Pub Date : 2022-05-16DOI: 10.1101/2022.05.13.22275070
N. Oguro, N. Yajima, Y. Miyawaki, R. Yoshimi, Y. Shimojima, K. Sada, K. Hayashi, K. Shidahara, N. Sakurai, C. Hidekawa, D. Kishida, T. Ichikawa, Y. Ishikawa, N. Kurita
Objectives: Accessing the Internet has increased the gap in patient health literacy (HL), impacting patient-doctor trust. We examined how trust in physicians is affected by functional HL (the ability to read and write) and by broader concepts of HL, including communicative HL (the ability to extract information from communication to use) and critical HL (the ability to analyze and use information) among patients with systemic lupus erythematosus (SLE). Methods: This cross-sectional study enrolled 362 SLE patients at five academic centers between June 2020 and August 2021. The 14-item Functional Communicative Critical Health Literacy Scale assessed the three dimensions of HL (range: 1-4 points). Outcomes were trust in one's physician and physicians generally using the 5-item Wake Forest Physician Trust Scale (range: 0-100 points). General linear models adjusted for age, sex, education, income, disease activity, disease duration, depression, and time using the Internet. Results: Trust in one's physician increased with higher functional and communicative HL (per 1-pt increase, 3.21 [95%CI 0.61, 5.81], 5.8 [95%CI 1.96, 9.63]). Trust in physicians in general increased with higher communicative HL and decreased with higher critical HL (per 1-pt increase, 7.01 [95%CI 2.27, 11.76], -6.83 [95%CI -11.67, -1.99]). Longer Internet use was associated with both higher communicative and critical HL. Conclusions: Our findings suggest that rheumatologists can help patients build trust by encouraging dialogue about their health issues with their doctors and family members, rather than trying to improve their ability to discern health information.
{"title":"The impact of communicative and critical health literacy on trust in physicians among patients with systemic lupus erythematosus: the TRUMP2-SLE project","authors":"N. Oguro, N. Yajima, Y. Miyawaki, R. Yoshimi, Y. Shimojima, K. Sada, K. Hayashi, K. Shidahara, N. Sakurai, C. Hidekawa, D. Kishida, T. Ichikawa, Y. Ishikawa, N. Kurita","doi":"10.1101/2022.05.13.22275070","DOIUrl":"https://doi.org/10.1101/2022.05.13.22275070","url":null,"abstract":"Objectives: Accessing the Internet has increased the gap in patient health literacy (HL), impacting patient-doctor trust. We examined how trust in physicians is affected by functional HL (the ability to read and write) and by broader concepts of HL, including communicative HL (the ability to extract information from communication to use) and critical HL (the ability to analyze and use information) among patients with systemic lupus erythematosus (SLE). Methods: This cross-sectional study enrolled 362 SLE patients at five academic centers between June 2020 and August 2021. The 14-item Functional Communicative Critical Health Literacy Scale assessed the three dimensions of HL (range: 1-4 points). Outcomes were trust in one's physician and physicians generally using the 5-item Wake Forest Physician Trust Scale (range: 0-100 points). General linear models adjusted for age, sex, education, income, disease activity, disease duration, depression, and time using the Internet. Results: Trust in one's physician increased with higher functional and communicative HL (per 1-pt increase, 3.21 [95%CI 0.61, 5.81], 5.8 [95%CI 1.96, 9.63]). Trust in physicians in general increased with higher communicative HL and decreased with higher critical HL (per 1-pt increase, 7.01 [95%CI 2.27, 11.76], -6.83 [95%CI -11.67, -1.99]). Longer Internet use was associated with both higher communicative and critical HL. Conclusions: Our findings suggest that rheumatologists can help patients build trust by encouraging dialogue about their health issues with their doctors and family members, rather than trying to improve their ability to discern health information.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85647527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this issue of The Journal of Rheumatology, Carluzzo et al1 explored different factors that contribute to the empowerment of individuals with arthritis. The study used data obtained from 12,560 US participants in the Live Yes! INSIGHTS program, based on sociodemographic information and patient-reported outcome measures (PROMs) about physical and mental health, emotional support, and empowerment.
{"title":"Beyond Empowerment in Rheumatology Care","authors":"A. D. de Lara, I. Peláez-Ballestas","doi":"10.3899/jrheum.220348","DOIUrl":"https://doi.org/10.3899/jrheum.220348","url":null,"abstract":"In this issue of The Journal of Rheumatology, Carluzzo et al1 explored different factors that contribute to the empowerment of individuals with arthritis. The study used data obtained from 12,560 US participants in the Live Yes! INSIGHTS program, based on sociodemographic information and patient-reported outcome measures (PROMs) about physical and mental health, emotional support, and empowerment.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82617115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Griffiths et al recently reported that in a cohort of Australian patients with ankylosing spondylitis included in the Optimising Patient outcomes in Australian RheumatoLogy (OPAL) dataset, the median persistence (persistence defined as the time to discontinuation of treatment) was longest for patients treated with golimumab (GOL) in all lines of therapy, and shortest for those treated with etanercept (ETN).1 In drawing this conclusion, the authors have overlooked some statistical aspects relating to the reporting of time-to-event data that make it difficult to evaluate the robustness of their conclusions.
{"title":"Some Key Issues Relating to the Reporting and Interpretation of Time-to-Event Data","authors":"I. M. Schou","doi":"10.3899/jrheum.220053","DOIUrl":"https://doi.org/10.3899/jrheum.220053","url":null,"abstract":"Griffiths et al recently reported that in a cohort of Australian patients with ankylosing spondylitis included in the Optimising Patient outcomes in Australian RheumatoLogy (OPAL) dataset, the median persistence (persistence defined as the time to discontinuation of treatment) was longest for patients treated with golimumab (GOL) in all lines of therapy, and shortest for those treated with etanercept (ETN).1 In drawing this conclusion, the authors have overlooked some statistical aspects relating to the reporting of time-to-event data that make it difficult to evaluate the robustness of their conclusions.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78226591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Tollisen, A. Selvaag, A. Aasland, T. Ingebrigtsen, J. Sagen, A. Lerdal, B. Flatø
Objective To explore quality of life (QOL) using the individualized Patient Generated Index (PGI) in young adults who were diagnosed with juvenile idiopathic arthritis (JIA) in childhood, and to examine associations between PGI ratings and standardized health-related outcome measures. Methods Patients (N = 79, mean age 25.1 [SD 4.2] yrs, 72% female) completed the PGI and the standardized measures: Health Assessment Questionnaire–Disability Index, 12-item Short Form Health Survey (SF-12; physical and mental health-related QOL [HRQOL]), Brief Pain Inventory (pain severity and interference), 5-item Hopkins Symptom Checklist, and visual analog scale for fatigue. Information on morning stiffness, medications, and demographics was also collected. Patients were compared to 79 matched controls. Results The most frequently nominated areas of importance for patients’ personally generated QOL (assessed by PGI) were physical activity (n = 38, 48%), work/school (n = 31, 39%), fatigue (n = 29, 37%) and self-image (n = 26, 33%). Nomination of physical activity was associated with older age, morning stiffness, and more pain interference. Nomination of fatigue was associated with current use of disease-modifying antirheumatic drugs, whereas nomination of self-image was associated with polyarticular course JIA and pain interference. Nomination of work/school was not associated with other factors. Higher PGI scores (indicating better QOL) correlated positively with all SF-12 subscales except role emotional, and negatively with disability, pain severity, pain interference, and morning stiffness. Compared to controls, patients had more pain, poorer physical HRQOL, and less participation in full-time work or school. Conclusion Physical activity, work/school, fatigue, and self-image were frequently nominated areas affecting QOL in young adults with JIA. The PGI included aspects of QOL not covered in standardized measures.
{"title":"Personally Generated Quality of Life Outcomes in Adults With Juvenile Idiopathic Arthritis","authors":"A. Tollisen, A. Selvaag, A. Aasland, T. Ingebrigtsen, J. Sagen, A. Lerdal, B. Flatø","doi":"10.3899/jrheum.211245","DOIUrl":"https://doi.org/10.3899/jrheum.211245","url":null,"abstract":"Objective To explore quality of life (QOL) using the individualized Patient Generated Index (PGI) in young adults who were diagnosed with juvenile idiopathic arthritis (JIA) in childhood, and to examine associations between PGI ratings and standardized health-related outcome measures. Methods Patients (N = 79, mean age 25.1 [SD 4.2] yrs, 72% female) completed the PGI and the standardized measures: Health Assessment Questionnaire–Disability Index, 12-item Short Form Health Survey (SF-12; physical and mental health-related QOL [HRQOL]), Brief Pain Inventory (pain severity and interference), 5-item Hopkins Symptom Checklist, and visual analog scale for fatigue. Information on morning stiffness, medications, and demographics was also collected. Patients were compared to 79 matched controls. Results The most frequently nominated areas of importance for patients’ personally generated QOL (assessed by PGI) were physical activity (n = 38, 48%), work/school (n = 31, 39%), fatigue (n = 29, 37%) and self-image (n = 26, 33%). Nomination of physical activity was associated with older age, morning stiffness, and more pain interference. Nomination of fatigue was associated with current use of disease-modifying antirheumatic drugs, whereas nomination of self-image was associated with polyarticular course JIA and pain interference. Nomination of work/school was not associated with other factors. Higher PGI scores (indicating better QOL) correlated positively with all SF-12 subscales except role emotional, and negatively with disability, pain severity, pain interference, and morning stiffness. Compared to controls, patients had more pain, poorer physical HRQOL, and less participation in full-time work or school. Conclusion Physical activity, work/school, fatigue, and self-image were frequently nominated areas affecting QOL in young adults with JIA. The PGI included aspects of QOL not covered in standardized measures.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80283477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Delays in diagnosis remain a major gap in the care of patients with axial spondyloarthritis (axSpA). Despite efforts to improve awareness among family physicians and nonrheumatologist specialists, the average duration from onset of symptoms to diagnosis of axSpA is approximately 8 years,1 which is one of the longest in rheumatology. Such delays in diagnosis are associated with late initiation of therapy and worse disease outcomes.
{"title":"Spondyloarthritis Among Patients With Uveitis: Can We Improve Referral Pathways?","authors":"L. Eder","doi":"10.3899/jrheum.220263","DOIUrl":"https://doi.org/10.3899/jrheum.220263","url":null,"abstract":"Delays in diagnosis remain a major gap in the care of patients with axial spondyloarthritis (axSpA). Despite efforts to improve awareness among family physicians and nonrheumatologist specialists, the average duration from onset of symptoms to diagnosis of axSpA is approximately 8 years,1 which is one of the longest in rheumatology. Such delays in diagnosis are associated with late initiation of therapy and worse disease outcomes.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84018299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Kędra, P. Claudepierre, R. Flipo, M. Garrido-Cumbrera, F. Alliot-Launois, E. Desfleurs, L. Grange, L. Gossec
The effect of axial spondyloarthritis (axSpA) on patients' quality of life (QOL) has been well assessed in terms of body structures and functions, but literature is scarce in terms of social interactions and activities, work, and fears related to social interactions or activities.1.
{"title":"Impact of Axial Spondyloarthritis on Quality of Life: Results From the European Map of Axial Spondyloarthritis (EMAS) Study in France","authors":"J. Kędra, P. Claudepierre, R. Flipo, M. Garrido-Cumbrera, F. Alliot-Launois, E. Desfleurs, L. Grange, L. Gossec","doi":"10.3899/jrheum.210864","DOIUrl":"https://doi.org/10.3899/jrheum.210864","url":null,"abstract":"The effect of axial spondyloarthritis (axSpA) on patients' quality of life (QOL) has been well assessed in terms of body structures and functions, but literature is scarce in terms of social interactions and activities, work, and fears related to social interactions or activities.1.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84884285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Realizing in the fall of 2021 that I had started medical school exactly 50 years ago, on September 7, 1971, I thought that it would be interesting for the 2022 Dunlop-Dottridge Lecture to briefly review what we knew about vasculitis prior to 1971 and then reflect on what we have learned since.
{"title":"Vasculitis: What Have We Learned in the Last 50 Years?","authors":"S. Carette","doi":"10.3899/jrheum.220207","DOIUrl":"https://doi.org/10.3899/jrheum.220207","url":null,"abstract":"Realizing in the fall of 2021 that I had started medical school exactly 50 years ago, on September 7, 1971, I thought that it would be interesting for the 2022 Dunlop-Dottridge Lecture to briefly review what we knew about vasculitis prior to 1971 and then reflect on what we have learned since.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82587023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Calcinosis (hydroxyapatite and calcium phosphate crystal deposition) within the extracellular matrix of the dermis and subcutaneous tissue is a frequent manifestation of adult and pediatric systemic autoimmune rheumatic diseases, specifically systemic sclerosis, dermatomyositis, mixed connective tissue disease, and systemic lupus erythematosus. In this article, we review classification of calcinosis, highlight mechanisms that may contribute to the pathogenesis of calcinosis, and summarize the evidence evaluating nonpharmacologic and pharmacologic interventions for the treatment of calcinosis.
{"title":"Management of Calcinosis Cutis in Rheumatic Diseases","authors":"Hadiya Elahmar, B. Feldman, S. Johnson","doi":"10.3899/jrheum.211393","DOIUrl":"https://doi.org/10.3899/jrheum.211393","url":null,"abstract":"Calcinosis (hydroxyapatite and calcium phosphate crystal deposition) within the extracellular matrix of the dermis and subcutaneous tissue is a frequent manifestation of adult and pediatric systemic autoimmune rheumatic diseases, specifically systemic sclerosis, dermatomyositis, mixed connective tissue disease, and systemic lupus erythematosus. In this article, we review classification of calcinosis, highlight mechanisms that may contribute to the pathogenesis of calcinosis, and summarize the evidence evaluating nonpharmacologic and pharmacologic interventions for the treatment of calcinosis.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75073049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We thank Dr Schou for her insightful comments.1 The interpretation of data from an observational study such as this is complex, and the conclusions are by necessity less robust than in a randomized controlled trial.
{"title":"Dr. Griffiths et al reply","authors":"J. Leadbetter, H. Griffiths","doi":"10.3899/jrheum.220120","DOIUrl":"https://doi.org/10.3899/jrheum.220120","url":null,"abstract":"We thank Dr Schou for her insightful comments.1 The interpretation of data from an observational study such as this is complex, and the conclusions are by necessity less robust than in a randomized controlled trial.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89469464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Matsuda, T. Kotani, H. Kuwabara, Takayasu Suzuka, Takao Kiboshi, Y. Wada, T. Ishida, Youhei Fujiki, Hideyuki Shiba, K. Hata, T. Shoda, Y. Hirose, T. Takeuchi
Objective To address the pathomechanism of microscopic polyangiitis (MPA) complicated by interstitial lung disease (ILD) using serum biomarker profile and pulmonary histopathology. Methods Serum biomarkers from patients with MPA-ILD (n = 32), MPA without ILD (n = 17), and healthy controls (n = 10) were examined. Based on the biomarker profiles, principal component analysis (PCA) and cluster analysis were performed to classify patients with MPA-ILD into subgroups. Clinical characteristics and prognosis were assessed for each subgroup. Two lung biopsies were examined following H&E staining and immunostaining. Results T cell and macrophage polarization was skewed toward the T helper (Th) 2 cells and M2 macrophages in the MPA-ILD group relative to that in MPA without ILD group. The PCA allowed classification of the 19 biomarker profiles into 3 groups: (1) B cell– and neutrophil-related cytokines, vascular angiogenesis-related factors, extracellular matrix-producing factors; (2) Th1-driven cytokines, M1 macrophage-driven cytokines, and Th2-driven cytokines; and (3) M2 macrophage-induced and driven cytokines. The cluster analysis stratified the patients with MPA-ILD into clinically fibrotic-dominant (CFD) and clinically inflammatory-dominant (CID) groups. Notably, severe infections were significantly higher in the CFD group than in the CID group. Immunohistochemical staining demonstrated intense CXC motif chemokine ligand 13 staining in B cells and Th2 cells in the interstitium of the lungs of patients with MPA-ILD. Conclusion. The activation of M2 macrophages, Th2 cells, and B cells plays a key role in the pathomechanism of MPA-ILD. Classification of MPA-ILD based on serum biomarker profile would be useful in predicting the disease activity and the complications of severe infection in MPA-ILD.
{"title":"Association of M2 Macrophages, Th2, and B Cells With Pathomechanism in Microscopic Polyangiitis Complicated by Interstitial Lung Disease","authors":"S. Matsuda, T. Kotani, H. Kuwabara, Takayasu Suzuka, Takao Kiboshi, Y. Wada, T. Ishida, Youhei Fujiki, Hideyuki Shiba, K. Hata, T. Shoda, Y. Hirose, T. Takeuchi","doi":"10.3899/jrheum.220123","DOIUrl":"https://doi.org/10.3899/jrheum.220123","url":null,"abstract":"Objective To address the pathomechanism of microscopic polyangiitis (MPA) complicated by interstitial lung disease (ILD) using serum biomarker profile and pulmonary histopathology. Methods Serum biomarkers from patients with MPA-ILD (n = 32), MPA without ILD (n = 17), and healthy controls (n = 10) were examined. Based on the biomarker profiles, principal component analysis (PCA) and cluster analysis were performed to classify patients with MPA-ILD into subgroups. Clinical characteristics and prognosis were assessed for each subgroup. Two lung biopsies were examined following H&E staining and immunostaining. Results T cell and macrophage polarization was skewed toward the T helper (Th) 2 cells and M2 macrophages in the MPA-ILD group relative to that in MPA without ILD group. The PCA allowed classification of the 19 biomarker profiles into 3 groups: (1) B cell– and neutrophil-related cytokines, vascular angiogenesis-related factors, extracellular matrix-producing factors; (2) Th1-driven cytokines, M1 macrophage-driven cytokines, and Th2-driven cytokines; and (3) M2 macrophage-induced and driven cytokines. The cluster analysis stratified the patients with MPA-ILD into clinically fibrotic-dominant (CFD) and clinically inflammatory-dominant (CID) groups. Notably, severe infections were significantly higher in the CFD group than in the CID group. Immunohistochemical staining demonstrated intense CXC motif chemokine ligand 13 staining in B cells and Th2 cells in the interstitium of the lungs of patients with MPA-ILD. Conclusion. The activation of M2 macrophages, Th2 cells, and B cells plays a key role in the pathomechanism of MPA-ILD. Classification of MPA-ILD based on serum biomarker profile would be useful in predicting the disease activity and the complications of severe infection in MPA-ILD.","PeriodicalId":35278,"journal":{"name":"The Journal of rheumatology. Supplement","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90691548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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