Pub Date : 2025-12-16DOI: 10.1093/clinchem/hvaf170
Jack W Goodall,Thomas G Nadin,Bethan S Lloyd Jones,Otto C Willan,Adam C Lomas,Athina Tampaki,Thomas C Darton,Rachel S Tattersall
{"title":"Improving Recognition of Secondary Hemophagocytic Lymphohistiocytosis (HLH) through a Ferritin-Based Automated Alert: An Interrupted Time Series Analysis.","authors":"Jack W Goodall,Thomas G Nadin,Bethan S Lloyd Jones,Otto C Willan,Adam C Lomas,Athina Tampaki,Thomas C Darton,Rachel S Tattersall","doi":"10.1093/clinchem/hvaf170","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf170","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"31 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145759868","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}
Pub Date : 2025-12-16DOI: 10.1093/clinchem/hvaf166
Clara Daschner,Marcus E Kleber,Anders H Berg,Faeq Husain-Syed,Jürgen E Scherberich,Bernhard K Krämer,Winfried März,Babak Yazdani
BACKGROUNDSerum uromodulin (SUmod) and carbamylated albumin (C-Alb) are emerging biomarkers for chronic kidney disease (CKD) progression and mortality. SUmod reflects tubular health, while C-Alb is associated with excretory kidney function, CKD progression, and cardiovascular (CV) mortality. We hypothesized that the combined use of these markers would improve mortality risk assessments.METHODSWe analyzed the associations of C-Alb and SUmod levels with the estimated glomerular filtration rate (eGFR) along with their combined predictive value for assessing mortality in 3316 participants of the Ludwigshafen Risk and Cardiovascular Health study showing mid to high CV risk.RESULTSSUmod correlated moderately with eGFR (ρ = 0.39, P < 0.001) and weakly and inversely with C-Alb (ρ = -0.19, P < 0.001); C-Alb negatively correlated with eGFR (ρ = -0.38, P < 0.001). Patients in the C-Alb high/SUmod low group had the highest mortality risk [hazard ratio (HR)= 3.30; 95% CI, 2.73-3.99], which remained significant after adjustment for confounders, including eGFR (HR = 1.89; 95% CI, 1.24-1.89). In risk-prediction models for all-cause mortality, adding SUmod increased the area under the curve (AUC) from 0.728 to 0.746 (P < 0.001), C-Alb to 0.738 (P = 0.026), and both combined to 0.751 (P < 0.001). For CV mortality, AUC rose from 0.698 to 0.721 with SUmod (P < 0.001), to 0.711 with C-Alb (P = 0.018), and to 0.727 (P = 0.004) in the combined model.CONCLUSIONSSUmod and C-Alb levels yield complementary insights into kidney function, biology, and mortality risk beyond eGFR. Low SUmod/high C-Alb revealed the highest mortality risk, even after multivariate adjustment.GERMAN CLINICAL TRIALS REGISTER NUMBERDRKS00032641.
{"title":"Association of Serum Uromodulin and Carbamylated Albumin with All-Cause and Cardiovascular Mortality in Patients with No or Mild Chronic Kidney Disease.","authors":"Clara Daschner,Marcus E Kleber,Anders H Berg,Faeq Husain-Syed,Jürgen E Scherberich,Bernhard K Krämer,Winfried März,Babak Yazdani","doi":"10.1093/clinchem/hvaf166","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf166","url":null,"abstract":"BACKGROUNDSerum uromodulin (SUmod) and carbamylated albumin (C-Alb) are emerging biomarkers for chronic kidney disease (CKD) progression and mortality. SUmod reflects tubular health, while C-Alb is associated with excretory kidney function, CKD progression, and cardiovascular (CV) mortality. We hypothesized that the combined use of these markers would improve mortality risk assessments.METHODSWe analyzed the associations of C-Alb and SUmod levels with the estimated glomerular filtration rate (eGFR) along with their combined predictive value for assessing mortality in 3316 participants of the Ludwigshafen Risk and Cardiovascular Health study showing mid to high CV risk.RESULTSSUmod correlated moderately with eGFR (ρ = 0.39, P < 0.001) and weakly and inversely with C-Alb (ρ = -0.19, P < 0.001); C-Alb negatively correlated with eGFR (ρ = -0.38, P < 0.001). Patients in the C-Alb high/SUmod low group had the highest mortality risk [hazard ratio (HR)= 3.30; 95% CI, 2.73-3.99], which remained significant after adjustment for confounders, including eGFR (HR = 1.89; 95% CI, 1.24-1.89). In risk-prediction models for all-cause mortality, adding SUmod increased the area under the curve (AUC) from 0.728 to 0.746 (P < 0.001), C-Alb to 0.738 (P = 0.026), and both combined to 0.751 (P < 0.001). For CV mortality, AUC rose from 0.698 to 0.721 with SUmod (P < 0.001), to 0.711 with C-Alb (P = 0.018), and to 0.727 (P = 0.004) in the combined model.CONCLUSIONSSUmod and C-Alb levels yield complementary insights into kidney function, biology, and mortality risk beyond eGFR. Low SUmod/high C-Alb revealed the highest mortality risk, even after multivariate adjustment.GERMAN CLINICAL TRIALS REGISTER NUMBERDRKS00032641.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"20 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145759870","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}
Pub Date : 2025-12-12DOI: 10.1093/clinchem/hvaf175
Marlies Oostendorp,Eline A Van der Hagen,Stanley Lo,Vincent Delatour,Denis Grote-Koska,Antje Staaden,Marieke A Frasa,Jenny E Kootstra-Ros,Lauren Westenberg,Libor Vítek,Aleš Dvořák,David Křepelka,Cas Weykamp,Christian V Hulzebos,Miranda Van Berkel
{"title":"The Analytical Performance of Neonatal Total Bilirubin Assays Does Not Meet the Clinical Need.","authors":"Marlies Oostendorp,Eline A Van der Hagen,Stanley Lo,Vincent Delatour,Denis Grote-Koska,Antje Staaden,Marieke A Frasa,Jenny E Kootstra-Ros,Lauren Westenberg,Libor Vítek,Aleš Dvořák,David Křepelka,Cas Weykamp,Christian V Hulzebos,Miranda Van Berkel","doi":"10.1093/clinchem/hvaf175","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf175","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"125 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145732752","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}
Pub Date : 2025-12-03DOI: 10.1093/clinchem/hvaf155
Yusheng Zhu,Jarrett Sell
BACKGROUNDHuman immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) encompasses the use of antiviral medications to prevent HIV acquisition in individuals without HIV who are at risk. Currently available HIV PrEP medications are nucleoside reverse transcriptase inhibitors and integrase inhibitors. HIV testing is required to confirm that patients do not have an HIV infection before PrEP, when restarting PrEP after a long pause, and during ongoing maintenance of PrEP.CONTENTThis article reviews current practices and recent developments in PrEP. Daily oral HIV PrEP is a common approach for HIV PrEP. The challenge with oral HIV PrEP is medication adherence. Recently, long-acting injectable medications for HIV PrEP have become available, which may improve adherence. HIV testing plays a critical role in PrEP programs. Methods for HIV testing for PrEP programs include laboratory-based antigen/antibody immunoassays, rapid testing with reflex confirmation, and RNA testing. The World Health Organization encourages the use of rapid HIV assays for self-testing because provider-administered testing may be a barrier to PrEP uptake. Currently available HIV self-testing (HIVST) methods are primarily antibody-based rapid assays. To improve the effectiveness of HIV PrEP, a greater range of medications, including novel long-acting antiretroviral agents, broadly neutralizing antibodies, and other drugs, are needed. Additionally, more accessible PrEP service delivery and high-sensitivity HIV tests, especially nucleic acid-based HIVST methods, are warranted.SUMMARYHIV PrEP and related monitoring are essential parts of HIV prevention. More effective medications will improve the effectiveness of HIV PrEP, and more accessible PrEP service delivery and high-sensitivity HIV tests, especially HIVST methods, can improve HIV prevention with PrEP.
{"title":"Pre-Exposure Prophylaxis (PrEP)-Associated HIV Monitoring and Self-Testing.","authors":"Yusheng Zhu,Jarrett Sell","doi":"10.1093/clinchem/hvaf155","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf155","url":null,"abstract":"BACKGROUNDHuman immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) encompasses the use of antiviral medications to prevent HIV acquisition in individuals without HIV who are at risk. Currently available HIV PrEP medications are nucleoside reverse transcriptase inhibitors and integrase inhibitors. HIV testing is required to confirm that patients do not have an HIV infection before PrEP, when restarting PrEP after a long pause, and during ongoing maintenance of PrEP.CONTENTThis article reviews current practices and recent developments in PrEP. Daily oral HIV PrEP is a common approach for HIV PrEP. The challenge with oral HIV PrEP is medication adherence. Recently, long-acting injectable medications for HIV PrEP have become available, which may improve adherence. HIV testing plays a critical role in PrEP programs. Methods for HIV testing for PrEP programs include laboratory-based antigen/antibody immunoassays, rapid testing with reflex confirmation, and RNA testing. The World Health Organization encourages the use of rapid HIV assays for self-testing because provider-administered testing may be a barrier to PrEP uptake. Currently available HIV self-testing (HIVST) methods are primarily antibody-based rapid assays. To improve the effectiveness of HIV PrEP, a greater range of medications, including novel long-acting antiretroviral agents, broadly neutralizing antibodies, and other drugs, are needed. Additionally, more accessible PrEP service delivery and high-sensitivity HIV tests, especially nucleic acid-based HIVST methods, are warranted.SUMMARYHIV PrEP and related monitoring are essential parts of HIV prevention. More effective medications will improve the effectiveness of HIV PrEP, and more accessible PrEP service delivery and high-sensitivity HIV tests, especially HIVST methods, can improve HIV prevention with PrEP.","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"198200 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145664099","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}
Pub Date : 2025-12-03DOI: 10.1093/clinchem/hvaf161
Mari L DeMarco
{"title":"Phosphorylated Tau in Developing and Degenerating Brains: A 30-Year-Old Puzzle Revisited.","authors":"Mari L DeMarco","doi":"10.1093/clinchem/hvaf161","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf161","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"198200 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145664150","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}
Pub Date : 2025-12-03DOI: 10.1093/clinchem/hvaf137
David H Wang
{"title":"PREEMPT'ing Overreliance on Peripheral Blood-Based ColoRectal Cancer Screening.","authors":"David H Wang","doi":"10.1093/clinchem/hvaf137","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf137","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"30 1","pages":""},"PeriodicalIF":9.3,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145664145","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}
Pub Date : 2025-12-02DOI: 10.1093/clinchem/hvaf120
Steffen Halbgebauer, Badrieh Fazeli, Veronika Klose, Gabriele Nagel, Angela Rosenbohm, Dietrich Rothenbacher, Franziska Bachhuber, Sarah Jesse, Markus Otto, G Bernhard Landwehrmeyer, Ahmed Abdelhak, Axel Petzold, Albert C Ludolph, Hayrettin Tumani
Background: Serum glial fibrillary acidic protein (GFAP) is a biomarker for astrocytic injury and astrogliosis. Concentrations are elevated in numerous neurological disorders, including a pronounced increase in Alzheimer disease (AD). However, GFAP levels in the serum also increase with age. Consequently, the integration of GFAP levels into clinical routine and their interpretation demands age-adjusted reference values.
Methods: Serum from 1273 subjects (952 noninflammatory and nonneurodegenerative neurological controls and 321 subjects with AD) was analyzed for GFAP using the microfluidic Ella system. Age-dependent serum GFAP reference values were estimated by additive quantile regression analysis and visualized with percentiles and z-scores.
Results: AD exhibited elevated serum GFAP levels in comparison to control patients (P < 0.0001). This remained the case when the newly generated age-corrected z-scores were applied (P < 0.0001). In the control cohort, a nonlinear elevation of serum GFAP with increasing age was observed (Spearman correlation coefficient 0.62, 95% CI 0.58-0.66, P < 0.0001). In contrast, the AD cohort exhibited a more linear increase (0.16, 95% CI 0.05-0.26, P = 0.004). Age-dependent cut-offs for serum GFAP were determined for different AD age groups. The calculated areas under the curve (AUCs; 0.97) demonstrated excellent diagnostic test performance in the early-onset age group. This effect was less marked in the elderly subjects (AUC 0.72).
Conclusions: Our novel GFAP z-scores enable the integration and interpretation of serum GFAP levels in clinical practice, moving from the group to individual level. They support both intra- and interindividual interpretation of single GFAP levels in neurological diseases with astrocytic pathology, including an accurate discrimination of AD.
背景：血清胶质原纤维酸性蛋白（GFAP）是星形胶质细胞损伤和星形胶质增生的生物标志物。在许多神经系统疾病中浓度升高，包括阿尔茨海默病（AD）的显著增加。然而，血清中GFAP水平也随着年龄的增长而增加。因此，将GFAP水平纳入临床常规及其解释需要年龄调整的参考值。方法：采用微流控Ella系统分析1273例血清GFAP，其中952例为非炎症性和非神经退行性神经对照，321例为AD患者。年龄依赖性血清GFAP参考值通过加性分位数回归分析估计，并以百分位数和z分数可视化。结果：AD患者血清GFAP水平高于对照组（P < 0.0001）。当应用新生成的年龄校正z分数时，情况仍然如此（P < 0.0001）。在对照组中，血清GFAP随年龄增长呈非线性升高（Spearman相关系数0.62,95% CI 0.58-0.66, P < 0.0001）。相比之下，AD组表现出更线性的增加（0.16,95% CI 0.05-0.26, P = 0.004）。测定不同AD年龄组血清GFAP的年龄依赖性截止值。计算出的曲线下面积（auc; 0.97）在早发年龄组中表现出良好的诊断测试性能。这种效应在老年受试者中不太明显（AUC为0.72）。结论：我们的新GFAP z-评分能够在临床实践中整合和解释血清GFAP水平，从群体水平转移到个体水平。它们支持在星形细胞病理的神经系统疾病中单个GFAP水平的个体内和个体间解释，包括对AD的准确区分。
{"title":"Age-Specific Control and Alzheimer Disease Reference Curves and z-Scores for Glial Fibrillary Acidic Protein in Blood.","authors":"Steffen Halbgebauer, Badrieh Fazeli, Veronika Klose, Gabriele Nagel, Angela Rosenbohm, Dietrich Rothenbacher, Franziska Bachhuber, Sarah Jesse, Markus Otto, G Bernhard Landwehrmeyer, Ahmed Abdelhak, Axel Petzold, Albert C Ludolph, Hayrettin Tumani","doi":"10.1093/clinchem/hvaf120","DOIUrl":"10.1093/clinchem/hvaf120","url":null,"abstract":"<p><strong>Background: </strong>Serum glial fibrillary acidic protein (GFAP) is a biomarker for astrocytic injury and astrogliosis. Concentrations are elevated in numerous neurological disorders, including a pronounced increase in Alzheimer disease (AD). However, GFAP levels in the serum also increase with age. Consequently, the integration of GFAP levels into clinical routine and their interpretation demands age-adjusted reference values.</p><p><strong>Methods: </strong>Serum from 1273 subjects (952 noninflammatory and nonneurodegenerative neurological controls and 321 subjects with AD) was analyzed for GFAP using the microfluidic Ella system. Age-dependent serum GFAP reference values were estimated by additive quantile regression analysis and visualized with percentiles and z-scores.</p><p><strong>Results: </strong>AD exhibited elevated serum GFAP levels in comparison to control patients (P < 0.0001). This remained the case when the newly generated age-corrected z-scores were applied (P < 0.0001). In the control cohort, a nonlinear elevation of serum GFAP with increasing age was observed (Spearman correlation coefficient 0.62, 95% CI 0.58-0.66, P < 0.0001). In contrast, the AD cohort exhibited a more linear increase (0.16, 95% CI 0.05-0.26, P = 0.004). Age-dependent cut-offs for serum GFAP were determined for different AD age groups. The calculated areas under the curve (AUCs; 0.97) demonstrated excellent diagnostic test performance in the early-onset age group. This effect was less marked in the elderly subjects (AUC 0.72).</p><p><strong>Conclusions: </strong>Our novel GFAP z-scores enable the integration and interpretation of serum GFAP levels in clinical practice, moving from the group to individual level. They support both intra- and interindividual interpretation of single GFAP levels in neurological diseases with astrocytic pathology, including an accurate discrimination of AD.</p>","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":" ","pages":"1234-1242"},"PeriodicalIF":6.3,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279030","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}
Pub Date : 2025-12-02DOI: 10.1093/clinchem/hvaf117
Louis Nevejan, Xavier Bossuyt
{"title":"Commentary on Aberrant Plasma Cells in the Absence of M-protein: Ancillary Testing beyond Protein Electrophoresis.","authors":"Louis Nevejan, Xavier Bossuyt","doi":"10.1093/clinchem/hvaf117","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf117","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"71 12","pages":"1200"},"PeriodicalIF":6.3,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654068","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}
Pub Date : 2025-12-02DOI: 10.1093/clinchem/hvaf130
Maria Alice Willrich, Linda B Baughn
{"title":"Commentary on Aberrant Plasma Cells in the Absence of M-Protein: Ancillary Testing beyond Protein Electrophoresis.","authors":"Maria Alice Willrich, Linda B Baughn","doi":"10.1093/clinchem/hvaf130","DOIUrl":"https://doi.org/10.1093/clinchem/hvaf130","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":"71 12","pages":"1201"},"PeriodicalIF":6.3,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654008","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}
Pub Date : 2025-12-02DOI: 10.1093/clinchem/hvaf102
Andrew M Ford, Alberto Rubio Tapia
{"title":"The Devil Is in the Details: Clinical Relevance of Serologic Antibody Titers to Predict the Diagnosis of Celiac Disease in Pediatric Type 1 Diabetes.","authors":"Andrew M Ford, Alberto Rubio Tapia","doi":"10.1093/clinchem/hvaf102","DOIUrl":"10.1093/clinchem/hvaf102","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":" ","pages":"1184-1185"},"PeriodicalIF":6.3,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945730","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}
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