Journal of the Academy of Nutrition and Dietetics最新文献

{"title":"Using a Combination Amino Acid, Carbohydrate, and Micronutrient Beverage for Preoperative Nutrition Allows Safe Gastric Emptying for Anesthesia Provision in a Prospective, Single-Group Intervention.","authors":"Jennifer A Bowden, Sarah Heath, Gregory L Snow, Anton E Bowden, John R Edwards","doi":"10.1016/j.jand.2025.156223","DOIUrl":"10.1016/j.jand.2025.156223","url":null,"abstract":"<p><strong>Background: </strong>Appropriate preoperative nutrition is a critical element of positive surgical outcomes and enhanced recovery. Immediately preoperatively, gastric clearance of nutritional intake must be considered for safely providing anesthesia. Despite updates in preoperative fasting guidelines regarding clear liquids, practical implementation of multinutrient preoperative supplements has been hampered by aspiration concerns.</p><p><strong>Objective: </strong>The study aim was to provide an objective measurement of gastric clearance times using a multinutrient supplement to confirm an appropriate immediate preoperative window for nutrient provision beyond simple carbohydrates and noncaloric fluids.</p><p><strong>Design: </strong>This is a prospective, single-group intervention, gastric ultrasound study.</p><p><strong>Participants/setting: </strong>Fifty-six individuals participated, with 52 adults from the community in the clinic procedure room and 4 patients undergoing spine surgery in the surgical center preoperative area.</p><p><strong>Intervention: </strong>Following an overnight fast, participants consumed a 250 mL exemplar amino acid, micronutrient, and carbohydrate-containing supplement and were followed for gastric emptying time.</p><p><strong>Main outcome measure: </strong>Ultrasound measurements were taken before and after consuming the multinutrient supplement to determine gastric emptying time both qualitatively and quantitatively.</p><p><strong>Statistical analysis: </strong>Analysis included descriptive statistics, a 1-sample t test for gastric emptying, and ordinal and linear regression analysis for participant characteristic relationships.</p><p><strong>Key results: </strong>Ultrasound cross-sectional area determined 57% of subjects were safe for surgery with residuals <1.5 mL/kg by 30 minutes postconsumption, 93% by 60 minutes, and 96% by 75 minutes, including participants taking glucagon-like peptide-1 receptor agonists or having surgery that day (P < .0001 for mean time <120 minutes).</p><p><strong>Conclusions: </strong>All participants consuming a 250 mL preoperative exemplar supplement containing 12 g amino acids, select micronutrients, and 45 g carbohydrates had gastric clearance within 2 hours, with a majority safe for surgery within 1 hour, demonstrating effective emptying of amino acids in addition to the standard carbohydrates typically utilized preoperatively and an opportunity to provide more effective preoperative nutrition.</p>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":" ","pages":"156223"},"PeriodicalIF":4.0,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145450500","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":"Nutrition Support Interventions in Adults with Hematologic Malignancies: A Systematic Review and Meta-Analysis","authors":"Rachel Newman PhD, RDN ,&nbsp;Mary Rozga PhD, RDN ,&nbsp;Deepa Handu PhD, RDN ,&nbsp;Vanessa Fuchs-Tarlovsky MD, PhD, RD ,&nbsp;Lauren Fay MPH, RD-AP, CSO, CNSC ,&nbsp;Kim Robien PhD, RD, CSO, FAND ,&nbsp;Lisa Moloney PhD, RDN","doi":"10.1016/j.jand.2025.156221","DOIUrl":"10.1016/j.jand.2025.156221","url":null,"abstract":"<div><h3>Background</h3><div>Malnutrition is common in adults with hematologic malignancies and can negatively influence treatment outcomes.</div></div><div><h3>Objective</h3><div>This systematic review evaluated the association between nutrition support interventions compared with alternative or usual care, and primary outcomes (nutritional status, anthropometric measures, length of stay, readmissions, and quality of life) and secondary outcomes (survival, mucositis, graft-vs-host disease, delayed engraftment, inflammation, cost, and calorie or protein intake), in adults with hematologic malignancies.</div></div><div><h3>Methods</h3><div>MEDLINE, CINAHL, Cochrane CENTRAL, Food Science Source, and SPORTDiscus databases were searched for controlled trials and observational studies published in English in peer-reviewed journals from January 2000 to July 2024. Risk of bias (RoB) was assessed using the Cochrane RoB 2 tool for randomized controlled trials (RCTs), RoB in Non-randomized Studies of Interventions for non-RCTs, and RoB in Nonrandomized Studies of Exposures for observational studies. Meta-analyses used a maximum likelihood random-effects model, and heterogeneity was quantified using <em>I</em>². Certainty of evidence for primary outcomes was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation method.</div></div><div><h3>Results</h3><div>Twenty-one articles (11 RCTs, 9 cohorts, 1 non-RCT) representing 2122 participants were included. RoB was low (2 studies), some concerns/moderate (11 studies), and high (8 studies). Meta-analysis indicated a decrease in length of stay for enteral nutrition over parenteral nutrition, and no effect on length of stay for glutamine-enriched nutrition support; however, evidence was of very low certainty. Individualized nutrition support interventions, including the calculation of estimated needs, demonstrated benefit in decreasing weight loss. Overall, the association between nutrition support interventions and nutritional status, weight, readmissions, quality of life, and secondary outcomes was uncertain (very low certainty).</div></div><div><h3>Conclusions</h3><div>No single nutrition support intervention emerged as superior for all outcomes of interest, although current best practices were supported. Certainty of evidence was very low for primary outcomes, and heterogeneity limited conclusions for secondary outcomes. Further high-quality research is needed.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 3","pages":"Article 156221"},"PeriodicalIF":4.0,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923230","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":"A 2-Group Path Analysis of a Food Environment Conceptual Model by Food Security Status: Home Food Environment Variables Were Associated With Healthy Eating Index 2015 Component Scores for Total Vegetables Among Those With Food Security","authors":"Cerra C. Antonacci PhD, MBE, MHS ,&nbsp;Regine Haardörfer PhD, MEd, MS ,&nbsp;Megan R. Winkler PhD, RN ,&nbsp;Terry J. Hartman PhD, MPH, RD ,&nbsp;Alexandra B. Morshed PhD, MS ,&nbsp;Candace Muncy ,&nbsp;Michelle C. Kegler DrPH, MPH","doi":"10.1016/j.jand.2025.156222","DOIUrl":"10.1016/j.jand.2025.156222","url":null,"abstract":"<div><h3>Background</h3><div>The Model of Community Nutrition Environments is a well-known conceptual model in public health nutrition, although few studies have tested the model as a valid representation of food environment-diet pathways. Further, no study has explored whether the model differs by food security status, despite documented disparities in food environments and diet for those experiencing food insecurity.</div></div><div><h3>Objective</h3><div>To test the Model of Community Nutrition Environments by food security status using multigroup path analysis.</div></div><div><h3>Design</h3><div>This secondary analysis of baseline data from a hybrid-effectiveness implementation trial, Healthy Homes/Healthy Families, which included a home environment survey and 2 unscheduled 24-hour dietary recalls, was merged with the US Department of Agriculture 2019 Food Access Research Atlas.</div></div><div><h3>Participants/setting</h3><div>Participants recruited through 4 United Way 2-1-1 agencies in Georgia were eligible if they were aged 18 to 70 years, spoke English, and self-reported a body mass index ≥20. Baseline data collection occurred from October 2020 to December 2022 (N = 510 participants).</div></div><div><h3>Main outcome measures</h3><div>Main outcomes included Healthy Eating Index 2015 component scores for total fruits and total vegetables.</div></div><div><h3>Analyses</h3><div>Multigroup path analysis compared the unstandardized effects of pathways in the Model of Community Nutrition Environments for those who were food secure and food insecure.</div></div><div><h3>Results</h3><div>The 2-group model had good global model fit (root mean square error of approximation = 0.000, comparative fit index = 1.000, Tucker-Lewis index = 1.000, standardized root mean square residual = 0.047). Home availability (<em>b</em> = .08 ± .04; <em>P</em> = .029) and accessibility (<em>b</em> = .68 ± .27; <em>P</em> = .012) of fruits and vegetables were positively associated with Healthy Eating Index 2015 scores for total vegetables among those with food security. No significant associations were found with either outcome among those with food insecurity. The food secure model explained more variance in the outcomes than the food insecure model (food secure: <em>R</em>²_total _fruits = 0.20, <em>R</em>²_{total vegetables} = 0.36; food insecure: <em>R</em>²_{total fruits} = 0.10, <em>R</em>²_total _vegetables = 0.06).</div></div><div><h3>Conclusions</h3><div>Additional mechanisms need to be added to the Model of Community Nutrition Environments to better explain food environment-diet pathways for those experiencing food insecurity.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 2","pages":"Article 156222"},"PeriodicalIF":4.0,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022959","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":"What's New Online","authors":"","doi":"10.1016/S2212-2672(25)00777-4","DOIUrl":"10.1016/S2212-2672(25)00777-4","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 11","pages":"Page 1631"},"PeriodicalIF":4.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145335088","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":"November 2025 People & Events","authors":"","doi":"10.1016/j.jand.2025.09.003","DOIUrl":"10.1016/j.jand.2025.09.003","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 11","pages":"Page 1775"},"PeriodicalIF":4.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145332774","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":"Evaluation of the Feasibility and Construct Validity of a Novel Method to Measure Household Fruit and Vegetable Procurement in Low-Income Community Settings","authors":"Melissa L. Horning PhD ,&nbsp;Kristen S. Gorman PhD ,&nbsp;Julia Steiner MPH ,&nbsp;Julian Wolfson PhD ,&nbsp;Jiayi Hu MS ,&nbsp;Melissa N. Laska PhD, RD ,&nbsp;Jayne A. Fulkerson PhD ,&nbsp;Lisa Harnack DrPH, RD","doi":"10.1016/j.jand.2025.10.011","DOIUrl":"10.1016/j.jand.2025.10.011","url":null,"abstract":"<div><h3>Background</h3><div>Many interventions focus on improving fruit and vegetable (F/V) procurement for those experiencing low incomes or food insecurity. To address current F/V procurement measurement limitations, a novel F/V procurement tool was developed.</div></div><div><h3>Objective</h3><div>The main objectives are to describe the tool and evaluate the tool’s feasibility and construct validity.</div></div><div><h3>Design</h3><div>This cross-sectional study used baseline data from the ongoing Mobile Food Market Cluster Randomized Trial, conducted in the Twin Cities metropolitan area of Minnesota.</div></div><div><h3>Participants/setting</h3><div>During 2023, participants (mean age = 64 years) residing in subsidized housing completed surveys and three 24-hour dietary recalls, and they recorded 4 weeks of F/V procurement using a novel tool submitted weekly by mail. The tool captured F/V items and amounts procured for the home from any type of procurement location, including food pantries. For inclusion in analysis, Wave 1 and 2 trial participants (N = 161) must have completed at least 3 of 4 F/V procurement booklets; 87% (n = 140) met this threshold.</div></div><div><h3>Main outcome measures</h3><div>Main outcomes were Healthy Eating Index-2020 score, Healthy Eating Index-2020 Total Fruit and Total Vegetable component scores, and daily F/V servings consumed.</div></div><div><h3>Statistical analyses performed</h3><div>Descriptive statistics assessed feasibility data (eg, booklet completion rates) and F/V servings by location/source data. The F/V procurement tool’s construct validity was assessed with adjusted linear models testing associations between average weekly servings procured of F/V combined, fruit only, and vegetables only, and dietary and survey measures.</div></div><div><h3>Results</h3><div>On average, 58% of weekly F/V servings procured were from a supermarket and 19% from a food pantry. In adjusted models, each 10-serving increase in F/V procurement was significantly associated with a higher Healthy Eating Index-2020 score by 1.8 points (95% CI, 0.6 to 2.9), Healthy Eating Index-2020 Total Fruit component score by 0.2 points (95% CI, 0.1 to 0.4), and daily F/V intake by 0.2 servings (95% CI, 0.1 to 0.3). No other measures were significantly associated with F/V servings procured.</div></div><div><h3>Conclusions</h3><div>This novel F/V procurement tool may be a feasible method for comprehensively measuring various ways F/V enter households. Construct validity was observed for most diet quality and dietary intake measures examined.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 2","pages":"Article 156220"},"PeriodicalIF":4.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306596","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 Effectiveness of Medical Nutrition Therapy in Prevention and Treatment of Chronic Disease: A Position Paper of the Academy of Nutrition and Dietetics","authors":"Lisa Moloney PhD, RDN ,&nbsp;Mary Rozga PhD, RDN ,&nbsp;Alison Steiber PhD, RDN ,&nbsp;Deepa Handu PhD, RDN","doi":"10.1016/j.jand.2025.10.010","DOIUrl":"10.1016/j.jand.2025.10.010","url":null,"abstract":"<div><div>It is the position of the Academy of Nutrition and Dietetics that all individuals with nutrition-related health conditions or risk factors should have access to medical nutrition therapy (MNT) provided by a registered dietitian nutritionist (RDN). MNT provided by RDNs is effective in improving health outcomes for many chronic conditions that are leading drivers of morbidity, mortality, and health care costs in the United States. Widespread access to MNT using an individualized, client-centered, and evidence-based approach has the potential to improve population health, reduce health disparities, and reduce health care costs associated with nutrition-related health conditions. This Academy of Nutrition and Dietetics position paper summarizes recent evidence from systematic reviews on the effectiveness of MNT provided by an RDN for the prevention and treatment of nutrition-related health conditions. A total of 25 systematic reviews published between 2017 and 2024 were summarized and assessed for certainty of evidence. Systematic reviews with high or moderate certainty of evidence demonstrate that MNT is likely effective in improving a range of health outcomes in adults with pre-diabetes, type 1 diabetes, type 2 diabetes, obesity, pre-hypertension, hypertension, dyslipidemia, chronic kidney disease, head and neck cancer, and chronic obstructive pulmonary disease compared with no MNT or standard care. Barriers exist to accessing MNT, including inadequate staffing of RDNs in some areas, a lack of provider referrals to an RDN for MNT, and a lack of payer coverage and reimbursement. This position was approved in September 2025 and will remain in effect until December 31, 2032.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 2","pages":"Article 156219"},"PeriodicalIF":4.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285338","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":"Perspectives on Messaging Strategies to Increase Participation in Universal Free School Meal Programs: A Qualitative Study With Parents of Elementary School-Aged Children","authors":"Amanda B. Zeitlin MPH ,&nbsp;Alix Zuceth Durán Gómez MD ,&nbsp;Cristina J.Y. Lee MPH ,&nbsp;Andrea Pedroza-Tobias PhD, MSc ,&nbsp;Christina A. Hecht PhD ,&nbsp;Anisha I. Patel MD, MSPH, MSHS ,&nbsp;Kenneth Hecht LLB ,&nbsp;Anna H. Grummon PhD, MSPH","doi":"10.1016/j.jand.2025.09.011","DOIUrl":"10.1016/j.jand.2025.09.011","url":null,"abstract":"<div><h3>Background</h3><div>At least 8 states currently have universal free school meal programs that offer school meals at no charge to all students regardless of their household income. Marketing campaigns offer a scalable strategy for motivating parents to encourage their children to participate in these programs, but little is known about what topics campaigns should address.</div></div><div><h3>Objective</h3><div>To explore perceptions of the content and design of messages encouraging school meal participation among parents of elementary school-aged children.</div></div><div><h3>Design</h3><div>Qualitative online semistructured interviews conducted during February and March 2024. Interviews explored parents’ reactions to messages encouraging school meal participation with a variety of topics (eg, saving time, improving nutrition) and design elements (eg, cartoons, photographs).</div></div><div><h3>Participants</h3><div>Parents of children in grades 1 through 5 not frequently consuming school meals and living in states with universal free school meal programs (N = 18; 14 women; 6 Spanish-speaking).</div></div><div><h3>Analysis</h3><div>Discussions were transcribed verbatim. Investigators developed codes in vivo and analyzed transcripts using a thematic approach.</div></div><div><h3>Results</h3><div>Parents perceived messages that focused on how school meals are convenient and save money to be most likely to motivate them to encourage their children to eat school meals. Parents also believed that school meals can foster social and developmental benefits. Parents perceived messages describing the nutritional quality of school meals as likely to be motivating, but only if they perceived school meals to be nutritious. Some parents reported they did not know school meals were free, despite living in states with universal free school meals. In terms of design, parents preferred succinct messages with bold colors, modern layouts, and references or statistics.</div></div><div><h3>Conclusions</h3><div>Campaigns seeking to motivate parents to encourage their children to participate in universal free school meal programs may wish to discuss convenience, saving money, and social and developmental benefits, and to communicate that school meals are free for all students. Future studies will be needed to evaluate whether campaigns discussing these topics successfully promote school meal participation.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 2","pages":"Article 156209"},"PeriodicalIF":4.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145256991","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":"In Memoriam: Karen Ann Lechowich, MBA, RDN, FAND (1948–2025)","authors":"","doi":"10.1016/j.jand.2025.09.001","DOIUrl":"10.1016/j.jand.2025.09.001","url":null,"abstract":"","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"125 12","pages":"Page 1921"},"PeriodicalIF":4.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145537100","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":"Nickel Allergy Masquerading as Irritable Bowel Syndrome: Case Report","authors":"Desiree de Waal MS, RD, CD, FAND","doi":"10.1016/j.jand.2025.09.010","DOIUrl":"10.1016/j.jand.2025.09.010","url":null,"abstract":"<div><div>Nickel allergy is a common cause of contact dermatitis, but not a well-known cause of gastrointestinal symptoms. Registered dietitian nutritionists, faced with a patient with multiple nontraditional food intolerances and continued gastrointestinal distress, worry about declining nutritional health. The prevalence of nickel allergy is estimated to be approximately 11.4% in the general population. Many clinicians are unaware that systemic nickel allergy syndrome causes symptoms similar to irritable bowel syndrome. Elimination of nickel in the diet is not possible, as it occurs naturally in the environment, but reducing exposure is possible. This case report describes a woman with dermatologic nickel allergy who experienced gastrointestinal symptoms and received a diagnosis of nonresponding irritable bowel syndrome. The patient noted that her multiple symptoms, both intestinal and extraintestinal, either resolved or were better managed after she started a low-nickel diet. This case demonstrates that clinicians should be aware of nickel allergy as a potential contributor to nonresponding irritable bowel syndrome.</div></div>","PeriodicalId":379,"journal":{"name":"Journal of the Academy of Nutrition and Dietetics","volume":"126 1","pages":"Article 156208"},"PeriodicalIF":4.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224588","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}