Acta Oto-Laryngologica最新文献

{"title":"β-catenin expression as a strong predictor of recurrence in juvenile angiofibroma.","authors":"Marlinda Adham, Regina Talitha Rosa, Alok Thakar, Lisnawati Rachmadi, Indrati Suroyo, Joedo Prihartono","doi":"10.1080/00016489.2025.2504635","DOIUrl":"https://doi.org/10.1080/00016489.2025.2504635","url":null,"abstract":"<p><strong>Background: </strong>Juvenile angiofibroma (JA) is a rare fibrovascular tumor affecting young males. Although histologically benign, JA is clinically aggressive, with high morbidity, mortality, and recurrence rates. While β-catenin expression is known to contribute to JA growth, its role in recurrence remains uncertain.</p><p><strong>Objective: </strong>This study investigates the relationship between β-catenin expression and recurrence risk in JA patients.</p><p><strong>Method: </strong>An analytical observational case-control study was conducted at Dr. Cipto Mangunkusumo Hospital, analyzing 33 JA patients who underwent tumor excision (2013-2022). Patients without recurrence were controls, while those with recurrence were cases. Immunohistochemistry and H-scoring quantified β-catenin expression, and statistical analysis examined its association with recurrence. ROC curves determined cut-off values.</p><p><strong>Results: </strong>Among 33 patients (all male, aged 9-28 years; mean: 16.2 years), 15 had recurrences. High β-catenin expression was significantly associated with recurrence (<i>p</i> = 0.000), with an H-score cut-off of 124.2 (100% sensitivity/specificity). Age ≤18 years correlated with higher recurrence risk (<i>p</i> < .05; OR 8.9). Tumor size, volume, stage, pre-extirpation procedures, surgical techniques, and intraoperative blood loss had no significant effect.</p><p><strong>Conclusion: </strong>High β-catenin expression is a strong predictor of JA recurrence, suggesting its potential as a prognostic marker. Targeting β-catenin pathways may aid in recurrence prevention and improved JA management.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-6"},"PeriodicalIF":1.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traditional and adaptive speech audiometry in single-sided deaf (SSD) subjects rehabilitated by bone conductive implants (BCI), quality of life and long-term utilization.","authors":"Edoardo Covelli, Chiara Filippi, Francesco Lazzerini, Elisabetta Tromboni, Silvia Tarentini, Sofia Pizzolante, Francesca Forli, Stefano Berrettini, Luca Bruschini","doi":"10.1080/00016489.2025.2504032","DOIUrl":"https://doi.org/10.1080/00016489.2025.2504032","url":null,"abstract":"<p><strong>Background: </strong>Single-sided deafness (SSD) encompasses the presence of a profoundly deaf ear with a normal, contralateral one. Patients with SSD may have difficulty with speech intelligibility in noise and localizing sounds.</p><p><strong>Aims/objectives: </strong>This retrospective study aims to evaluate the long-term effectiveness of bone conduction implant (BCI) in a group of patients with SSD.</p><p><strong>Material and methods: </strong>Audiologic benefit was assessed through conventional speech audiometry and adaptive Matrix test. Impact on quality of life was evaluated with the Glasgow Benefit Inventory (GBI) questionnaire. BCI usage data were also obtained from each subject.</p><p><strong>Results: </strong>Thirty-two patients were included. No statistically significant improvements were found at standard audiometric tests using BCI, but at Matrix test the mean SRT is reached at S/N -1.16 dB without BCI and -2.07 with BCI with a statistically significant difference (<i>p</i> = 0.026). The mean GBI score was 25.12, ranging from -8.3 to 47.2. Ten subjects (31%) discontinued the BCI use overtime.</p><p><strong>Conclusions and significance: </strong>Benefit assessment of BCI in SSD recipients can be difficult. Adaptive audiometric test could be useful. Quality of life measures seem to suggest potential 'beyond-auditory' benefits. SSD recipients can be inconsistent users of BCI.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-7"},"PeriodicalIF":1.2,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seasonality and climatic associations with deep neck space abscesses in Korea: a canonical correlation analysis.","authors":"Su Il Kim, Hun Hee Lee, Su Jin Kim, Young-Gyu Eun, Young Chan Lee","doi":"10.1080/00016489.2025.2501602","DOIUrl":"https://doi.org/10.1080/00016489.2025.2501602","url":null,"abstract":"<p><strong>Background: </strong>Deep neck space abscesses are a significant medical issue, but their seasonality and climatic associations remain unclear.</p><p><strong>Objectives: </strong>This study aimed to examine the seasonality of deep neck space abscesses and identify associated climatic factors using a nationwide, population-based dataset.</p><p><strong>Material and methods: </strong>We utilized Korean National Health Insurance data (2010-2019) to identify patients with peritonsillar, retropharyngeal, and parapharyngeal abscesses (J36, J39.0, J39.1). Seasonality was assessed by calculating the ratio of the highest to lowest monthly incidence. Multivariate canonical correlation analysis (CCA) evaluated associations with climatic factors, including temperature, humidity, precipitation, sunlight, ground temperature, particulate matter (<10 µm), ultraviolet A dose, and daily temperature range.</p><p><strong>Results: </strong>The incidence of deep neck space abscesses peaked in winter and was lowest in summer, with seasonality ratios of 2.03 (peritonsillar) and 2.15 (retropharyngeal and parapharyngeal). CCA demonstrated a strong correlation between climatic factors and abscess incidence. The two canonical roots had high canonical coefficients R of 0.7996 and 0.5542, respectively (<i>p</i> < 0.0001 and <0.0001).</p><p><strong>Conclusion and significance: </strong>This large population-based study highlights the seasonality and climatic relevance of deep neck space abscesses. Further research is needed to explore demographic factors affecting incidence.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-8"},"PeriodicalIF":1.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT-4 vs. multi-disciplinary tumor board decisions for the therapeutic management of primary laryngeal cancer.","authors":"Erim Pamuk, Yaşar Enez Bilen, Çağrı Külekçi, Oğuz Kuşcu","doi":"10.1080/00016489.2025.2502563","DOIUrl":"https://doi.org/10.1080/00016489.2025.2502563","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence-based clinical decision support systems are promising tools for addressing the increasing complexity of oncological data and treatment. However, the integration and validation of models such as ChatGPT within multidisciplinary decision-making processes for head and neck cancers remain limited.</p><p><strong>Objective: </strong>To evaluate the performance of ChatGPT-4 in the management of primary laryngeal cancer and compare it with multidisciplinary tumor board (MDT) decisions.</p><p><strong>Methods: </strong>The medical records of 25 patients with untreated laryngeal cancer were evaluated using ChatGPT-4 for therapeutic recommendations. The coherence of responses was graded from Grade 1 (totally coherent) to Grade 4 (totally incoherent) and compared with actual MDT decisions. The association between patient features and response grades was also assessed.</p><p><strong>Results: </strong>ChatGPT-4 provided totally coherent (Grade 1) responses consistent with MDT decisions in 72% of the patients. The rates of Grade 2 and Grade 3 coherent responses were 20% and 8%, respectively. There were no totally incoherent responses. There was no significant association between the grade of coherence and T stage, N stage, tumor localization, differentiation, or age (<i>p</i> = 0.106, <i>p</i> = 0.588, <i>p</i> = 0.271, <i>p</i> = 0.677, <i>p</i> = 0.506, respectively).</p><p><strong>Conclusion: </strong>With further improvements, ChatGPT-4 can be a promising adjunct tool for clinicians in decision-making for primary laryngeal cancer.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-6"},"PeriodicalIF":1.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A descriptive study on laryngotracheal stenosis in the Northern Sweden.","authors":"Anders Erlandsson, Martin Lundahl, Anna Holm, Katarina Olofsson","doi":"10.1080/00016489.2025.2503000","DOIUrl":"https://doi.org/10.1080/00016489.2025.2503000","url":null,"abstract":"<p><strong>Background: </strong>We have in a retrospective design used laryngotracheal stenosis (LTS) classification to describe stenotic subsites and through international classification of disease (ICD-10) codes its diagnostic origins. The diagnostic challenge posed by varied etiologies can lead to treatment delays, in potentially life-threatening conditions.</p><p><strong>Aims/objectives: </strong>The purpose of this study is to explore and ascertain the etiological and anatomical distribution of LTS to reduce misdiagnosis and as such delayed access to adequate treatment.</p><p><strong>Material and methods: </strong>The included cases were consecutively recruited between 1999 and 2019, all labeled with relevant ICD-10 codes for the research question in combination with medical records for evaluation of its accuracy. The primary outcome was the causes, and anatomical locations of LTS.</p><p><strong>Results: </strong>A total of 1441 records were screened, with 1071 cases meeting the inclusion criteria. The most common cause was unilateral vocal fold immobility, followed by glottic cancer. Benign causes were more prevalent than malignant ones, with glottic-level stenoses being most frequent.</p><p><strong>Conclusion and significance: </strong>Unilateral vocal fold immobility is the most prevalent cause of LTS in our material. These findings can enhance diagnostic efficiency by increasing clinical awareness of common etiologies.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-5"},"PeriodicalIF":1.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Side selection of cochlear implant in patients after head trauma: a new perspective.","authors":"Xinyue Zou, Jingyuan Chen, Biao Chen, Ying Shi, Chunling Ma, Simeng Lu, Yujing Cheng, Ying Kong, Yongxin Li","doi":"10.1080/00016489.2025.2501598","DOIUrl":"https://doi.org/10.1080/00016489.2025.2501598","url":null,"abstract":"<p><strong>Background: </strong>Head trauma often leads to bilateral sensorineural hearing loss (SNHL), and determining the optimal side for cochlear implantation (CI) remains a critical issue that requires further investigation. Objective: To evaluate the role of preoperative aided threshold (AT) testing in selecting the optimal CI side for patients with bilateral SNHL caused by head trauma.</p><p><strong>Methods: </strong>This study included 9 patients with bilateral SNHL resulting from head trauma. Preoperative audiological and radiological evaluations were performed. The correlation between preoperative AT, duration of deafness (DoD), radiological findings, and Nijmegen Cochlear Implant Questionnaire (NCIQ) scores was analyzed.</p><p><strong>Results: </strong>Preoperative AT showed a tendency for a negative correlation with advanced sound perception scores (r = -0.740, <i>p</i> = 0.057), while DoD exhibited a significant negative correlation with auditory self-confidence (r = -0.803, <i>p</i> = 0.029). Imaging combined with AT provides a foundational framework for selecting the implantation side; however, the limited sample size restricts the generalizability of the findings.</p><p><strong>Conclusion: </strong>Lower preoperative AT and shorter DoD may predict better auditory rehabilitation outcomes following CI. It is recommended to integrate imaging and audiological evaluations for individualized decision-making. Future studies with larger sample sizes are necessary to validate these findings and explore the clinical implications of early CI.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-9"},"PeriodicalIF":1.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation method of dynamic range parameters for cochlear implants based on neural response telemetry threshold.","authors":"Yao Liu, Yue Wang, Yu Chen, Wei Wang","doi":"10.1080/00016489.2025.2492359","DOIUrl":"https://doi.org/10.1080/00016489.2025.2492359","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of correlation studies between subjective behavioral test threshold and neural response telemetry (NRT) thresholds in cochlear implant (CI) patients. At present, there is no predictive model that can predict the parameters of CI adjustment objectively and reliably.</p><p><strong>Objectives: </strong>To explore the correlation between the subjective behavior test method threshold and the NRT thresholds in patients with CI with normal cochlear (NC) morphology and inner ear malformation (IEM). To explore the value of using deep learning technology to predict the parameters of machine adjustment and guide the postoperative machine adjustment.</p><p><strong>Methods: </strong>NRT and subjective behavior tests were conducted on 57 cases of CI patients with NC morphology and 20 cases of IEM using electrodes 1, 6, 11, 16, and 22, respectively. The correlation between the NRT thresholds and T and C values was analyzed. Using deep learning techniques, establish a prediction model based on convolutional neural networks to predict the parameters of machine adjustment of CI.</p><p><strong>Results: </strong>The average NRT thresholds values of the NC group and the IEM group were both greater than the T values, close to and slightly smaller than the C values. The average values of T values, C values, and NRT thresholds in the IEM group were slightly higher than those in the NC group. The NRT thresholds of the both groups is significantly correlated with the C values and T values. The constructed prediction model has high accuracy between the predicted values and the actual values of each electrode. Moreover, the linear regression equation between the predicted and actual values is highly similar.</p><p><strong>Conclusions: </strong>The NRT thresholds is significantly related to the subjective behavior test threshold. The correlation between NRT thresholds and T or C values can be used to assist in CI tuning. Especially for patients with IEM, different machine adjustment strategies should be adopted compared to NC patients. Moreover, the constructed neural network prediction model can also guide the postoperative adjustment of patients with cochlear implants.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-9"},"PeriodicalIF":1.2,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a collaborative framework for assessment of peripheral facial paralysis using facial image regions of interest.","authors":"Xiaoyan Guo, Jiyue Chen, Pingju Lin, Qi Lu, Ting Kou, Kun Li, Shiming Yang, Weidong Shen","doi":"10.1080/00016489.2025.2502562","DOIUrl":"https://doi.org/10.1080/00016489.2025.2502562","url":null,"abstract":"<p><strong>Background: </strong>While accurate evaluation of PFP is crucial for determining optimal treatment strategies, current clinical assessments rely heavily on subjective evaluations, leading to considerable variability between inter- and intra-observer ratings.</p><p><strong>Objective: </strong>This study aimed to develop and validate a collaborative framework for evaluating PFP based on regions of interest in facial images.</p><p><strong>Methods: </strong>We developed and tested two approaches: (1) a collaborative framework integrating image interpretation techniques (representation learning <i>via</i> CNN) with predefined handcrafted features based on regions of interest in facial images, and (2) a convolutional neural network (CNN) model trained exclusively on full-face patient images. The diagnostic accuracy of both systems was evaluated using a test set and compared with otologists' assessments.</p><p><strong>Results: </strong>The collaborative framework achieved a mean Area Under the Curve (AUC) of 0.92 for PFP prediction in the test set, surpassing the 0.76 AUC achieved by the CNN trained on full-face images. The framework's performance matched that of experienced otologists (accuracy: 80.0% vs. 77.2%; sensitivity: 85.3% vs. 77.7%). Moreover, system assistance improved primary clinicians' mean accuracy by 17.7 percentage points.</p><p><strong>Conclusions: </strong>These findings demonstrate that our collaborative framework-based automated diagnosis system can effectively assist clinicians in PFP diagnosis.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of endoscopic full-thickness cartilage-perichondrium complex tympanoplasty in the treatment of adhesive otitis media: a retrospective study.","authors":"Miao Xie, Siyu Li, Rui Yang, Yuchen Zhou, Xia Gao, Maoli Duan, Ling Lu","doi":"10.1080/00016489.2025.2501604","DOIUrl":"https://doi.org/10.1080/00016489.2025.2501604","url":null,"abstract":"<p><strong>Background: </strong>Adhesive otitis media (AdOM) is a common residual disease and surgical treatment for AdOM remains controversial.</p><p><strong>Objectives: </strong>The aims of present study are to investigate the feasibility and short-term effectiveness of endoscopic full-thickness cartilage-perichondrium complex tympanoplasty in the AdOM.</p><p><strong>Methods: </strong>This was a retrospective study on AdOM patients. Thirty-four patients were enrolled and followed for 1 year. Pure tone audiometry at pre and post-surgery were performed. The Chinese version of the chronic otitis media outcome test 15 (COMOT-15) was applied to assess symptoms of the patients.</p><p><strong>Results: </strong>All operated ears of the patients had dry ears at 1-year follow-up. The mean PTA decreased from 50.21 ± 11.08 to 37.06 ± 11.41 dB HL postoperatively (<i>p</i> < 0.0001), and the mean air-bone gap decreased from 24.85 ± 10.56 to 16.97 ± 7.68 dB HL postoperatively (<i>p</i> < 0.0001). Further, the average total score of COMOT-15 decreased from 30.56 ± 14.90 to 12.79 ± 12.53 postoperatively (<i>p</i> < 0.0001). The average symptomatic score of COMOT-15 decreased from 18.29 ± 9.23 to 7.38 ± 6.81 (<i>p</i> < 0.0001), and the average psychological score of COMOT-15 decreased from 12.24 ± 6.90 to 5.41 ± 6.19 respectively (<i>p</i> < 0.0001).</p><p><strong>Conclusions: </strong>Endoscopic full-thickness cartilage-perichondrium complex tympanoplasty is effective in treating AdOM. A prospective study is needed in the future.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-7"},"PeriodicalIF":1.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compliance with tympanostomy tube insertion guidelines in Finland.","authors":"Vesa Lahdes, Tuomo Puhakka, Tero Vahlberg, Lotta Haavisto","doi":"10.1080/00016489.2025.2494827","DOIUrl":"https://doi.org/10.1080/00016489.2025.2494827","url":null,"abstract":"<p><strong>Backround: </strong>Tympanostomy tube insertion (TTI) is the most common pediatric surgical procedure in otorhinolaryngology.</p><p><strong>Objectives: </strong>To evaluate the appropriateness of TTI in relation to national recommendations in Finland. As a secondary aim, we assessed long term ear-related quality of life if surgical criteria are unmet.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed all TTI procedures performed on children under 10 years of age in 2019 in Turku University Hospital, Finland. Factors contributing to the operation were identified and evalued in detail. In 2021, caregivers received a questionnaire including Otitis Media 6 -questionnaire to assess ear-related quality of life.</p><p><strong>Results: </strong>A total of 355 operations were analyzed. The national criteria for recurrent acute otitis media were met in 119/355 cases (33%) and chronic otitis media with effusion criteria in 81/355 (23%), while 155/355 (44%) did not fulfil either criterion. Ear-related quality of life was high across all groups with no significant differences observed.</p><p><strong>Conclusions and significance: </strong>The substantial proportion of procedures conducted outside Finnish recommendations underlines the necessity for continuous professional education and systematic evaluation of clinical decision-making. Observed discrepancies between Finnish and international guidelines further support the re-evaluation of Finnish criteria to ensure alignment with global standards and evidence-based practice.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-5"},"PeriodicalIF":1.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963813","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}