Journal of Allergy and Clinical Immunology-In Practice最新文献

{"title":"Stinging Ant Anaphylaxis: Advances in Diagnosis and Treatment","authors":"Jeremy C. McMurray MD ,&nbsp;Karla E. Adams MD ,&nbsp;Troy Wanandy PhD ,&nbsp;Adriana Le MBBS, FRACP ,&nbsp;Robert J. Heddle MBBS, PhD, FRACP, FRCPA","doi":"10.1016/j.jaip.2024.07.014","DOIUrl":"10.1016/j.jaip.2024.07.014","url":null,"abstract":"<div><div>Stinging ants represent a wide range of over 200 different species across the world, of which <em>Solenopsis</em>, <em>Myrmecia, Pogonomyrmex</em>, and <em>Brachyponera</em> genera account for a substantial economic and healthcare burden. <em>S. invicta</em> (red imported fire ant [IFA]) and <em>M. pilosula</em> (jack jumper ant [JJA]) are 2 species of high clinical importance, known to cause anaphylaxis in humans, with numerous reported fatalities. Diagnostic testing should be performed in patients with a history of a systemic reaction with skin testing and/or <em>in vitro</em> specific immunoglobulin E (IgE) testing. <em>In vitro</em> testing is commercially available for IFA through whole-body extract specific IgE and JJA venom-specific IgE, but not widely available for other stinging ant species. Commercial venom component testing for IFA and JJA is currently not available. Patients with a clinical history and positive specific IgE testing should undergo treatment with specific immunotherapy, which is currently available for IFA and JJA. Buildup may be performed using conventional, semi-rush, rush, or ultra-rush schedules with similar risk profiles for IFA. Optimal duration for whole=body extract immunotherapy for IFA and specific JJA venom immunotherapy is not well studied, but generally recommended for at least 3 to 5 years. Sting challenges are used in research settings, primarily to assess treatment efficacy of immunotherapy.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 1","pages":"Pages 25-37"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venom Component Allergen IgE Measurement in the Diagnosis and Management of Insect Sting Allergy","authors":"Simon Blank PhD ,&nbsp;Peter Korošec PhD ,&nbsp;Benjamin O. Slusarenko MSc ,&nbsp;Markus Ollert MD, DMSci ,&nbsp;Robert G. Hamilton PhD, D(ABMLI)","doi":"10.1016/j.jaip.2024.07.023","DOIUrl":"10.1016/j.jaip.2024.07.023","url":null,"abstract":"<div><div>Accurate identification of allergy-eliciting stinging insect(s) is essential to ensuring effective management of Hymenoptera venom-allergic individuals with venom-specific immunotherapy. Diagnostic testing using whole-venom extracts with skin tests and serologic-based analyses remains the first level of discrimination for honeybee versus vespid venom sensitization in patients with a positive clinical history. As a second-level evaluation, serologic testing using molecular venom allergens can further discriminate genuine sensitization (honeybee venom: Api m 1, 3, 4, and 10 vs yellow jacket venom/<em>Polistes dominula</em> venom Ves v 1/Pol d 1 and Ves v 5/Pol d 5) from interspecies cross-reactivity (hyaluronidases [Api m 2, Ves v 2, and Pol d 2] and dipeptidyl peptidases IV [Api m 5, Ves v 3, and Pol d 3]). Clinical laboratories use a number of singleplex, oligoplex, and multiplex immunoassays that employ both extracted whole-venom and molecular venom allergens (highlighted earlier) for confirmation of allergic venom sensitization. Established quantitative singleplex autoanalyzers have general governmental regulatory clearance worldwide for venom-allergic patient testing with maximally achievable analytical sensitivity (0.1 kU_A/L) and confirmed reproducibility (interassay coefficient of variation &lt;10%). Emerging oligoplex and multiplex (fixed-panel) assays conserve on serum and are more cost-effective, but they need regulatory clearance in some countries and are prone to higher rates of detecting asymptomatic sensitization. Ultimately, the patient’s clinical history, combined with proof of sensitization, is the final arbiter in the diagnosis of Hymenoptera venom allergy.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 1","pages":"Pages 1-14"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Easier Way to Measure Small Airway Function?","authors":"Rory Chan MBChB, PhD ,&nbsp;Brian Lipworth MD ,&nbsp;Tom Fardon MD, FRCPE ,&nbsp;Peter J. Barnes FRS, FMedSci","doi":"10.1016/j.jaip.2024.10.023","DOIUrl":"10.1016/j.jaip.2024.10.023","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 1","pages":"Pages 119-120"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"May 2024 Practice Notes","authors":"","doi":"10.1016/S2213-2198(24)01205-4","DOIUrl":"10.1016/S2213-2198(24)01205-4","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 1","pages":"Pages A15-A16"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143143775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age- and Elicitor-Dependent Characterization of Hymenoptera Venom-Induced Anaphylaxis in Children and Adolescents","authors":"Margitta Worm MD ,&nbsp;Ewa Cichocka-Jarosz MD ,&nbsp;Franziska Ruëff MD ,&nbsp;Thomas Spindler MD ,&nbsp;Alice Köhli MD ,&nbsp;Johannes Trück MD ,&nbsp;Lars Lange MD ,&nbsp;Karin Hartmann MD ,&nbsp;Thomas Hawranek MD ,&nbsp;Katja Nemat MD ,&nbsp;Claudia Pföhler MD ,&nbsp;Maria Beatrice Bilò MD ,&nbsp;Dominique Sabouraud-Leclerc MD ,&nbsp;Nicola Wagner MD ,&nbsp;Nikolaos Papadopoulos MD ,&nbsp;Susanne Hämmerling MD ,&nbsp;Luis Felipe Ensina MD ,&nbsp;Sabine Dölle-Bierke PhD ,&nbsp;Veronika Höfer MSc","doi":"10.1016/j.jaip.2024.08.036","DOIUrl":"10.1016/j.jaip.2024.08.036","url":null,"abstract":"<div><h3>Background</h3><div>Hymenoptera venom is one of the most frequent causes of anaphylaxis. Studies from adults indicate the clinical profiles and risk factors of Hymenoptera venom-induced anaphylaxis (VIA). Much less is known about pediatric VIA.</div></div><div><h3>Objective</h3><div>To understand elicitor- and age-related factors determining pediatric VIA by analyzing data from the anaphylaxis registry.</div></div><div><h3>Methods</h3><div>We selected pediatric VIA, pediatric food-induced anaphylaxis (FIA), and adult VIA cohorts from the anaphylaxis registry and performed a comparative data analysis regarding elicitors, symptoms, and management.</div></div><div><h3>Results</h3><div>We identified 725 pediatric patients with VIA, 3,149 with pediatric FIA, and 5,534 with adult VIA. In pediatric VIA, boys were more frequently affected, atopy was not increased, and the onset of the reaction after exposure was fast (≤30 min; 91%) compared with pediatric FIA. Symptoms in pediatric VIA were age dependent, and although respiratory symptoms occurred most frequently besides skin symptoms in both pediatric patients with VIA and FIA, cardiovascular symptoms were more frequently reported in pediatric patients with VIA than pediatric patients with FIA. The analysis of pediatric versus adult VIA revealed clear differences in the frequency of involved organ systems (skin: 93% vs 78%; respiratory: 77% vs 64%; and cardiovascular: 61% vs 85%). For both pediatric and adult VIA, the rates of adrenaline application by a professional were low (29% vs 31%) but hospitalization rates were higher in children than in adults (61% vs 42%). Venom immunotherapy was frequently initiated regardless of age (78% each).</div></div><div><h3>Conclusions</h3><div>Pediatric VIA is more frequent in boys, symptoms are age dependent, and hospitalization is often required. Adrenaline should be applied according to current guidelines. Venom immunotherapy is an important treatment option in pediatric VIA and should be considered in severely affected children.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 1","pages":"Pages 69-78.e2"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Feasibility of Peanut, Tree Nut, and Sesame Oral Immunotherapy in Infants and Toddlers in a Real-World Setting","authors":"Jenny Huang MD ,&nbsp;Leah H. Puglisi MS ,&nbsp;Kevin A. Cook MD ,&nbsp;John M. Kelso MD ,&nbsp;Hannah Wangberg MD","doi":"10.1016/j.jaip.2024.09.025","DOIUrl":"10.1016/j.jaip.2024.09.025","url":null,"abstract":"<div><h3>Background</h3><div>Oral immunotherapy (OIT) for food allergy has been largely studied in older children within the context of clinical trials, and its availability has historically been limited for younger patients with food allergy. Data have shown that the most impact may actually be seen with the use of OIT in younger infants and toddlers.</div></div><div><h3>Objective</h3><div>To evaluate the safety and feasibility of OIT in subjects 24 months and younger in a real-world setting using commercially available food products.</div></div><div><h3>Methods</h3><div>This was a retrospective study of subjects 24 months and younger initiated on OIT for peanut, tree nut, or sesame allergy within the Scripps Clinic allergy department. Medical records were reviewed for data regarding initial oral food challenges, OIT, and adverse outcomes.</div></div><div><h3>Results</h3><div>Fifty-two subjects 24 months and younger were initiated on OIT. Most subjects (84.6%) were on single-food OIT, and some (15.4%) were on multifood OIT. No increased adverse outcomes were observed on multifood OIT. Of the 59 initial oral food challenges, objective reactions occurred during 42 challenges, most being low-grade reactions. During initial oral food challenges, 86.1% of peanut-allergic children tolerated 1/8 of 1 Bamba stick with no reaction. Most subjects (73.1%) updosed at home, and most (51.9%) had no reactions while updosing. Some had low-grade cutaneous reactions, none requiring epinephrine or emergency evaluation.</div></div><div><h3>Conclusions</h3><div>OIT in infants is safe and feasible to perform in a real-world setting using commercially available food products with at-home updosing, thus increasing the availability of OIT for patients.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 1","pages":"Pages 185-191.e3"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Viral Determinants of Childhood Asthma Exacerbation Severity and Treatment Response","authors":"Nidhya Navanandan MD, MSCS ,&nbsp;Nathan D. Jackson PhD ,&nbsp;Katharine L. Hamlington PhD ,&nbsp;Jamie L. Everman PhD ,&nbsp;Elmar Pruesse PhD ,&nbsp;Elizabeth A. Secor MA ,&nbsp;Zoe Stewart BS ,&nbsp;Katrina Diener BS ,&nbsp;Isabel Hardee MD ,&nbsp;Alec Edid BA ,&nbsp;Helio Sulbaran BS ,&nbsp;Rakesh D. Mistry MD, MS ,&nbsp;Todd A. Florin MD, MSCE ,&nbsp;Angela C. Yoder MS ,&nbsp;Camille M. Moore PhD ,&nbsp;Stanley J. Szefler MD ,&nbsp;Andrew H. Liu MD ,&nbsp;Max A. Seibold PhD","doi":"10.1016/j.jaip.2024.09.020","DOIUrl":"10.1016/j.jaip.2024.09.020","url":null,"abstract":"<div><h3>Background</h3><div>Although respiratory viruses are common triggers of asthma exacerbations, the influence of viral infection characteristics on exacerbation presentation and treatment response in the pediatric emergency department (ED) is unclear.</div></div><div><h3>Objective</h3><div>To assess viral infection characteristics of children experiencing ED asthma exacerbations and to test their associations with severity and treatment response.</div></div><div><h3>Methods</h3><div>This is a prospective study of children, aged 4 to 18 years, who received standard ED asthma exacerbation treatment with inhaled bronchodilators and systemic corticosteroids. Nasal swabs collected for viral metagenomic analyses determined virus presence, load, and species. Outcomes included exacerbation severity (Pediatric Asthma Severity [PAS] score, clinician impression, and vital signs) and treatment response (discharge home without needing additional asthma therapies).</div></div><div><h3>Results</h3><div>Of 107 children, 47% had moderate/severe exacerbations by PAS and 64% demonstrated treatment response. Viral metagenomic analysis on nasal swabs from 73 children detected virus in 86%, with 10 different species identified, primarily rhinovirus A (RV-A), RV-C, and enterovirus D68. Exacerbations involving RV-A were milder (odds ratio [OR] = 0.25; 95% confidence interval [CI] = 0.07-0.83) and tended to be more responsive to treatment than non-RV-A infections, whereas exacerbations involving enterovirus D68 were more severe (OR = 8.3; 95% CI = 1.3-164.7) and had no treatment response association. Viral load was not associated with treatment response but exhibited a strong linear relationship with heart rate (<em>r</em>_partial = 0.48), respiratory rate (<em>r</em>_partial = 0.25), and oxygen saturation (<em>r</em>_partial = –0.25), indicative of severity.</div></div><div><h3>Conclusions</h3><div>The majority of ED asthma exacerbations are triggered by respiratory viruses. Viral species are associated with severity and treatment response, suggesting that early pathogen detection could inform ED treatment decisions. Additional studies are needed to identify differences in pathobiology underlying exacerbations triggered by different viral species, and how to effectively treat these heterogeneous exacerbations.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 1","pages":"Pages 95-104.e5"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catamenial anaphylaxis in adolescents and young adults: A case series","authors":"Dehlia Moussaoui MD ,&nbsp;Tracy Foran BMed, FRANZCOG ,&nbsp;Stephanie Richards BSc (Hons), MBBS, FRACP, FRCPA ,&nbsp;Sonia R. Grover MBBS, FRANZCOG, FFPMANZCA, MD","doi":"10.1016/j.jaip.2024.09.032","DOIUrl":"10.1016/j.jaip.2024.09.032","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 1","pages":"Pages 220-224"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"(FEV3-FEV1)/FVC: A Terminal-Airflow Variable for Airway Hyperresponsiveness and Inflammation Prediction in Patients With Symptoms Despite Preserved Spirometry","authors":"Wuping Bao MD ,&nbsp;Yanmei Lin BS ,&nbsp;Lei Zhao BS ,&nbsp;Yingying Zhang MD ,&nbsp;Jingwang Lin BS ,&nbsp;Junfeng Yin PhD ,&nbsp;Yiting Wu BS ,&nbsp;Jifei Wu BS ,&nbsp;Yan Zhou MD ,&nbsp;Min Zhang MD","doi":"10.1016/j.jaip.2024.10.010","DOIUrl":"10.1016/j.jaip.2024.10.010","url":null,"abstract":"<div><h3>Background</h3><div>Small-airway function assessment is crucial for asthma diagnosis and management. Abnormalities in terminal airflow deserve attention.</div></div><div><h3>Objective</h3><div>This study investigated whether (FEV₃-FEV₁)/FVC correlates with airway hyperresponsiveness (AHR) and inflammation in patients with preserved spirometry.</div></div><div><h3>Methods</h3><div>This cross-sectional study enrolled patients with FEV₁ of 80% predicted or greater, FEV₁/FVC of 0.7 or greater, and recurring asthma-like symptoms. Data included demographics, FeNO, impulse oscillometry, and spirometry. Univariate and combined models predicting AHR were analyzed in 553 patients and validated in 561. We also assessed correlations between sputum inflammation and spirometrics.</div></div><div><h3>Results</h3><div>Airway-hyperresponsive patients exhibited higher (FEV₃-FEV₁)/FVC ratios compared with those who were negative for AHR. This ratio showed the strongest association with the methacholine dose causing a 20% FEV₁ decrease and the response dose ratio (r = –0.26 and 0.39, respectively; <em>P</em> &lt; .001 for both). The area under the receiver operating characteristic curve for AHR diagnosis using (FEV₃-FEV₁)/FVC was 0.751, increasing to 0.821 when it was combined with FeNO, as confirmed in the validation cohort. Moreover, (FEV₃-FEV₁)/FVC was superior to maximal expiratory flow at 50% of FVC for identifying eosinophilic airway inflammation characterized by elevated FeNO levels. It correlated better with sputum eosinophil count than with the other spirometrics.</div></div><div><h3>Conclusions</h3><div>Elevated (FEV₃-FEV₁)/FVC levels were evident in AHR-positive patients with preserved FEV₁/FVC ratios. They serve as a sensitive marker of AHR and airway inflammation correlating with the response dose ratio, a provocative dose causing a 20% fall in FEV₁, and sputum eosinophils, suggesting their utility in monitoring patients at risk for uncontrolled asthma.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 1","pages":"Pages 107-118.e8"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Cholinergic Urticaria Activity Score (CholUAS)","authors":"Pia Schnarkowski MD ,&nbsp;Pascale Salameh PhD ,&nbsp;Eva Grekowitz MD ,&nbsp;Dorothea Terhorst-Molawi MD ,&nbsp;Marcus Maurer MD ,&nbsp;Karsten Weller MD ,&nbsp;Sabine Altrichter MD","doi":"10.1016/j.jaip.2024.10.011","DOIUrl":"10.1016/j.jaip.2024.10.011","url":null,"abstract":"<div><h3>Background</h3><div>In cholinergic urticaria (CholU), itchy wheal and flare-type skin reactions are triggered by sweat-inducing activities. The CholU activity score (CholUAS) is used to assess disease activity but has not yet been validated. The aim of the study was to validate the CholUAS, develop an English version, and provide instructions for scoring.</div></div><div><h3>Methods</h3><div>Cognitive debriefing of CholUAS was performed. Patients with CholU (n = 75) used the CholUAS on 7 consecutive days, underwent provocation testing, completed additional anchor instrument questionnaires including global evaluation tools, and established quality of life instruments. A scoring protocol for the calculation of the weekly CholUAS, the CholUAS7, was developed. The CholUAS7 was tested for validity, reliability, and influencing factors. An English version of the CholUAS was developed.</div></div><div><h3>Results</h3><div>The final CholUAS contains 3 questions that are used for scoring as well as 1 global question. The weekly CholUAS, CholUAS7, showed excellent test-retest reliability and good correlations with anchor instruments. Statistical analysis showed no significant influence of age or duration of disease on CholUAS7 results.</div></div><div><h3>Conclusion</h3><div>The validated CholUAS is ready for use in clinical trials and routine clinical practice.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 1","pages":"Pages 213-219.e3"},"PeriodicalIF":8.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}