Sleep medicine最新文献

{"title":"Association of sleep-wake state discrepancy and depressive symptoms with restorative sleep in patients with depression","authors":"Keita Kawai ,&nbsp;Kunihiro Iwamoto ,&nbsp;Seiko Miyata ,&nbsp;Ippei Okada ,&nbsp;Motoo Ando ,&nbsp;Hiroshige Fujishiro ,&nbsp;Akiko Noda ,&nbsp;Norio Ozaki ,&nbsp;Masashi Ikeda","doi":"10.1016/j.sleep.2025.01.021","DOIUrl":"10.1016/j.sleep.2025.01.021","url":null,"abstract":"<div><h3>Objective</h3><div>One of the common symptoms of mood disorders is insomnia, and the recovery processes can be negatively impacted by a lack of restorative sleep. Although factors related to restorative sleep in healthy subjects have been investigated, evaluations of these factors in patients with depression have been rarely done. Patients with depression are known to have sleep-wake state discrepancy, which can further influence their restorative sleep beyond that associated with depressive symptoms. Thus, we investigated restorative sleep in depressed patients in our current study, and attempted to identify associated factors, with a particular focus on sleep-wake state discrepancy.</div></div><div><h3>Methods</h3><div>In the 91 participants evaluated in this cross-sectional study, all subjects filled out questionnaires on their symptoms prior to undergoing polysomnography (PSG). Sleep duration and restorative sleep were evaluated on the morning after the PSG. The association between restorative sleep and various factors was then examined using multiple regression analysis.</div></div><div><h3>Results</h3><div>A negative association with restorative sleep was found through multiple regression analysis for depressive symptoms (β = −0.055, p = 0.007), daytime sleepiness (β = −0.106, p = 0.020), and overestimation of wake after sleep onset (β = −0.006, p = 0.030).</div></div><div><h3>Conclusions</h3><div>By subjectively and objectively assessing sleep, addressing depressive symptoms, and implementing appropriate sleep hygiene, clinicians could be able to improve restorative sleep in depressed patients.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"127 ","pages":"Pages 166-169"},"PeriodicalIF":3.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053542","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":"Objectively-measured sleep characteristics and the associated factors among rural and urban in-school Nigerian adolescents","authors":"Oluwatosin Eunice Olorunmoteni ,&nbsp;Adesegun O. Fatusi ,&nbsp;F Xavier Gómez-Olivé ,&nbsp;Karine Scheuermaier","doi":"10.1016/j.sleep.2025.01.020","DOIUrl":"10.1016/j.sleep.2025.01.020","url":null,"abstract":"<div><h3>Purpose</h3><div>Poor sleep is increasing worldwide but sleep studies, using objective measures, are limited in Africa. Thus, we described the actigraphy-measured sleep characteristics of Nigerian in-school adolescents and the differences in these sleep characteristics in rural versus urban-dwelling adolescents using actigraphy plus a sleep diary.</div></div><div><h3>Methods</h3><div>This comparative, quantitative study involved 170 adolescents aged 13–19 attending six rural and six urban schools in southwestern Nigeria. Participants wore actiwatches and filled sleep diaries concurrently for one week. We ran a mixed model analysis with each sleep characteristic as a dependent variable in each model and the fixed effects of age, weekday versus weekend, rural versus urban residence, sex, and religion.</div></div><div><h3>Results</h3><div>The adolescents were 54.1 % females with a mean age of 15.6 ± 1.3 years. Overall, adolescents’ mean bedtime was 22.50 ± 0.85, mean waketime was 5.73 ± 0.68 and mean total sleep time (TST) was 06.07 ± 0.95 h. On both weekdays and weekends, urban adolescents had significantly later bedtimes, earlier waketimes, shorter time-in-bed (TIB) and TST (all <em>p</em> &lt; 0.05) while rural adolescents had lower sleep efficiency, more frequent awakenings and WASO (all <em>p</em> <em>&lt;</em> 0.05). In mixed-model analyses, older adolescents had later bedtimes (<em>p</em> = 0.035) and shorter TST (<em>p</em> = 0.047), urban adolescents had later bedtimes, earlier wake times, shorter TIB and TST than rural adolescents (all p &lt; 0.05), and on weekdays, all adolescents had earlier bedtimes, waketimes, shorter TIB and TST than on weekends (all p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Adolescents, especially the urban ones, had insufficient sleep with a catch-up-sleep on weekends. Multipronged interventions, including controlling causes of late bedtimes and delaying school start-times are needed to improve sleep, especially among older and urban adolescents.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"127 ","pages":"Pages 158-165"},"PeriodicalIF":3.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047786","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":"Predictors of early childhood insomnia according to parent-rated degree of severity","authors":"Perran Boran ,&nbsp;Hatice Ezgi Barış ,&nbsp;Mahmut Caner Us ,&nbsp;Hülya Barlak ,&nbsp;Öykü Özbörü Aşkan ,&nbsp;Zeynep Teke ,&nbsp;Karen Spruyt","doi":"10.1016/j.sleep.2025.01.019","DOIUrl":"10.1016/j.sleep.2025.01.019","url":null,"abstract":"<div><div>This study aimed to investigate child and maternal-related predictors of Early Childhood Insomnia (ECI) based on a parent-rated severity in a convenience sample of mother-infant dyads with ECI.</div><div>We conducted a single-center, cross-sectional prospective study involving infants aged 6–36 months who attended the Pediatric Behavioral Sleep Outpatient Clinic at Marmara University Hospital, Istanbul, over 5 years for ECI. Infant sleep was evaluated by Brief Infant Sleep Questionnaire. Beck Depression and Anxiety Inventories were used to assess maternal depression and anxiety. Predictive factors for parent perceived ECI severity were examined by logistic regression models.</div><div>Among 759 registered mother-child dyads, the mean age of the children at diagnosis was 15.5 ± 7.5 months, and 56.7 % were male. Overall, 76.5 % of the mothers rated their child's sleep to be a serious problem. The odds of parent-reported serious sleep problems were increased in children who woke up often and spent longer in wakefulness. The strongest predictor of ECI severity was maternal sleep deprivation and having a former colicky infant. In addition, mothers scoring higher on maternal anxiety symptoms were more likely to rate their children's sleep as serious than women with lower anxiety scores.</div><div>This study further underscored that heightened maternal sleep deprivation, elevated maternal anxiety symptoms, and previous exposure to a colicky infant were significant predictors of the perceived severity of ECI. Future research should explore interventions aimed at improving maternal well-being and infant sleep patterns to potentially mitigate the severity of ECI and its impact on family dynamics.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"127 ","pages":"Pages 138-144"},"PeriodicalIF":3.8,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042248","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 overlooked factor: Sleep quality in assessing malnutrition risk and nutritional status in adolescents with cystic fibrosis","authors":"Mahmut Bodur,&nbsp;Ayca Aydin,&nbsp;Rüveyda Yildirim","doi":"10.1016/j.sleep.2025.01.018","DOIUrl":"10.1016/j.sleep.2025.01.018","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to assess the relationship between sleep quality, malnutrition risk, and nutritional status in adolescents with cystic fibrosis(CF).</div></div><div><h3>Material and method</h3><div>This cross-sectional study was conducted with 55 adolescents (aged 10–18 years) diagnosed with CF. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and malnutrition risk was evaluated based on disease-specific criteria. Nutritional status was assessed using body mass index (BMI), BMI percentiles, dietary energy intake, and food group consumption. Multiple linear regression analyses were used to determine the relationship between sleep quality, malnutrition risk, and nutritional status.</div></div><div><h3>Results</h3><div>Among the participants, 50.9 % had poor sleep quality, and 29.1 % were classified as high-risk for malnutrition. Poor sleep quality was significantly associated with increased malnutrition risk (p &lt; 0.05), independent of dietary energy intake and BMI percentiles. Lower BMI percentile was strongly associated with higher malnutrition risk (p &lt; 0.001), identifying BMI as a critical predictor. Specifically, 27.3 % of participants had a BMI &lt;10th percentile, which contributed to their classification as high-risk for malnutrition. However, dietary energy intake did not significantly predict malnutrition risk despite its relevance in dietary management.</div></div><div><h3>Conclusion</h3><div>This study emphasizes the crucial role of sleep quality in assessing malnutrition risk among adolescents with CF. Poor sleep quality was associated with higher malnutrition risk, suggesting that sleep disturbances may contribute to nutritional challenges. Sleep quality should be considered a key factor in assessing malnutrition risk among adolescents with CF and integrated into clinical practice to develop comprehensive management strategies addressing sleep disturbances and nutritional challenges, improving health outcomes.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"127 ","pages":"Pages 120-126"},"PeriodicalIF":3.8,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024769","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":"Association of early-onset psychiatric disorders with REM sleep behavior disorder – A retrospective study","authors":"Connie Xie ,&nbsp;Aditii Makwana ,&nbsp;Helen Driver ,&nbsp;Garima Shukla","doi":"10.1016/j.sleep.2025.01.015","DOIUrl":"10.1016/j.sleep.2025.01.015","url":null,"abstract":"<div><h3>Background</h3><div>REM sleep behaviour disorder (RBD) is a known predictor of the subsequent development of neurodegenerative diseases, particularly Parkinson's disease and other alpha synucleinopathies. RBD has also been found to be common among children with other psychiatric disorders such as anxiety, depression, and ADHD.</div></div><div><h3>Objective</h3><div>This retrospective study aims to analyze the prevalence of early-onset psychiatric disorders among patients referred for RBD to our sleep laboratory. Our hypothesis is that early-onset psychiatric disorders are more common in patients with polysomnographically confirmed RBD.</div></div><div><h3>Methods</h3><div>A retrospective chart review was performed through the Kingston Health Sciences Centre (KHSC) Sleep Laboratory. Data collection involved gathering information regarding the patient's sleep study, psychiatric diagnoses and/or symptoms, mental health medication history and any neurodegenerative conditions noted in hospital clinical notes.</div></div><div><h3>Results</h3><div>Patients referred for and polysomnographically confirmed RBD were more likely to have presented with symptoms, or received a clinical diagnosis, of an early-onset psychiatric disorder at 32 % compared to the obstructive sleep apnea (OSA) control group at 3 %. <em>Conclusions</em>: History of early-onset psychiatric disorders is more common among patients referred as RBD compared to a control group of patients with OSA. Future studies are required to confirm the validity and replicability of this finding.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"127 ","pages":"Pages 127-132"},"PeriodicalIF":3.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141297","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":"On the imperative of including 24-h and longitudinal multidimensional physiological phenotyping in rodent models of sleep apnea","authors":"Jonathan Gaucher ,&nbsp;Guillaume Vial ,&nbsp;Sophie Bouyon ,&nbsp;Anne Briançon-Marjollet ,&nbsp;Gilles Faury ,&nbsp;Claire Arnaud ,&nbsp;Sébastien Bailly ,&nbsp;Renaud Tamisier ,&nbsp;Kenichiro Kinouchi ,&nbsp;Pierre Baldi ,&nbsp;David Gozal ,&nbsp;Jean-Louis Pépin","doi":"10.1016/j.sleep.2025.01.017","DOIUrl":"10.1016/j.sleep.2025.01.017","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"127 ","pages":"Pages 133-137"},"PeriodicalIF":3.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029632","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":"Prevalence and associated risk factors of anxiety-induced sleep disturbance: Sex-stratified comparison among school-going adolescents in Paraguay","authors":"Taufique Ahmed ,&nbsp;Muhammad Azimul Haque ,&nbsp;Tanjin Kabir Aunto ,&nbsp;Md Khalid Hasan","doi":"10.1016/j.sleep.2025.01.016","DOIUrl":"10.1016/j.sleep.2025.01.016","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to assess the prevalence and correlates of anxiety-induced sleep disturbance (AISD) in Paraguayan adolescents through sex-stratified analysis.</div></div><div><h3>Methods</h3><div>This study used the cross-sectional data from Paraguay's 2017 Global School-Based Student Health Survey (GSHS). A total of 3149 in-school adolescents (12–17 years; 51.2 % female) were included in the final analysis. Anxiety-induced sleep disturbance (AISD) was evaluated using the survey question: “During the past 12 months, how often have you been so anxious about something that you could not sleep at night?” Participants could respond on a scale from 1 (never) to 5 (always). For analysis, responses were categorized as follows: “never/rarely/occasionally” indicated no AISD, while “often/always” indicated the presence of AISD. Age-adjusted univariate and multiple logistic analyses were used to determine the correlates of AISD. Regression analysis findings were presented using adjusted odds ratios (AOR) and 95 % confidence intervals (CI), with a <em>p</em>-value &lt;0.05.</div></div><div><h3>Results</h3><div>The overall prevalence of AISD was 9.5 % among the respondents, significantly higher in girls (12 %) than boys (6.7 %). Loneliness, suicidal ideation, not attending physical education classes, and sitting activities were significantly associated with respondents’ AISD. In both sexes, those with loneliness and those who had suicidal ideation were more likely to suffer from AISD than their counterparts. Among girls, those who did not attend physical education class and those who engaged in sedentary activities for three hours or more had significantly higher odds of AISD than boys.</div></div><div><h3>Conclusion</h3><div>This study found differences in patterns of significant associations between risk factors of AISD for boys and girls. Therefore, different sex-based strategies are recommended to reduce the prevalence of AISD among adolescents in Paraguay.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"127 ","pages":"Pages 91-99"},"PeriodicalIF":3.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011830","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":"Sleep health among sexual and gender minority people in the United States: A scoping review","authors":"Sarah I. Leonard ,&nbsp;Maya R. Castiblanco ,&nbsp;Audrey Chang ,&nbsp;Joseph Belloir ,&nbsp;Billy A. Caceres ,&nbsp;Jean-Marie Bruzzese ,&nbsp;Kasey B. Jackman","doi":"10.1016/j.sleep.2024.12.033","DOIUrl":"10.1016/j.sleep.2024.12.033","url":null,"abstract":"<div><div>Sleep has been found to be essential to physical and mental health. Sexual and gender minority (SGM; e.g., lesbian, gay, bisexual, transgender, nonbinary) individuals experience significant health disparities, and emerging research indicates that this includes disparities in sleep health. However, the current literature on sleep health in this population has not previously been rigorously reviewed. This scoping review provides a comprehensive overview and synthesis of the current literature on SGM sleep health in the United States. Following established scoping review methodology, we systematically searched PubMed, CINAHL, PsycINFO, LGBTQ + Source, and Scopus; 76 studies met inclusion criteria. Included studies indicated significant sleep disparities exist for SGM people, particularly sexual minority women and gender minority people. Social determinants of health, including bullying and discrimination, were associated with worse sleep health. Included studies were heterogeneous and had methodological weaknesses, leaving opportunities for future research. Overall, findings point to the need for more rigorous research to advance understanding of sleep health across SGM subgroups and inform interventions to improve sleep health among SGM people, given the known negative impact of poor sleep on overall health.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"128 ","pages":"Pages 12-21"},"PeriodicalIF":3.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060722","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":"Treatment-emergent central sleep apnea in patients treated with a mandibular advancement device","authors":"Hédi Aïssani ,&nbsp;Jean-Daniel Kün-Darbois ,&nbsp;Clémence Moreau ,&nbsp;Frédéric Gagnadoux ,&nbsp;Wojciech Trzepizur ,&nbsp;IRSR Pays de la Loire Sleep Cohort Study Group","doi":"10.1016/j.sleep.2025.01.010","DOIUrl":"10.1016/j.sleep.2025.01.010","url":null,"abstract":"<div><h3>Objectives</h3><div>Treatment-emergent central sleep apnea (TECSA) is well established in continuous positive airway pressure therapy but was barely studied in mandibular advancement device (MAD) treatment. This study aims to evaluate the prevalence of TECSA in patients treated with a MAD and to determine its risk factors and clinical relevance.</div></div><div><h3>Materials and methods</h3><div>A total of 139 patients from the IRSR Pays de la Loire Sleep Cohort suffering from snores or obstructive sleep apnea syndrome (OSAS) and treated with a custom-made titratable MAD were included. Baseline and follow-up sleep recordings enabled identification of TECSA patients. Comparative analyses were carried out between TECSA and non-TECSA groups to identify potential risk factors. Clinical relevance of TECSA in both groups was assessed through baseline and follow-up Pichot's self-assessment questionnaire for depressive symptoms (QD2A), 36-item short form survey (SF-36) and Epworth Sleepiness Scale (ESS) scores.</div></div><div><h3>Results</h3><div>According to the definition selected, a prevalence between 0 % and 5.04 % was found for TECSA in the present study. No statistical differences were found in terms of treatment characteristics, sleep architecture, demographic data or comorbid conditions, although there was a trend towards a higher prevalence of arterial hypertension in TECSA-1 than in non-TECSA group (42.9 % vs 25.4 % respectively, <em>p</em> = 0.379). Baseline ESS showed a trend towards a higher score in TECSA-1 patients compared to non-TECSA patients (13/24 vs 10/24 respectively, <em>p</em> = 0.074), with a high proportion of TECSA-1 patients suffering from excessive daytime sleepiness before initiation of treatment (85.7 %, vs 52.4 % in non-TECSA patients, <em>p</em> = 0.124). No statistical differences were found regarding delta Pichot's QD2A and ESS scores between baseline and follow-up although there was a trend towards higher ESS scores at follow-up in TECSA-1 group compared to non-TECSA patients. Median delta SF-36 score for the General health scale was significantly lower in TECSA-1 and there was a trend towards lower scores for Mental health category in TECSA-1 patients.</div></div><div><h3>Conclusions</h3><div>TECSA is a rare phenomenon that can occur in patients treated with a MAD for an OSAS. Clinical, polysomnographic and treatment-related risk factors have yet to be reassessed in larger cohorts. These findings suggest probably poorer subjective clinical outcomes in terms of sleepiness and quality of life in patients with MAD-related TECSA.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"127 ","pages":"Pages 81-88"},"PeriodicalIF":3.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011761","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":"Behavioral insomnia in young children: Integrating behavioral and cognitive approaches for a comprehensive treatment strategy","authors":"Florian Lecuelle ,&nbsp;Marie-Josèphe Challamel ,&nbsp;Michal Kahn ,&nbsp;Liat Tikotzky ,&nbsp;Jodi A. Mindell ,&nbsp;Oliviero Bruni ,&nbsp;Patricia Franco ,&nbsp;Benjamin Putois","doi":"10.1016/j.sleep.2025.01.005","DOIUrl":"10.1016/j.sleep.2025.01.005","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"127 ","pages":"Pages 89-90"},"PeriodicalIF":3.8,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011704","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}