British medical bulletin最新文献

{"title":"All-inside arthroscopic procedures for chronic lateral ankle instability: evidence-based clinical practice guidelines.","authors":"Shi-Ming Feng, Nicola Maffulli, C Niek van Dijk, Hai-Lin Xu, Kai Fehske, Christian Plaass, Francesco Oliva, Thomas Karius, Shun-Hong Gao, Wei Xu, Lu Bai, Run-Lai Song, Yue-Feng Hao, Hui Zhang, Yang-Bo Xu, Ning Zhang, Lei Lou, Tian-Tian Ren, Guo-Dong Wang, Qi Li, Jian-Hua Wu, Yong-Zhan Zhu, Gang Yin, Tong-Fu Wang, Jian-Zhong Qin, Amol Saxena, Chao Ma","doi":"10.1093/bmb/ldaf001","DOIUrl":"10.1093/bmb/ldaf001","url":null,"abstract":"<p><strong>Background: </strong>All-inside arthroscopic procedures are now frequently employed to manage chronic lateral ankle instability (CLAI) with satisfactory functional outcomes. Currently, no evidence-based guidelines exist for all-inside arthroscopic procedures for CLAI. Many surgical decisions remain uncertain and challenging.</p><p><strong>Sources of data: </strong>Published scientific literature in PubMed, MEDLINE, Web of Science, EMBASE, and Cochrane databases.</p><p><strong>Areas of agreement: </strong>All-inside arthroscopic repair and reconstruction procedures are reliable treatments for CLAI.</p><p><strong>Areas of controversy: </strong>The all-inside arthroscopic procedures for CLAI present significant challenges, particularly in the following aspects.</p><p><strong>Growing points: </strong>Given the lack of guidelines for the all-inside arthroscopic procedures for CLAI, this evidence-based clinical practice guideline provides 11 recommendations to address the controversy.</p><p><strong>Areas timely for developing research: </strong>In patients with CLAI undergoing all-inside arthroscopic procedures, comparative studies are urgently needed to establish the optimal timing for weight-bearing, as well as return to work and sports.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"154 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779168","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":"Extracorporeal shock wave therapy for erectile dysfunction: rethinking study design, implementation, and analysis.","authors":"Janak Desai, Eric Huyghe, Gayle D Maffulli, Carmen Nussbaum-Krammer, Jessica Tittelmeier, Christoph Schmitz","doi":"10.1093/bmb/ldaf004","DOIUrl":"10.1093/bmb/ldaf004","url":null,"abstract":"<p><strong>Introduction: </strong>Extracorporeal shock wave therapy (ESWT) for erectile dysfunction (ED) presents a challenging paradox. While numerous clinical studies, systematic reviews, and meta-analyses have been published, indicating a substantial body of evidence supporting the efficacy and safety of ESWT, significant questions remain. Notably, the American Urological Association (AUA) continues to classify ESWT for ED as investigational (Evidence Level: Grade C), suggesting that the true therapeutic effect of ESWT may differ considerably from current estimates. This review aims to critically assess the evidence and propose strategies to address this unresolved discrepancy.</p><p><strong>Source of data: </strong>We systematically searched two electronic databases (PubMed and Ovid/Embase) and published systematic reviews on ESWT for ED and compiled a systematic literature review and meta-analysis based on 87 relevant studies.</p><p><strong>Areas of agreement: </strong>There is clear evidence that ESWT for ED is effective and can therefore be a valuable treatment modality in the management of ED.</p><p><strong>Areas of controversy: </strong>Current assessments of ESWT for ED as investigational by, e.g. the AUA may not stem from a lack of clinical studies, insufficient related basic science, or an inadequate number of systematic reviews and meta-analyses. Instead, the deficits lie in the area of the scientific quality of the clinical studies published to date.</p><p><strong>Growing points: </strong>We hypothesize that this unfortunate situation will only change if the following aspects are rigorously considered in future clinical studies on ESWT for ED: adequate characterization and reporting of extracorporeal shock waves, appropriate handling of missing data and intercurrent events, and comprehensive classification of ESWT in the overall context of the available treatment options for ED.</p><p><strong>Areas timely for developing research: </strong>We are convinced that the consistent implementation of these aspects will significantly contribute to establishing ESWT as the first truly regenerative therapy in the management of ED. This overall aim justifies the corresponding efforts for the benefit of our patients.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"154 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092822","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":"Clinical practice guidelines for rehabilitation following surgical management of chronic lateral ankle instability: enhancing recovery based on available evidence.","authors":"Shi-Ming Feng, Xin Luo, Nicola Maffulli, C Niek van Dijk, Francesco Oliva, Kai Fehske, Christian Plaass, Thomas Karius, Amol Saxena, Shun-Hong Gao, Hong-Mou Zhao, Jia-Ju Zhao, Chao Ma","doi":"10.1093/bmb/ldaf002","DOIUrl":"https://doi.org/10.1093/bmb/ldaf002","url":null,"abstract":"<p><strong>Background: </strong>Rehabilitation is a crucial component of comprehensive disease management and functional recovery. Despite advancements in surgical techniques for chronic lateral ankle instability (CLAI), there is still a lack of standardized, evidence-based rehabilitation protocols.</p><p><strong>Source of data: </strong>After nine clinical questions were proposed by the guidance steering group, an independent search strategy was conducted for all clinical questions, encompassing the PubMed, MEDLINE, Web of Science, EMBASE, and Cochrane databases.</p><p><strong>Areas of agreement: </strong>Rehabilitation is crucial to optimize surgical outcomes and patient recovery. An appropriate and well-structured rehabilitation plan can optimize a safe return to sports and daily activities.</p><p><strong>Areas of controversy: </strong>Rehabilitation for surgical management of CLAI poses significant challenges, especially in the areas of preoperative preparation, control of postoperative swelling and pain, early-stage rehabilitation, advanced rehabilitation, and return to exercise.</p><p><strong>Growing points: </strong>Given the lack of established guidelines for rehabilitation following surgical management of CLAI, this clinical practice guideline presents nine key recommendations aimed at addressing the existing controversies in this area. For CLAI patients undergoing surgery, preoperative rehabilitation should include exercise and education, followed by postoperative focus on pain and swelling management. Early rehabilitation emphasizes nonweight-bearing functional training, with gradual progression to weight-bearing exercises, dynamic balance, and strength training over the first 18 weeks. Regular follow-up visits are essential to monitor recovery and promote functional restoration.</p><p><strong>Areas timely for developing research: </strong>In patients undergoing surgery for CLAI, there is a pressing need for comparative studies to assess the necessity of immobilization and to determine the optimal selection of braces.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"154 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983948","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":"Current perspectives on the mental health of UK military personnel and veterans.","authors":"Severija Juškaitė, Jennifer Stone, Neil Greenberg, Daniel Dyball, Nicola T Fear","doi":"10.1093/bmb/ldaf003","DOIUrl":"10.1093/bmb/ldaf003","url":null,"abstract":"<p><strong>Introduction: </strong>This narrative review sets out to explore the current literature surrounding the mental health of serving personnel and veterans.</p><p><strong>Sources of data: </strong>UK literature published in peer-reviewed scientific journals and publicly available UK Ministry of Defence reports.</p><p><strong>Areas of agreement: </strong>Evidence suggests that common mental disorders are more prevalent in the UK serving and veteran personnel than in the general population. Risk factors include being female, adverse childhood events, combat exposure, and physical combat injury.</p><p><strong>Areas of controversy: </strong>Post-traumatic stress disorder rates are broadly similar between UK serving personnel and the general population, though certain groups are at increased risk, such as veterans who deployed to Iraq/Afghanistan in combat roles.</p><p><strong>Growing points: </strong>Understanding ways to maximize positive psychological outcomes, address poor sleep, and support those with combat injuries and chronic pain are key priorities for research/interventions. The prevalence of moral injury and military sexual trauma in the UK Armed Forces is currently unknown.</p><p><strong>Areas timely for developing research: </strong>A longitudinal study following recruits including those who are part of the Lesbian, Gay, Bisexual, Transgender, Queer/Questioning or other sexualities and gender identities (LGBTQ+) community, or who have a neurodivergent condition, from entry to post-service would enhance our understanding of how serving in the Armed Forces impacts the mental health and wellbeing.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"154 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075908","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":"Management of knee osteoarthritis using bone marrow aspirate concentrate: a systematic review.","authors":"Filippo Migliorini, Marco Pilone, Jacopo Ascani, Luise Schäfer, Madhan Jeyaraman, Nicola Maffulli","doi":"10.1093/bmb/ldae016","DOIUrl":"10.1093/bmb/ldae016","url":null,"abstract":"<p><strong>Introduction: </strong>Knee osteoarthritis (OA) is a common degenerative joint condition and a major cause of disability in the general population.</p><p><strong>Source of data: </strong>Recent published literature identified from PubMed, EMBASE, Google Scholar, and Scopus.</p><p><strong>Areas of agreement: </strong>Orthobiological therapies try to regenerate articular cartilage and stop the progression of the degenerative lesion. Intra-articular injections of biological derivates have been increasingly used in the last decade.</p><p><strong>Areas of controversy: </strong>The indications for the use of bone marrow aspirate concentrate (BMAC) are still unclear.</p><p><strong>Growing points: </strong>We systematically reviewed the current literature on BMAC in the management of knee OA, giving an update on the current indications for the selection of the ideal patient and the preparations and efficacy of BMAC compared to other biological alternatives.</p><p><strong>Areas timely for developing research: </strong>BMAC is a valuable source of mesenchymal stem cells, offering potential benefits in attenuating the inflammatory pathway associated with knee OA. Intra-articular injection of BMAC has shown effectiveness in clinical trials improving functional outcomes of knee OA patients. The superiority of BMAC over other orthobiological treatments cannot be assessed because of conflicting results.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589232","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":"Obesity: ethical issues.","authors":"Christopher Mayes, Jane Williams","doi":"10.1093/bmb/ldae022","DOIUrl":"10.1093/bmb/ldae022","url":null,"abstract":"<p><strong>Introduction: </strong>This article reviews the ethical issues surrounding obesity in public health and clinical contexts. We examine how obesity intersects with medical and social norms that raise questions of liberty, fairness, safety, and effectiveness or consequences.</p><p><strong>Sources of data: </strong>PubMed, Cochrane Library, and Google Scholar.</p><p><strong>Areas of agreement: </strong>We identify three main areas of agreement that are pertinent to ethical analysis of obesity: stigma is considered harmful, there needs to be a more-than personal responsibility approach, and a general acceptance of a global rise in body weight.</p><p><strong>Areas of controversy: </strong>There are many areas of controversy, we limit our focus to four: conflicts of interest in the creation of guidelines and policies, mortality rates, whether weight is a meaningful proxy for health, and how to treat childhood obesity.</p><p><strong>Areas timely for developing research: </strong>Post-genomic explanations, such as exposure to endocrine disrupting toxins, and development of epigenomics and microbiomics in the form of personalized nutrition are two developing areas we identify.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827432","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":"The athletes heart-from acute stimulus to chronic adaptation.","authors":"Joseph D Maxwell, David Oxborough","doi":"10.1093/bmb/ldae021","DOIUrl":"10.1093/bmb/ldae021","url":null,"abstract":"<p><strong>Introduction: </strong>The complex phenomenon of the athlete's heart (AH) describes the chronic physiological structural and functional adaptation secondary to repeated exposure of an acute exercise stimulus.</p><p><strong>Sources of data: </strong>This narrative review is based on published evidence.</p><p><strong>Areas of agreement: </strong>Highly trained athletic individuals frequently display cardiac parameters which are suggestive of an AH and can exceed the traditional 'normal' limits.</p><p><strong>Area of controversy: </strong>The physiological processes underpinning the extent of cardiac adaption and how this is closely linked to exercise type, but also sex, ethnicity, and body size.</p><p><strong>Growing points: </strong>Since its seminal description by Morganroth and colleagues in 1975, our understanding of the AH has evolved in tandem with improvements in cardiac imaging techniques alongside the exploration of more diverse athletic populations. This narrative review aims to provide a balanced discussion of the multi-factorial nature of structure and function of the AH with specific reference to the unique physiological exercise stimuli.</p><p><strong>Areas timely for developing research: </strong>Despite great interest in cardiac adaptations across a broad spectrum of athletic populations, future research designs should consider the use of new and novel imaging techniques to enhance our understanding of the acute cardiovascular responses which ultimately mediates such adaptations, especially in athletic populations underrepresented in the literature.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806381","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":"Percutaneous repair of the Achilles tendon with one knot offers equivalent results as the same procedure with two knots. A comparative prospective study.","authors":"Nicola Maffulli, George Christidis, Nikolaos Gougoulias, Panagiotis Christidis, Daryl Poku, Rifat Hassan, Filippo Migliorini, Francesco Oliva","doi":"10.1093/bmb/ldae019","DOIUrl":"10.1093/bmb/ldae019","url":null,"abstract":"<p><strong>Purpose: </strong>The present prospective comparative study included patients with acute Achilles tendon rupture (ATR) who underwent percutaneous repair with one knot compared to percutaneous repair with two knots.</p><p><strong>Methods: </strong>All patients underwent the procedure under local anesthesia. A total of 29 patients underwent percutaneous repair with two knots (Group A), and 33 patients underwent percutaneous repair with one knot (Group B). All patients were treated by a single surgeon between 2019 and 2021 and were followed prospectively for 24 months.</p><p><strong>Results: </strong>Patients' characteristics at baseline were similar between the two groups, except for age [38.0(15.0) vs 32.0(15.0) years, P = 0.028]. The procedure took longer for the two knots technique [19.0(4.0) vs 13.0(3.0) min, P < 0.001]. The Achilles tendon total rupture score was not different between the two techniques (90.7 ± 3.26 vs 90.5 ± 2.18, P = 0.737), as was the elongation of the gastrosoleus-Achilles tendon complex measured by the Achilles tendon resting angle [-1.0(2.0) vs - 1.0(2.0), P < 0.380]. The calf circumference of the injured and non-injured leg did not differ between the groups. Plantarflexion strength of the operated leg was significantly weaker than the non-operated leg in both groups. The European Foot and Ankle Society and patient reported outcome measures score by Piedade et al. scores were not statistically significant different between the two groups. No patient experienced a re-rupture, a venous thrombo-embolism episode, or injury to the sural nerve.</p><p><strong>Conclusion: </strong>The modified technique offered similar objective and subjective outcome measures, in addition to reduced operative time.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823774","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":"Safety and performance of a novel synthetic biomimetic scaffold for iliac crest defect reconstruction during surgical treatment of pelvic girdle pain: a first-in-human trial.","authors":"Peter V Giannoudis, Paul Andrzejwski, George Chloros, Elizabeth M A Hensor","doi":"10.1093/bmb/ldae023","DOIUrl":"10.1093/bmb/ldae023","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical treatment of pelvic girdle pain (PGP) involves arthrodesis of sacroiliac (SI) and pubic symphysis joints. Fusion of pubic symphysis involves the implantation of an autologous iliac crest tricortical graft harvested from the iliac crest. The objective was to assess the safety of a novel synthetic graft substitute (b.Bone) for iliac crest reconstruction and to evaluate the results of PGP surgical treatment.</p><p><strong>Sources of data: </strong>Consecutive participants undergoing pelvic fusion and requiring iliac crest reconstruction were enrolled and followed-up for 12 months in a prospective first-in-human clinical investigation. Adverse events were documented, and health-related quality of life was evaluated using EuroQol-5D-5L questionnaire. Iliac crest defect healing was evaluated by the Modified Lane and Sandhu radiological scoring system. In addition, relevant published peer-reviewed scientific articles identified from PubMed.</p><p><strong>Areas of agreement: </strong>The EQ-5D-5L scores improved steadily reaching the highest point at 365 days. By 365 days complete healing of the bone defect was observed.</p><p><strong>Areas of controversy: </strong>The management of PGP remains challenging with mixed results reported in the literature.</p><p><strong>Growing points: </strong>While there is lack of consensus on how to manage PGP, the present study shows improved outcomes at one year following surgery. The synthetic b.Bone scaffold is a safe option with good healing outcomes for iliac crest defect reconstruction.</p><p><strong>Areas timely for developing research: </strong>Although b.Bone synthetic scaffold found to be safe, further studies reporting on surgical treatment of PGP are required to confirm the findings in comparative trials.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"153 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11738167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000532","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":"Physicians' required competencies in AI-assisted clinical settings: a systematic review.","authors":"Lotte Schuitmaker, Jojanneke Drogt, Manon Benders, Karin Jongsma","doi":"10.1093/bmb/ldae025","DOIUrl":"10.1093/bmb/ldae025","url":null,"abstract":"<p><strong>Background: </strong>Utilizing Artificial Intelligence (AI) in clinical settings may offer significant benefits. A roadblock to the responsible implementation of medical AI is the remaining uncertainty regarding requirements for AI users at the bedside. An overview of the academic literature on human requirements for the adequate use of AI in clinical settings is therefore of significant value.</p><p><strong>Sources of data: </strong>A systematic review of the potential implications of medical AI for the required competencies of physicians as mentioned in the academic literature.</p><p><strong>Areas of agreement: </strong>Our findings emphasize the importance of physicians' critical human skills, alongside the growing demand for technical and digital competencies.</p><p><strong>Areas of controversy: </strong>Concrete guidance on physicians' required competencies in AI-assisted clinical settings remains ambiguous and requires further clarification and specification. Dissensus remains over whether physicians are adequately equipped to use and monitor AI in clinical settings in terms of competencies, skills and expertise, issues of ownership regarding normative guidance, and training of physicians' skills.</p><p><strong>Growing points: </strong>Our review offers a basis for subsequent further research and normative analysis on the responsible use of AI in clinical settings.</p><p><strong>Areas timely for developing research: </strong>Future research should clearly outline (i) how physicians must be(come) competent in working with AI in clinical settings, (ii) who or what should take ownership of embedding these competencies in a normative and regulatory framework, (iii) investigate conditions for achieving a reasonable amount of trust in AI, and (iv) assess the connection between trust and efficiency in patient care.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":"153 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11738171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000531","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}