Age and ageing最新文献

{"title":"Effects of the 'ReacStep' training program on balance recovery and fall risk factors in older people: an assessor-blinded randomised controlled trial.","authors":"Shivam Sharma, Carly Chaplin, Cameron Hicks, Daniel Treacy, Melanie K Farlie, Steven Phu, Natassia Smith, Hannah Gibson, Chrissie Ho, Eve Coleman, Tiffany Huang, Collen G Canning, Natalie E Allen, J C Close, Stephen R Lord, Yoshiro Okubo","doi":"10.1093/ageing/afag259","DOIUrl":"https://doi.org/10.1093/ageing/afag259","url":null,"abstract":"<p><strong>Background: </strong>Reactive balance training (RBT) using repeated perturbations may reduce falls; however, training methods are not easily replicated or translatable to clinical settings. This study aimed to examine the effects of a novel RBT program on balance recovery from laboratory-induced trips and slips and fall risk factors in older people using simple and low-cost equipment.</p><p><strong>Methods: </strong>We conducted a randomised controlled trial involving 88 older people. An intervention group (n = 43) received the ReacStep program, which involved tether-release reactive stepping and intentional slips once a week for 6 weeks. Both the intervention and control (n = 45) groups received home-based strength training for 8 weeks. Blinded staff assessed reactive balance (laboratory-induced falls), physical functions at baseline (week 1) and post intervention (week 8). Weekly short-message service (SMS) surveys ascertained falls in daily life over 12 months.</p><p><strong>Results: </strong>Both groups were comparable in demographics, with a mean age of 72 years (SD = 5.6). Adherence to ReacStep sessions was high (90%). There were no significant differences between groups in laboratory-assessed reactive balance falls at post-test or daily-life falls over 1 year (P = .19). However, at post-test, the intervention group demonstrated significant improvements in maximum step length and choice stepping reaction time compared to controls (P <.05).</p><p><strong>Conclusion: </strong>The ReacStep program demonstrated excellent adherence, was well tolerated and improved the ability to take larger and quicker steps in older people. As these improvements did not translate to unexpected trips and slips and daily life falls, the findings highlight the need for further optimization of the program for improving reactive balance and preventing falls.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 9","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty index deficit interchangeability: an empirical test using random survival forests in adults with cardiovascular disease.","authors":"Jack Quach, Olga Theou, Kenneth Rockwood, Scott Kehler, Joanna Blodgett","doi":"10.1093/ageing/afag262","DOIUrl":"https://doi.org/10.1093/ageing/afag262","url":null,"abstract":"<p><strong>Background: </strong>The frailty index (FI) assumes that deficits are interchangeable; the type of individual items matters less than the total count. Machine learning is increasingly used to create shorter FIs, often motivated by perceived barriers to collecting many items in clinical settings despite availability of electronic health records. We explored whether FI item selection matters when predicting mortality in adults living with cardiovascular disease (CVD).</p><p><strong>Methods: </strong>We analysed 3669 adults living with CVD from the National Health and Nutrition Examination Survey (1999-2018) with a 46-item FI. Cox and random survival forest models predicted all-cause and CVD-specific mortality using individual items or composite FI scores. Items were ranked by permutation importance. At each item count k (1-46), we compared the top k items as individual predictors, the top k items combined into a single FI and 200 FIs each built from randomly selected k items.</p><p><strong>Results: </strong>Models using 46 individual items outperformed composite FI approaches for both outcomes (C-index: 0.71 [0.69-0.74] vs 0.64-0.67). Importance-ranked FI performance peaked at ~10 items then declined. Randomly built FIs improved steadily, converging with the importance-ranked composites by ~35 items (all-cause) and 20 items (CVD). Analyses using imputation produced consistent results.</p><p><strong>Conclusions: </strong>When enough items are included, which specific items make up the FI has negligible influence on prediction. Combining items into a single score discards some prognostic information, but this trade-off maintains the generalisability that makes the FI practical. Short importance-ranked FIs benefit from avoiding dilution rather than capturing an optimal item set, and any such selection is outcome-specific and sample-dependent.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 9","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond single-drug indicators: the power of unsupervised phenotyping in mitigating medication-related harm.","authors":"Richard Woodman","doi":"10.1093/ageing/afag230","DOIUrl":"https://doi.org/10.1093/ageing/afag230","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health and health service use of Australian female live-in caregivers at multiple caregiver trajectory timepoints: a population-based dataset with time-matched controls.","authors":"Leigh Tooth, Richard Hockey, Gita D Mishra","doi":"10.1093/ageing/afag240","DOIUrl":"10.1093/ageing/afag240","url":null,"abstract":"<p><strong>Objective: </strong>To compare health and health service use in female live-in caregivers along multiple timepoints with population-based controls over a 20-year period.</p><p><strong>Methods: </strong>Data from 6000 women aged 50-77 caring for someone who was ill, disabled or frail, were collected over eight waves of Australian Longitudinal Study on Women's Health 1946-51 cohort (from 2001 to 2022). Physical functioning (PF), general mental health (MH), depressive symptoms, stress and general practitioner (GP) and medical specialist visits were compared between caregivers and time-matched controls, before, during and after caregiving. Fully adjusted mixed linear models or logistic regression, including sensitivity analyses by caregiving intensity, were conducted.</p><p><strong>Results: </strong>In adjusted results, caregivers and controls had similar initial levels of PF, but caregivers had significantly poorer PF over time including during [2.39 (-3.68, -1.10)] and after stopping caregiving [-2.19 (-3.51, -0.87)]. Caregivers had poorer MH on all three measures [eg, -5.56 (-6.61, -4.51) on SF-36 MH] and more GP visits across the study than controls, with the poorest scores in the period before stopping caregiving. Accessing medical specialists did not differ between caregivers and controls until after stopping caregiving, when caregivers had higher odds [1.22 (1.06, 1.40)]. Associations were stronger in caregivers providing higher intensity care.</p><p><strong>Conclusions: </strong>Caregiver physical and MH was poorest and GP visits highest prior to stopping caregiving, while specialist visits increased after stopping caregiving. Interventions to assist caregivers manage their own health needs, particularly in the period before stopping caregiving, and assisting them maintain health service use throughout and following caregiving cessation should be tested.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomised, double-blind, placebo-controlled crossover trial on cannabinoid-based medication for behavioural disorders in old patients with severe dementia: the study results.","authors":"Federica Bianchi, Barbara Broers, Jules Alexandre Desmeules, Angeline Langlois, James Wampfler, François Curtin, Sophie Pautex","doi":"10.1093/ageing/afag239","DOIUrl":"https://doi.org/10.1093/ageing/afag239","url":null,"abstract":"<p><strong>Background: </strong>Behavioural and psychological symptoms of dementia (BPSD) are frequent in patients with severe dementia and represent a major clinical challenge. Cannabinoid-based medications (CBM) have been proposed as a possible therapeutic option, but clinical evidence is still limited.</p><p><strong>Methods: </strong>We performed a multicenter, randomised, double-blind, placebo-controlled crossover trial in five long-term care facilities in Geneva, Switzerland. Patients with severe dementia received oral Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) oil (1:2 ratio, up to 20 mg/40 mg daily) and placebo in two 8-week periods separated by a 1-week washout. The primary outcome was agitation measured by the Cohen-Mansfield Agitation Inventory (CMAI). Secondary outcomes included behavioural scales, pain, as-needed psychotropic medication use and safety.</p><p><strong>Results: </strong>Twenty-five patients (average age 83 years) were randomised, and nineteen completed both study periods. No significant difference was observed between active treatment and placebo for the CMAI and other main behavioural outcomes. However, the use of pro re nata psychotropic medications was significantly lower during the active treatment period. The treatment was well tolerated, and no serious adverse events related to the study drug were observed.</p><p><strong>Conclusions: </strong>In this real-life crossover study, THC/CBD oil did not show superiority over placebo in reducing agitation in severe dementia. However, it was safe and associated with a significant reduction in the use of as-needed psychotropic medications prescribed for behavioural and psychological symptoms of dementia. CBM may represent a possible adjunctive option in selected patients, but further studies are needed.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world effectiveness of SGLT2 inhibitors in adults aged 75 years or older: a target trial emulation.","authors":"Hisashi Noma, Atsushi Goto, Taiki Sugimoto, Hiroshi Sunada, Futoshi Oda, Megumi Maeda, Haruhisa Fukuda","doi":"10.1093/ageing/afag246","DOIUrl":"https://doi.org/10.1093/ageing/afag246","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) improve cardiovascular and renal outcomes, but evidence in adults aged ≥75 years remains limited, particularly compared with dipeptidyl peptidase-4 inhibitors (DPP-4i).</p><p><strong>Methods: </strong>We conducted a target trial emulation using linked administrative claims and health examination data in Japan. Individuals aged ≥75 years with type 2 diabetes who newly initiated an SGLT2i or DPP-4i were identified. Intention-to-treat (ITT) effects were estimated using inverse probability weighting, with a 1-month induction period for mortality, cardiovascular and renal outcomes.</p><p><strong>Results: </strong>The study included 8486 individuals (2204 SGLT2i users, 6282 DPP-4i users). After a 1-month induction period, SGLT2i initiation was associated with lower all-cause mortality (hazard ratio [HR] 0.677, 95% confidence interval [CI] 0.500-0.916) and lower risk of end-stage renal disease or dialysis (HR 0.374, 95% CI 0.157-0.890). No clear differences were observed for heart failure hospitalisation (HR 1.103, 95% CI 0.854-1.426) or myocardial infarction (HR 1.015, 95% CI 0.768-1.341) in the ITT analysis. Stroke occurred more frequently among SGLT2i users (HR 1.420, 95% CI 1.165-1.828), although this finding should be interpreted cautiously.</p><p><strong>Conclusions: </strong>Among adults aged ≥75 years with type 2 diabetes, SGLT2i initiation was associated with lower all-cause mortality and renal risk compared with DPP-4i initiation. The higher observed stroke risk requires cautious interpretation because residual confounding, competing mortality and heterogeneity in vulnerable older adults may contribute to this signal.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antithrombotic strategy according to age in patients with atrial fibrillation and drug-eluting stents: a post hoc analysis of the ADAPT AF-DES randomised trial.","authors":"Sang-Hyup Lee, Soo-Jin Kim, Ae-Young Her, Byung-Ryul Cho, Gwang-Sil Kim, Taek-Geun Kwon, Sang-Wook Lim, Jaemin Shim, Ji-Yong Jang, Yong-Joon Lee, Seung-Jun Lee, Hee Tae Yu, Sung-Jin Hong, Chul-Min Ahn, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang, Hui-Nam Pak, Jung-Sun Kim, Jung Ho Heo","doi":"10.1093/ageing/afag224","DOIUrl":"10.1093/ageing/afag224","url":null,"abstract":"<p><strong>Background: </strong>Evidence for non-vitamin K antagonist oral anticoagulant (NOAC) monotherapy for older patients with atrial fibrillation (AF) and drug-eluting stents is lacking.</p><p><strong>Objectives: </strong>We aimed to evaluate the safety and efficacy of NOAC monotherapy in older AF patients with drug-eluting stents.</p><p><strong>Methods: </strong>This is a secondary analysis of the ADAPT AF-DES randomised trial comparing NOAC monotherapy with combination therapy with NOAC plus clopidogrel in patients with AF and drug-eluting stents. Patients were stratified by age (≥75 years and <75 years). Apixaban or rivaroxaban was used as the NOAC. The primary endpoint was a net adverse clinical event at 1 year after randomisation, defined as a composite of all-cause death, myocardial infarction, stent thrombosis, stroke, systemic embolism or major or clinically relevant non-major bleeding defined by the International Society on Thrombosis and Haemostasis criteria.</p><p><strong>Results: </strong>Among 960 patients included in the ADAPT AF-DES trial, 376 (39.2%) patients were aged ≥75 years. In patients aged ≥75 years, the incidence of the primary endpoint was lower in the NOAC monotherapy group (9.8% vs. 22.3%; adjusted hazard ratio, 0.37; 95% confidence interval, 0.21-0.66; P < .001) than in the combination therapy group. In contrast, the incidences did not differ between treatment strategies in patients aged <75 years. The interaction between age groups and strategy groups did not reach statistical significance (P for interaction = .095). The reduction in major or clinically relevant non-major bleeding with NOAC monotherapy was consistent across age groups. In contrast, the benefit of NOAC monotherapy in major adverse cardiac and cerebrovascular events was more pronounced in patients aged ≥75 years, with a statistically significant interaction.</p><p><strong>Conclusions: </strong>In this post hoc analysis, NOAC monotherapy was associated with a lower risk of net adverse clinical events, specifically within the older age subgroup. Tailored approach regarding age and individual ischaemic risk may be needed.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Doing it together?' A dyadic qualitative study of perceptions, facilitators, barriers and expectations for physical activity in dementia.","authors":"Shanshan Wang, Yang Fei, Yat Wa Justina Liu, Daphne Sze Ki Cheung, Sze Him Isaac Leung, Jiaming Xiong, Cypher Ho Au-Yeung, Wendy Moyle","doi":"10.1093/ageing/afag235","DOIUrl":"10.1093/ageing/afag235","url":null,"abstract":"<p><strong>Introduction: </strong>Persons with dementia and their caregivers are more physically inactive than cognitively healthy peers or non-caregivers, yet little is known about their views on dyadic physical activities. This study explored the perceptions, facilitators, barriers and expectations related to dyadic physical activity among persons with dementia and their caregivers.</p><p><strong>Methods: </strong>An exploratory dyadic qualitative study was conducted with 24 community-dwelling dyads in Hong Kong SAR, China. Semi-structured dyadic interviews were analysed using inductive thematic analysis.</p><p><strong>Results: </strong>Four themes comprising 22 subthemes were identified. Dyads recognised mutual physical, psychological and relational benefits and valued activities that fostered shared enjoyment and relational resonance, though some questioned dyadic activity's relevance. Engagement was facilitated by clear rewards, established habits, everyday collaborative activities, culturally meaningful incentives and strong social and professional support in a facilitative environment. Participation was hindered by limited shared understanding of physical activity, negative emotions in partner, mismatched fitness levels and activity rhythms, social withdrawal by the person with dementia, time pressures and conflicting family attitudes. Dyads expected interventions to yield tangible health and fitness gains, be tailored to both partners' capacities and interests, provide appropriate challenge and ensure safety through explicit risk management strategies.</p><p><strong>Conclusion: </strong>Dyadic physical activity is not simply 'doing it together'. Instead, interventions should be tailored, health-oriented and relationally attuned, with explicit consideration of the practical and emotional challenges faced by both dyad members. Psychoeducation regarding the significance of physical activity may need to extend beyond the dyadic members to the wider family to promote 'doing it together'.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary prevention of myocardial infarction in people with dementia: a multi-jurisdictional retrospective cohort study in Asia, Europe and the USA.","authors":"Jenni Ilomäki, George S Q Tan, Xiwen Simon Qin, Anna-Maija Tolppanen, Julian Lin, Tian Tian Ma, Miyuki Hsing-Chun Hsieh, Stella Jung-Hyun Kim, Clara Marquina, Edward Chia-Cheng Lai, Li Wei, Stephen J Wood, Ian C K Wong, Gang Fang, Sirpa Hartikainen, Izabela Annis, Kui-Kai Lau, J Simon Bell","doi":"10.1093/ageing/afag220","DOIUrl":"10.1093/ageing/afag220","url":null,"abstract":"<p><strong>Background: </strong>Statins, renin-angiotensin system inhibitors (RASIs) and beta-blockers are guideline-recommended cardiovascular medications post-myocardial infarction (MI) for secondary prevention, but evidence for people with dementia is scarce.</p><p><strong>Objective: </strong>To evaluate the association between post-MI cardiovascular medication use and the risk of cardiovascular outcomes and mortality, focusing on people with dementia.</p><p><strong>Design: </strong>Large retrospective cohort study using data from Australia, Finland, Taiwan, the UK and the USA.</p><p><strong>Subjects: </strong>People with and without dementia.</p><p><strong>Methods: </strong>Seven exposure groups were assigned using one or combinations of the three guideline-recommended medication classes-(i) statin, RASI and beta-blocker, (ii) statin and beta-blocker, (iii) statin and RASI, (iv) RASI and beta-blocker, (v) statin only, (vi) beta-blocker only and (vii) RASI only, based on medication records during a 60-day landmark period post-MI. Recurrent MI, major adverse cardiovascular event (MACE) and all-cause mortality were evaluated as outcomes. Jurisdiction-specific results were pooled together using meta-analyses.</p><p><strong>Results: </strong>A total of 28 122 people with dementia and 260 360 people without dementia were included. Among people with dementia, using any single or two medications carried a similar risk of recurrent MI and MACE as using all three guideline-recommended medications, except that using RASI and a beta-blocker without a statin was associated with a lower risk of recurrent MI (HR 0.85; 95% CI, 0.75-0.96). Using a statin and RASI without beta-blockers resulted in similar all-cause mortality to using all three (HR 1.16; 95% CI, 0.97-1.39), while all the remaining single- or dual-medication regimens were associated with higher risks of all-cause mortality.</p><p><strong>Conclusions: </strong>For people with dementia, using one or two guideline-recommended medications appeared sufficient to protect against recurrent MI and MACE. Beta-blockers may not provide additional survival benefits over statins and RASIs.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip fracture as a model for trends in geriatric medicine.","authors":"Antony Johansen","doi":"10.1093/ageing/afag251","DOIUrl":"https://doi.org/10.1093/ageing/afag251","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}