Archives of Iranian Medicine最新文献

{"title":"Pathological Assessment of the Appendix in Appendectomies Performed in Children.","authors":"Farzaneh Javanmard, Yasin Hasanzadegan Sadegh","doi":"10.34172/aim.2024.38","DOIUrl":"10.34172/aim.2024.38","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis is known as the most common diagnosis of acute abdomen leading to surgery. Therefore, timely diagnosis is of special importance. This study was conducted with the aim of pathological assessment of the appendix in appendectomies performed in children to determine the rate of negative appendectomies and the predictors of negative appendectomy and to evaluate the paraclinical tools used in the diagnosis of acute appendicitis.</p><p><strong>Methods: </strong>This is a cross-sectional descriptive study. All children who underwent appendectomy at Shahid Motahari Hospital in Urmia from March 2021 to March 2022 were examined. The required data including demographic, paraclinical, and final pathology characteristics were collected and recorded. The investigated cases were classified into positive and negative appendectomy categories for comparison.</p><p><strong>Results: </strong>Among 234 pathology samples of the appendix, 22 cases were related to accidental appendectomy. In addition, 11.3% of cases were negative appendectomy and 88.7% were positive appendectomy. The age range of 8 to 14 years and male gender were associated with a lower negative appendectomy rate (both <i>P</i><0.001). Inflammatory (49.5%) and gangrenous appendicitis (30.2%) were the most commonly reported histopathologies. Sonography had a sensitivity of 84%, a specificity of 79%, and an overall diagnostic accuracy of 83%.</p><p><strong>Conclusion: </strong>A relatively significant number of accidental and negative appendectomies are performed. More careful investigation and the use of expectant and medical treatment instead of surgery, especially in females and young children, can be effective in improving diagnostic accuracy and preventing negative appendectomies.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 5","pages":"265-271"},"PeriodicalIF":2.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872827","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":"Infective Endocarditis in North Africa and the Middle East, 1990‒2019: Updates from the Global Burden of Disease Study 2019.","authors":"Elaheh Malakan Rad, Sara Momtazmanesh, Sahar Saeedi Moghaddam, Negar Rezaei, Nazila Rezaei, Hamidreza Jamshidi, Mohsen Naghavi, Bagher Larijani, Farshad Farzadfar","doi":"10.34172/aim.2024.34","DOIUrl":"10.34172/aim.2024.34","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis (IE), a severe and economically impactful condition, lacks substantial epidemiological data in the North Africa and Middle East (NAME) region. This study focused on analyzing the trends and burden of IE in NAME from 1990 to 2019, taking into account factors like age, gender, and socio-demographic index (SDI).</p><p><strong>Methods: </strong>The Global Burden of Disease data from 1990 to 2019 was retrieved from the Institute for Health Metrics and Evaluation (IHME) website.</p><p><strong>Results: </strong>Between 1990 and 2019, the age-standardized rates (ASR) for IE incidence increased by 59%, and prevalence and years lived with disability (YLDs) rose by 12% and 9%, respectively, while the ASRs for deaths, disability-adjusted life years (DALYs), and years of life lost (YLLs) saw reductions of 22%, 34%, and 34% in the NAME region. Death rates among children under five declined by 72%. Gender and the SDI did not significantly influence these changes. Saudi Arabia witnessed the most significant increase in ASR of IE incidence since 1990, while Turkey had the highest rates in 2019. The year 2019 also saw the highest death rate among those aged 70 and over, with over 91000 DALYs from IE. DALYs decreased by 71.5% for children under five from 1990 to 2019 but remained stable for individuals in their seventies. Jordan showed the most notable decrease in ASRs for deaths, DALYs, and YLLs among children under five.</p><p><strong>Conclusion: </strong>This study highlights the changing epidemiology of IE in the NAME region, recommending the establishment of multidisciplinary IE registries, antibiotic prophylaxis guidelines for healthcare-associated IE, and strategies to control antimicrobial resistance as key mitigation measures.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 5","pages":"229-238"},"PeriodicalIF":2.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863527","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":"Identifying Risk Indicators of Cardiovascular Disease in Fasa Cohort Study (FACS): An Application of Generalized Linear Mixed-Model Tree.","authors":"Fariba Asadi, Reza Homayounfar, Mojtaba Farjam, Yaser Mehrali, Fatemeh Masaebi, Farid Zayeri","doi":"10.34172/aim.2024.35","DOIUrl":"10.34172/aim.2024.35","url":null,"abstract":"<p><strong>Background: </strong>Today, cardiovascular disease (CVD) is the most important cause of death around the world. In this study, our main aim was to predict CVD using some of the most important indicators of this disease and present a tree-based statistical framework for detecting CVD patients according to these indicators.</p><p><strong>Methods: </strong>We used data from the baseline phase of the Fasa Cohort Study (FACS). The outcome variable was the presence of CVD. The ordinary Tree and generalized linear mixed models (GLMM) were fitted to the data and their predictive power for detecting CVD was compared with the obtained results from the GLMM tree. Statistical analysis was performed using the RStudio software.</p><p><strong>Results: </strong>Data of 9499 participants aged 35‒70 years were analyzed. The results of the multivariable mixed-effects logistic regression model revealed that participants' age, total cholesterol, marital status, smoking status, glucose, history of cardiac disease or myocardial infarction (MI) in first- and second-degree relatives, and presence of other diseases (like hypertension, depression, chronic headaches, and thyroid disease) were significantly related to the presence of CVD (<i>P</i><0.05). Fitting the ordinary tree, GLMM, and GLMM tree resulted in area under the curve (AUC) values of 0.58 (0.56, 0.61), 0.81 (0.77, 0.84), and 0.80 (0.76, 0.83), respectively, among the study population. In addition, the tree model had the best specificity at 81% but the lowest sensitivity at 65% compared to the other models.</p><p><strong>Conclusion: </strong>Given the superior performance of the GLMM tree compared with the standard tree and the lack of significant difference with the GLMM, using this model is suggested due to its simpler interpretation and fewer assumptions. Using updated statistical models for more accurate CVD prediction can result in more precise frameworks to aid in proactive patient detection planning.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 5","pages":"239-247"},"PeriodicalIF":2.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868949","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":"Cytomegalovirus Infection in Adult Patients with Inflammatory Bowel Disease: A Literature Review.","authors":"Zahra Momayaz Sanat, Zeinab Siami, Sudabeh Alatab, Homayoon Vahedi, Zeinab Fanni","doi":"10.34172/aim.2024.40","DOIUrl":"10.34172/aim.2024.40","url":null,"abstract":"<p><p>Human cytomegalovirus (HCMV) is classified within the <i>Herpesvirales</i> order and is prevalent in 50%‒80% of the general population. Most carriers experience this infection without noticeable clinical symptoms. HCMV causes a lifelong latent infection that can be reactivated due to immune disorders and inflammation. The reactivation of HCMV becomes particularly significant when it coincides with inflammatory bowel disease (IBD). While cytomegalovirus (CMV) colitis in IBD patients was identified years ago, the role of CMV in triggering flare-ups, acute severe colitis, treatment resistance, and other outcomes in IBD patients experiencing CMV reactivation remains a subject of ongoing debate. In this review, we aim to address an updated insight into aspects related to the CMV colitis in IBD patients including epidemiology, risk factors, clinical features, diagnostic tests, histology, place of immunosuppressants and indications for antiviral treatment. We suggest for personalized and thorough assessment based on the disease phase and colitis severity when prescribing drugs to these patients. Furthermore, we emphasize the importance of regular patient follow-up to monitor drug side effects, ensuring treatment success, and minimizing the risk of colectomy.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 5","pages":"277-286"},"PeriodicalIF":2.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868350","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":"Trends in Animal Bites and Rabies-related Deaths in Northern Iran: Implications for Public Health Interventions.","authors":"Ali Davoudi Kiakalayeh, Zakiye Gharib, Reza Mohammadi, Leila Kanafi Vahed, Sajad Davoudi-Kiakalayeh","doi":"10.34172/aim.2024.39","DOIUrl":"10.34172/aim.2024.39","url":null,"abstract":"<p><strong>Background: </strong>Rabies remains a public health problem in middle-income countries like Iran, despite being preventable. This study aimed to evaluate the six-year incidence of animal bites in the southern Caspian Sea region from 2016 to 2022, and focus on estimating the direct costs of animal bite cases using the incidence-based method.</p><p><strong>Methods: </strong>A multicenter, registry-based study was conducted using surveillance data of animal bites.</p><p><strong>Results: </strong>Of the 40922 cases reported during the study period, 65.9% were male and 34.1% were female. Animal bites were most frequent among individuals over 50 years of age (23.5%), while children under 10 years of age had the lowest frequency of animal bites (2.3%). Animal bites were most common in June. Dogs were responsible for 33277 (81%) cases, cats for 5,624 (13.7%) cases, cows for 1054 (2.5%) cases, and other animals for the remaining cases. During the six-year study period, four deaths due to rabies were reported in the study area. The annual bite incidence rate was 386.3 per 100000 people in northern Iran. The males-to-female ratio was highest in 2019 (M/F ratio=2.4, 95% CI=1.2‒3.4).</p><p><strong>Conclusion: </strong>The elderly are at higher risk of animal bites, especially in rural areas. It is important to emphasize the use of protective clothing, washing wounds with soap water and rabies vaccination as initial treatment. Targeted vaccination efforts for eligible animals should be prioritized to minimize unnecessary financial burden. Educating farmers about rabies prevention programs, especially in cases of cow bites, is also important.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 5","pages":"272-276"},"PeriodicalIF":2.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872828","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":"Genetic and Lifestyle Risk Factors of Metabolic Dysfunction-Associated Fatty Liver Disease and Its Relationship with Premature Coronary Artery Disease: A Study on the Pars Cohort.","authors":"Amir Anushiravani, Maryam Rayatpisheh, Amir Kasaeian, Iman Menbari Oskouie","doi":"10.34172/aim.2024.36","DOIUrl":"10.34172/aim.2024.36","url":null,"abstract":"<p><strong>Background: </strong>The main objective of this study is to identify the risk factors of metabolic dysfunction-associated fatty liver disease (MAFLD) in coronary artery disease (CAD) patients.</p><p><strong>Methods: </strong>The present retrospective cohort study is part of the Pars Cohort Study (PCS). The participants were categorized as having MAFLD or not. The pattern of independent variables in patients was compared with those who did not have MAFLD. All variables were retained in the multivariable logistic regression model.</p><p><strong>Results: </strong>Totally, 1862 participants with CAD were enrolled in this study. MAFLD was diagnosed in 647 (40.1%) participants. Gender, diabetes, hypertension, tobacco, opium, alcohol, age, weight, waist circumference, cholesterol, HDL, triglyceride, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were significantly different in MAFLD and non-MAFLD patients. Also, the results of multivariable logistic regression show male gender (OR=0.651, 95% CI: 0.470‒0.902, <i>P</i> value=0.01) and opium consumption (OR=0.563, 95% CI: 0.328‒0.968, <i>P</i> value<0.001) to be negative risk factors of MAFLD occurrence in CAD patients. Having diabetes (OR=2.414, 95% CI: 1.740-3.349, <i>P</i> value<0.001), high waist circumference (OR=1.078, 95% CI: 1.055‒1.102, <i>P</i> value<0.01), high triglyceride (OR=1.005, 95% CI: 1.001‒1.008, <i>P</i> value=0.006), and high ALT (OR=1.039, 95% CI: 1.026‒1.051, <i>P</i> value<0.01) were positive risk factors of MAFLD in CAD patients.</p><p><strong>Conclusion: </strong>Our study found that consuming opium decreases the likelihood of MAFLD in CAD patients, since these patients have decreased appetite and lower body mass index (BMI). On the other hand, female gender, having diabetes, high waist circumference, high triglyceride levels, and high ALT levels increase the probability of MAFLD in CAD patients.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 5","pages":"248-254"},"PeriodicalIF":2.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861758","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":"Silent Suffering: The Tragic Suicide Among Medical Residents.","authors":"Ali Montazeri, Sedigheh Hantoushzadeh, Seyed Jafar Razavi, Mohadese Dashtkoohi, Nasim Eshraghi, Marjan Ghaemi","doi":"10.34172/aim.2024.41","DOIUrl":"10.34172/aim.2024.41","url":null,"abstract":"","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 5","pages":"287-288"},"PeriodicalIF":1.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872298","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":"Neoadjuvant Chemotherapy in Patients with HER2-Negative Breast Cancer: A Report from Clinical Breast Cancer Registry of Iran.","authors":"Kamran Roudini, Mehrzad Mirzania, Tahereh Yavari, Monireh Sadat Seyyedsalehi, Azin Nahvijou, Jayran Zebardast, Mina Saadat, Ahmad Khajeh-Mehrizi","doi":"10.34172/aim.2024.30","DOIUrl":"10.34172/aim.2024.30","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy (NCT) has become an increasingly popular approach in management of breast cancer (BC). This study was conducted to evaluate the pathologic response and 36-month recurrence and survival rates of patients with human epidermal growth factor receptor 2 (HER2)-negative BC treated with different NCT regimens.</p><p><strong>Methods: </strong>A total of 163 female patients with HER2-negative BC who received NCT during 2017-2020 were identified from the Clinical Breast Cancer Registry of Iran and entered the study. The prescribed NCT regimens included 4 cycles of doxorubicin plus cyclophosphamide, 4 cycles of doxorubicin plus cyclophosphamide followed by 4 cycles of paclitaxel, 4 cycles of doxorubicin plus cyclophosphamide followed by 4 cycles of docetaxel or 6 cycles of doxorubicin plus cyclophosphamide plus docetaxel (TAC).</p><p><strong>Results: </strong>Thirty-two patients (19.6%) experienced pathologic complete response (pCR). TAC regimen, triple negative-BC and ki67>10% were significantly associated with increased pCR. The recurrence, overall survival (OS) and disease-free survival (DFS) rate at 36 months for all patients were 16.6%, 84.7% and 79.8%, respectively. Type of neoadjuvant regimen as well as age, hormone receptor status, Ki67, grade, clinical stage, type of surgery and pathologic response to chemotherapy did not significantly influence the survival and recurrence; however, TAC results in improved recurrence, OS and DFS rates.</p><p><strong>Conclusion: </strong>This study provides further evidence that NCT is a viable treatment option for patients with HER2-negative BC. The TAC regimen resulted in a significantly higher pCR rate compared to other regimens, but did not result in a significant improvement in recurrence, OS and DFS and rates.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 4","pages":"206-215"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867486","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":"Predictors of Recurrent Urolithiasis in Iran: Findings from a Nationwide Study.","authors":"Abbas Basiri, Amir Hossein Kashi, Mazyar Zahir, Nasrin Borumandnia, Maryam Taheri, Shabnam Golshan, Behzad Narouie, Hayat Mombeini","doi":"10.34172/aim.2024.29","DOIUrl":"10.34172/aim.2024.29","url":null,"abstract":"<p><strong>Background: </strong>Prevention of urinary stone recurrence is the ultimate goal in urolithiasis patients. In this study, we aimed to investigate the national prevalence rate and possible determinants of increased urolithiasis recurrence risk in a nationwide study in Iran.</p><p><strong>Methods: </strong>All data regarding stone occurrence and recurrence episodes were extracted from the cross-sectional Iran National Stone Survey (INSS) study, and the possible determinants of recurrence were evaluated in the subset of 2913 patients who had a positive history of at least one episode of urolithiasis.</p><p><strong>Results: </strong>The national prevalence rate of recurrent urolithiasis was 2.6% (95% CI: 2.5, 2.8) in Iran. Moreover, the relative ratio of recurrent stone formers to all stone formers was 39.8% (95% CI: 38.0, 41.6). Our univariable truncated negative binomial regressions suggested that a positive history of urolithiasis in the patient's father (prevalence ratio [PR] [95% CI]=1.83 [1.39, 2.41], <i>P</i><0.001), mother (PR [95% CI]=1.92 [1.39, 2.66], <i>P</i><0.001) or brother (PR [95% CI]=1.32 [1.03, 1.69], <i>P</i>=0.026); and residence in urban areas (PR [95% CI]=1.27 [1.04, 1.55], <i>P</i>=0.016) were significant predictors of repetitive recurrence episodes. However, when incorporated into a multivariable truncated negative binomial regression model, the only significant predictors of more frequent recurrence episodes were a positive history in father (PR [95% CI]=1.66 [1.24, 2.22], <i>P</i><0.001) and mother (PR [95% CI]=1.68 [1.20, 2.36], <i>P</i>=0.002); and urban residence (PR [95% CI]=1.24 [1.01, 1.51], <i>P</i>=0.031).</p><p><strong>Conclusion: </strong>Our results indicate that a positive family history of urolithiasis in mother and father and residence in urban areas are the significant predictors of recurrence risk in urolithiasis patients in Iran.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 4","pages":"200-205"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873670","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":"In Memory of Dr. Taba, the Legendary WHO Regional Director.","authors":"Yasmine Motarjemi","doi":"10.34172/aim.2024.33","DOIUrl":"10.34172/aim.2024.33","url":null,"abstract":"<p><p>The article is a tribute to Dr. Abdul-Hossein Tabatabai-Naini, the former Regional Director of the Eastern Mediterranean Regional Office (EMRO), on the occasion of WHO's 75th anniversary. It reports on his achievements, personality, and philosophy of medicine.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"27 4","pages":"227-228"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861617","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}