu , Arindam RoyChoudhury , Lily Belfi
{"title":"Beyond the image: The hidden problem of maladaptive mindsets in radiology residency and how to fix it","authors":"Olga Laur , Alan Wu , Arindam RoyChoudhury , Lily Belfi","doi":"10.1016/j.clinimag.2025.110563","DOIUrl":"10.1016/j.clinimag.2025.110563","url":null,"abstract":"<div><h3>Purpose</h3><div>Burnout, anxiety, and imposter syndrome are prevalent in radiology residency, where high clinical demands and a culture of perfectionism can reinforce maladaptive cognitive patterns. This study examines the prevalence of maladaptive and growth mindsets among residents and evaluates the impact of a brief educational intervention.</div></div><div><h3>Methods</h3><div>A 45-min didactic lecture on mindset theory was delivered to radiology trainees at five institutions. The lecture introduced three maladaptive mindsets - “Cog in the Wheel,” “Survival,” and “Perfectionist” - and one growth mindset, “Growth.” An anonymous post-lecture survey assessed mindset prevalence and the perceived importance of growth mindset development. Pearson's chi-square test was used for statistical analysis.</div></div><div><h3>Results</h3><div>Among 48 resident responses, 65 % identified with the “Perfectionist”, 62 % with “Survival,” and 56 % with “Cog in the Wheel” mindset. Only 6 % identified exclusively with the “Growth” mindset, while 35 % endorsed both growth and maladaptive mindsets. Only 8 % of respondents reported high familiarity with mindset theory pre-lecture. Ninety-percent of respondents rated growth mindset development as “very” or “extremely important” (<em>p</em> < 0.001) post-lecture, compared to 39 % retrospective rating pre-lecture. Additionally, 88 % found the session very helpful, and 75 % expressed high interest in further mindset training.</div></div><div><h3>Conclusion</h3><div>Maladaptive mindsets are prevalent among radiology residents, contributing to stress and burnout. A brief educational intervention significantly increased awareness and motivation to adopt a growth mindset. These findings underscore the need for structured mindset training, faculty modeling of growth-oriented behaviors, and institutional support to foster resilience and professional fulfillment. Future research should explore the long-term impact of mindset interventions.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"125 ","pages":"Article 110563"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653105","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}
Clinical ImagingPub Date : 2025-07-15DOI: 10.1016/j.clinimag.2025.110562
Osher Ngo Yung Lee , Farhad Niaghi , Rawan Abu Mughli , Maria Zulfiqar , Waqas Ahmad , Simmie Smith , Osama Majeed , Faisal Khosa
{"title":"Patient-centered research in radiology: A Canadian perspective","authors":"Osher Ngo Yung Lee , Farhad Niaghi , Rawan Abu Mughli , Maria Zulfiqar , Waqas Ahmad , Simmie Smith , Osama Majeed , Faisal Khosa","doi":"10.1016/j.clinimag.2025.110562","DOIUrl":"10.1016/j.clinimag.2025.110562","url":null,"abstract":"<div><div>This article examines the importance of patient-centered research in radiology with an emphasis on incorporating the patient perspective to improve patient-reported outcomes (PROs) and research relevance. The methods for effective patient engagement include creating patient advisory councils, developing PRO measures, and incorporating patients as active members of research teams. To solve logistic challenges and technical difficulties, communication tools such as visual aids, simplified language, and digital applications are discussed. Key barriers to patient engagement and potential solutions are discussed. The roles of artificial intelligence (AI) and mobile health (mHealth) platforms in simplifying data, as well as addressing ethical considerations related to data security, transparency, and informed consent, are highlighted.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"125 ","pages":"Article 110562"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653104","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}
Clinical ImagingPub Date : 2025-07-07DOI: 10.1016/j.clinimag.2025.110559
Lydia A. Kwarteng , Amie Y. Lee , Lulu Sakafu , Victoria Lee Mango , Lulu S. Fundikira , Frederick Lyimo , Ugumba Kwikima , Beatrice P. Mushi , Katherine Van Loon , Frank J. Minja
{"title":"Global radiology: Building equitable and effective partnerships with low and middle-income countries","authors":"Lydia A. Kwarteng , Amie Y. Lee , Lulu Sakafu , Victoria Lee Mango , Lulu S. Fundikira , Frederick Lyimo , Ugumba Kwikima , Beatrice P. Mushi , Katherine Van Loon , Frank J. Minja","doi":"10.1016/j.clinimag.2025.110559","DOIUrl":"10.1016/j.clinimag.2025.110559","url":null,"abstract":"<div><div>Global radiology partnerships can be leveraged to help address the shortage of radiology access in low and middle-income countries (LMICs). Concurrently, efforts to address inequities in global health initiatives and the power asymmetry between High-Income Countries (HIC) and LMIC partners are ongoing. As the field of radiology continues to expand its global health presence, it is important to ensure the creation of equitable partnerships that avoid perpetuating power imbalances. This paper reviews the critical need to establish and scale-up radiologic care in LMICs, provides historical background on the origins of global health and how these origins might impact current global health practice, briefly introduces the topic of the Decolonize Global Health (DGH) movement, and provides examples of best practices to foster equitable and effective global radiology partnerships.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"125 ","pages":"Article 110559"},"PeriodicalIF":1.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580074","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}
Clinical ImagingPub Date : 2025-07-06DOI: 10.1016/j.clinimag.2025.110558
Eun-Ju Kim , Seong Woo Cho , Jung-Ho Yang , Won Gi Jeong
{"title":"Artificial intelligence-assisted longitudinal assessment of coronary artery calcification in the Korean lung cancer screening CT program","authors":"Eun-Ju Kim , Seong Woo Cho , Jung-Ho Yang , Won Gi Jeong","doi":"10.1016/j.clinimag.2025.110558","DOIUrl":"10.1016/j.clinimag.2025.110558","url":null,"abstract":"<div><h3>Purpose</h3><div>The clinical implications of coronary artery calcification (CAC) growth remain underexplored. This study aims to assess CAC growth and its association with adverse cardiovascular events (ACEs) in individuals undergoing lung cancer screening (LCS) using artificial intelligence (AI)-assisted evaluation.</div></div><div><h3>Methods</h3><div>We included patients who underwent LCS low-dose chest CT (LDCT) between April 2017 and December 2023 with available follow-up LDCT scans. CAC severity was quantified using AI-based software. CAC growth was defined as incident CAC in those with baseline CAC = 0 or annual progression > 15 % in those with baseline CAC > 0. ACEs were categorized as major or minor events. Associations between CAC growth and ACEs were evaluated using Cox regression models, adjusting for baseline age and CAC status.</div></div><div><h3>Results</h3><div>Male patients (<em>n</em> = 193; mean age, 61.6 ± 5.2 years) were analyzed. Over a 4-year mean follow-up, 15.5 % experienced ACEs (major event: 4.1 %, minor event: 11.4 %). Greater baseline CAC severity correlated with a higher annual CAC increase (<em>p</em> < 0.001). Age (adjusted hazard ratio (HR) (95 % confidence interval (CI)) = 1.08 (1.00, 1.17); <em>p</em> = 0.041), CAC growth (adjusted HR (95 % CI) = 2.40 (1.13, 5.09); <em>p</em> = 0.023), and moderate to severe baseline CAC (adjusted HR (95 % CI) = 2.86 (1.11, 7.38); <em>p</em> = 0.030) in the three-tiered classification were significantly associated with a higher occurrence of total ACEs.</div></div><div><h3>Conclusions</h3><div>AI-assisted CAC growth tracking using serial LDCT scans provides prognostic value in LCS populations and may guide risk-based cardiovascular follow-up and prevention strategies in clinical practice.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"125 ","pages":"Article 110558"},"PeriodicalIF":1.8,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680366","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}