Pub Date : 2025-12-06DOI: 10.1016/j.amjsurg.2025.116771
{"title":"Don't forget your meds","authors":"","doi":"10.1016/j.amjsurg.2025.116771","DOIUrl":"10.1016/j.amjsurg.2025.116771","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"252 ","pages":"Article 116771"},"PeriodicalIF":2.7,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145740642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-05DOI: 10.1016/j.amjsurg.2025.116769
Nritya Nair, Jaspinder S Sanghera, Ioannis Liapis, Marcus Sirianno, Manish Tripathi, Michelle Holland, Smita Bhatia, Krista Mehari, Annabelle L Fonseca
Objective: Asian women remain underrepresented in surgical leadership despite increasing numbers in the workforce. Their intersectional experiences in academic surgery are poorly understood. This study explores barriers to career advancement faced by Asian women in academic surgery.
Methods: Semi-structured interviews were conducted with Asian women surgeons recruited via a national surgical society. Transcripts were analyzed using grounded theory.
Results: Twenty Asian women surgeons participated; 70% faculty, 35% international medical graduates. Six barrier domains were identified: (1) career advancement-opaque promotion criteria, exclusion from informal networks, disproportionate invisible labor, leadership stereotypes, and mid-career stagnation; (2) mentorship and sponsorship-limited mentorship beyond training, cultural and gender barriers to mentorship, and scarcity of sponsors; (3) bias and discrimination-racism, sexism, undermining of authority, heightened scrutiny, inequitable referrals, and double standards; (4) institutional barriers-favoritism, unsupportive leadership, tokenistic diversity efforts, and productivity-based compensation; (5) personal impact-social exclusion, burnout, disillusionment, and attrition; and (6) barriers related to IMG status, reflecting challenges uniquely reported by international medical graduates.
Conclusion: Structural reforms to improve promotion transparency, ensure leadership accountability, and formalize mentorship and sponsorship are essential to foster equity and retain Asian women in academic surgery.
{"title":"Beyond the scalpel: Barriers to advancement for Asian women in academic surgery.","authors":"Nritya Nair, Jaspinder S Sanghera, Ioannis Liapis, Marcus Sirianno, Manish Tripathi, Michelle Holland, Smita Bhatia, Krista Mehari, Annabelle L Fonseca","doi":"10.1016/j.amjsurg.2025.116769","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116769","url":null,"abstract":"<p><strong>Objective: </strong>Asian women remain underrepresented in surgical leadership despite increasing numbers in the workforce. Their intersectional experiences in academic surgery are poorly understood. This study explores barriers to career advancement faced by Asian women in academic surgery.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with Asian women surgeons recruited via a national surgical society. Transcripts were analyzed using grounded theory.</p><p><strong>Results: </strong>Twenty Asian women surgeons participated; 70% faculty, 35% international medical graduates. Six barrier domains were identified: (1) career advancement-opaque promotion criteria, exclusion from informal networks, disproportionate invisible labor, leadership stereotypes, and mid-career stagnation; (2) mentorship and sponsorship-limited mentorship beyond training, cultural and gender barriers to mentorship, and scarcity of sponsors; (3) bias and discrimination-racism, sexism, undermining of authority, heightened scrutiny, inequitable referrals, and double standards; (4) institutional barriers-favoritism, unsupportive leadership, tokenistic diversity efforts, and productivity-based compensation; (5) personal impact-social exclusion, burnout, disillusionment, and attrition; and (6) barriers related to IMG status, reflecting challenges uniquely reported by international medical graduates.</p><p><strong>Conclusion: </strong>Structural reforms to improve promotion transparency, ensure leadership accountability, and formalize mentorship and sponsorship are essential to foster equity and retain Asian women in academic surgery.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116769"},"PeriodicalIF":2.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145740554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-05DOI: 10.1016/j.amjsurg.2025.116765
Jorge G. Zarate Rodriguez , Catherine N. Zivanov , Jared Yee , Asima Badic , Piroska K. Kopar , Paul E. Wise , Matthew G. Mutch , Matthew L. Silviera , William C. Chapman Jr. , Kerri A. Ohman
Background
There is limited understanding of how consent is obtained for digital rectal (DRE) and intraoperative pelvic exams (IPE) in colorectal surgery.
Methods
Two-pronged survey of colorectal patients and surgeons. Participants self-rated their agreement with various statements regarding consent for surgery, DRE, and IPE.
Results
Out of 90 patients, 77 % agreed that surgeons may perform additional procedures other than those explicitly consented to preoperatively. 89 % agreed that DRE was implicit in the consent but 65 % preferred for it to have been explicitly discussed preoperatively. 75 % of patients agreed that IPE was implicit in the consent, but 58 % preferred for it to have been discussed preoperatively. Out 49 surgeons, 74 % routinely perform maneuvers such as IPE or instrumentation of the vagina when performing stapled anastomoses; only 7 % discuss this when obtaining surgical consent.
Conclusions
Consent discussions should explicitly include sensitive intraoperative exams to prevent erosion of patient autonomy and trust.
{"title":"Understanding patient and surgeon attitudes towards informed consent for sensitive intraoperative exams in colorectal surgery","authors":"Jorge G. Zarate Rodriguez , Catherine N. Zivanov , Jared Yee , Asima Badic , Piroska K. Kopar , Paul E. Wise , Matthew G. Mutch , Matthew L. Silviera , William C. Chapman Jr. , Kerri A. Ohman","doi":"10.1016/j.amjsurg.2025.116765","DOIUrl":"10.1016/j.amjsurg.2025.116765","url":null,"abstract":"<div><h3>Background</h3><div>There is limited understanding of how consent is obtained for digital rectal (DRE) and intraoperative pelvic exams (IPE) in colorectal surgery.</div></div><div><h3>Methods</h3><div>Two-pronged survey of colorectal patients and surgeons. Participants self-rated their agreement with various statements regarding consent for surgery, DRE, and IPE.</div></div><div><h3>Results</h3><div>Out of 90 patients, 77 % agreed that surgeons may perform additional procedures other than those explicitly consented to preoperatively. 89 % agreed that DRE was implicit in the consent but 65 % preferred for it to have been explicitly discussed preoperatively. 75 % of patients agreed that IPE was implicit in the consent, but 58 % preferred for it to have been discussed preoperatively. Out 49 surgeons, 74 % routinely perform maneuvers such as IPE or instrumentation of the vagina when performing stapled anastomoses; only 7 % discuss this when obtaining surgical consent.</div></div><div><h3>Conclusions</h3><div>Consent discussions should explicitly include sensitive intraoperative exams to prevent erosion of patient autonomy and trust.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"252 ","pages":"Article 116765"},"PeriodicalIF":2.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.1016/j.amjsurg.2025.116764
Manish Tripathi , Ioannis Liapis , Jaspinder Sanghera , Chandler A. Annesi , Archie Landrum , Sailesh Kumar , Smita Bhatia , Annabelle L. Fonseca
{"title":"Leveraging large language models to automate scoping reviews: A case study in treatment options for pancreatic cancer","authors":"Manish Tripathi , Ioannis Liapis , Jaspinder Sanghera , Chandler A. Annesi , Archie Landrum , Sailesh Kumar , Smita Bhatia , Annabelle L. Fonseca","doi":"10.1016/j.amjsurg.2025.116764","DOIUrl":"10.1016/j.amjsurg.2025.116764","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"252 ","pages":"Article 116764"},"PeriodicalIF":2.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145720469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.1016/j.amjsurg.2025.116767
Jonathan Zuo, Benjamin T Galen, Issam Koleilat
{"title":"The state of formal point-of-care ultrasound training in general surgery residency education.","authors":"Jonathan Zuo, Benjamin T Galen, Issam Koleilat","doi":"10.1016/j.amjsurg.2025.116767","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116767","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116767"},"PeriodicalIF":2.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145720426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.1016/j.amjsurg.2025.116768
Dillon J. Wade M.D. , Nawar Shara PhD , Katie E. Guinn BS , Waddah B. Al-Refaie M.D., FACS
{"title":"Rural surgery, reinvented: Harnessing AI across the care continuum","authors":"Dillon J. Wade M.D. , Nawar Shara PhD , Katie E. Guinn BS , Waddah B. Al-Refaie M.D., FACS","doi":"10.1016/j.amjsurg.2025.116768","DOIUrl":"10.1016/j.amjsurg.2025.116768","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"252 ","pages":"Article 116768"},"PeriodicalIF":2.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145720440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.1016/j.amjsurg.2025.116763
Ana M. Reyes , Maya Shah , Michael D. Cobler-Lichter , Talia R. Arcieri , Jessica M. Delamater , Edward B. Lineen , Julie Y. Valenzuela , Gerd D. Pust , Kenneth G. Proctor , Nicholas Namias , Patricia M. Byers
Background
Older adults represent a growing proportion of motorcyclists and experience poor outcomes after crashes, but the role of frailty has not been characterized. We hypothesized that certain injuries and adverse outcomes would be more common with frailty.
Methods
The Trauma Quality Improvement Program database was retrospectively reviewed for patients aged ≥50 years with motorcycle collisions from 2017 to 2021. Injury patterns were compared by frailty status and multivariable regression assessed the effect of frailty on mortality and adverse discharge.
Results
Among 58,149 patients, 14.9 % were frail. Frail patients sustained fewer lower extremity injuries but had higher rates of chest injury. Frailty was associated with mortality (aOR 1.31, 95 % CI 1.13–1.51) and discharge to healthcare facilities (aOR 1.52, 95 % CI 1.43–1.62).
Conclusions
These findings highlight opportunities for integrating frailty screening into motorcycle rider education and support the promotion of chest protection, such as protective vests, for older, frail riders.
背景：老年人在摩托车手中所占的比例越来越大，并且在碰撞后经历了不良后果，但虚弱的作用尚未被描述。我们假设某些损伤和不良后果在虚弱中更常见。方法：回顾性分析创伤质量改善计划数据库中2017年至2021年年龄≥50岁的摩托车碰撞患者。损伤模式通过虚弱状态进行比较，多变量回归评估虚弱对死亡率和不良出院的影响。结果：58,149例患者中虚弱者占14.9%。体弱患者下肢损伤较少，但胸部损伤率较高。虚弱与死亡率（aOR 1.31, 95% CI 1.13-1.51）和出院相关（aOR 1.52, 95% CI 1.43-1.62）。结论：这些发现突出了将虚弱筛查纳入摩托车骑手教育的机会，并支持促进胸部保护，如保护背心，为年老，虚弱的骑手。
{"title":"Frailty in older motorcycle riders increases the risk of chest trauma, mortality, and adverse discharge","authors":"Ana M. Reyes , Maya Shah , Michael D. Cobler-Lichter , Talia R. Arcieri , Jessica M. Delamater , Edward B. Lineen , Julie Y. Valenzuela , Gerd D. Pust , Kenneth G. Proctor , Nicholas Namias , Patricia M. Byers","doi":"10.1016/j.amjsurg.2025.116763","DOIUrl":"10.1016/j.amjsurg.2025.116763","url":null,"abstract":"<div><h3>Background</h3><div>Older adults represent a growing proportion of motorcyclists and experience poor outcomes after crashes, but the role of frailty has not been characterized. We hypothesized that certain injuries and adverse outcomes would be more common with frailty.</div></div><div><h3>Methods</h3><div>The Trauma Quality Improvement Program database was retrospectively reviewed for patients aged ≥50 years with motorcycle collisions from 2017 to 2021. Injury patterns were compared by frailty status and multivariable regression assessed the effect of frailty on mortality and adverse discharge.</div></div><div><h3>Results</h3><div>Among 58,149 patients, 14.9 % were frail. Frail patients sustained fewer lower extremity injuries but had higher rates of chest injury. Frailty was associated with mortality (aOR 1.31, 95 % CI 1.13–1.51) and discharge to healthcare facilities (aOR 1.52, 95 % CI 1.43–1.62).</div></div><div><h3>Conclusions</h3><div>These findings highlight opportunities for integrating frailty screening into motorcycle rider education and support the promotion of chest protection, such as protective vests, for older, frail riders.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"252 ","pages":"Article 116763"},"PeriodicalIF":2.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145720467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.amjsurg.2025.116757
Pooja Podugu , Amisha Paul , Ari Zlota , Priyash Hafiz , Tien Nguyen , Annabel Yang , Nikhil Madugula , Caleb Curry , Hope Carrane , Vanessa P. Ho , Justin Dvorak
Introduction
The utility of surveillance imaging (SI) after high-grade liver injury is unclear. We studied SI's detection rate and its association with unplanned interventions, emergency department (ED) visits, and mortality.
Methods
Adult patients with American Association for the Surgery of Trauma (AAST) grade III-V liver injury (2018–2024) were categorized by follow-up imaging: surveillance imaging (SI, no clinical change), clinically-prompted imaging (CI), or none. Outcomes included unplanned intervention, liver-related ED visits, and mortality.
Results
Among 252 patients, SI prompted intervention in 10 % of cases versus 31 % for CI. Unplanned interventions were more frequent after CI than SI (37 % vs. 18 %; p = 0.018). ED visits were marginally lower after SI versus CI (30 % vs. 43 %; p = 0.10). Mortality did not differ across groups.
Conclusions
SI identified complications in select patients and was associated with fewer unplanned interventions, marginally fewer ED visits, and no mortality difference compared to CI.
导读：监测成像（SI）在高级别肝损伤后的应用尚不清楚。我们研究了SI的检出率及其与计划外干预、急诊（ED）就诊和死亡率的关系。方法：美国创伤外科学会（AAST） III-V级肝损伤成年患者（2018-2024）按随访影像学分类：监测影像学（SI，无临床变化），临床提示影像学（CI），或无。结果包括计划外干预、肝脏相关急诊科就诊和死亡率。结果：在252例患者中，10%的病例采用SI，而31%的病例采用CI。CI后非计划干预比SI后更频繁（37%比18%；p = 0.018）。在SI和CI之后，急诊科的诊断率略低（30% vs 43%; p = 0.10）。死亡率在各组之间没有差异。结论：与CI相比，SI确定了部分患者的并发症，并且与计划外干预较少，ED就诊较少相关，且死亡率无差异。
{"title":"Assessing the utility of surveillance imaging in high-grade liver injury patients","authors":"Pooja Podugu , Amisha Paul , Ari Zlota , Priyash Hafiz , Tien Nguyen , Annabel Yang , Nikhil Madugula , Caleb Curry , Hope Carrane , Vanessa P. Ho , Justin Dvorak","doi":"10.1016/j.amjsurg.2025.116757","DOIUrl":"10.1016/j.amjsurg.2025.116757","url":null,"abstract":"<div><h3>Introduction</h3><div>The utility of surveillance imaging (SI) after high-grade liver injury is unclear. We studied SI's detection rate and its association with unplanned interventions, emergency department (ED) visits, and mortality.</div></div><div><h3>Methods</h3><div>Adult patients with American Association for the Surgery of Trauma (AAST) grade III-V liver injury (2018–2024) were categorized by follow-up imaging: surveillance imaging (SI, no clinical change), clinically-prompted imaging (CI), or none. Outcomes included unplanned intervention, liver-related ED visits, and mortality.</div></div><div><h3>Results</h3><div>Among 252 patients, SI prompted intervention in 10 % of cases versus 31 % for CI. Unplanned interventions were more frequent after CI than SI (37 % vs. 18 %; p = 0.018). ED visits were marginally lower after SI versus CI (30 % vs. 43 %; p = 0.10). Mortality did not differ across groups.</div></div><div><h3>Conclusions</h3><div>SI identified complications in select patients and was associated with fewer unplanned interventions, marginally fewer ED visits, and no mortality difference compared to CI.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"252 ","pages":"Article 116757"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.amjsurg.2025.116756
Makena Pook , Tahereh Najafi Ghezeljeh , Hiba Elhaj , Fateme Rajabiyazdi , Saba Balvardi , Stephanie Wong , Marylise Boutros , Gerald M. Fried , Lawrence Lee , Liane S. Feldman , Julio F. Fiore Jr.
Background
Understanding surgeons’ perspectives on post-discharge opioid prescribing is crucial for optimizing pain management while mitigating opioid-related harms.
Objective
To describe the perspectives of North American general surgeons towards opioid prescribing after hospital discharge.
Methods
This qualitative study involved semi-structured interviews with 30 general surgeons in the USA and Canada. Interviews were audio-recorded, transcribed verbatim, and continued until thematic saturation. Data were analyzed using inductive thematic analysis.
Results
Three themes were derived: motives for relying on opioids, motives for opioid minimization, and strategies for tailoring analgesia. Reliance on opioids was motivated by prescribing culture, convenience, patients' expectations, apprehension towards non-opioid analgesics, and limited pain management expertise. Motivations for opioid-minimization included cultural shift, non-opioids’ effectiveness, policy, and emerging research. Strategies for tailoring prescribing included addressing patient expectations and post-discharge follow-up.
Conclusions
Barriers to evidence-based prescribing, including tradition, convenience, and lacking expertise, should be addressed to optimize analgesia and mitigate opioid-related harms.
{"title":"General surgeons’ perspectives on post-discharge opioid prescribing: A qualitative study","authors":"Makena Pook , Tahereh Najafi Ghezeljeh , Hiba Elhaj , Fateme Rajabiyazdi , Saba Balvardi , Stephanie Wong , Marylise Boutros , Gerald M. Fried , Lawrence Lee , Liane S. Feldman , Julio F. Fiore Jr.","doi":"10.1016/j.amjsurg.2025.116756","DOIUrl":"10.1016/j.amjsurg.2025.116756","url":null,"abstract":"<div><h3>Background</h3><div>Understanding surgeons’ perspectives on post-discharge opioid prescribing is crucial for optimizing pain management while mitigating opioid-related harms.</div></div><div><h3>Objective</h3><div>To describe the perspectives of North American general surgeons towards opioid prescribing after hospital discharge.</div></div><div><h3>Methods</h3><div>This qualitative study involved semi-structured interviews with 30 general surgeons in the USA and Canada. Interviews were audio-recorded, transcribed verbatim, and continued until thematic saturation. Data were analyzed using inductive thematic analysis.</div></div><div><h3>Results</h3><div>Three themes were derived: motives for relying on opioids, motives for opioid minimization, and strategies for tailoring analgesia. Reliance on opioids was motivated by prescribing culture, convenience, patients' expectations, apprehension towards non-opioid analgesics, and limited pain management expertise. Motivations for opioid-minimization included cultural shift, non-opioids’ effectiveness, policy, and emerging research. Strategies for tailoring prescribing included addressing patient expectations and post-discharge follow-up.</div></div><div><h3>Conclusions</h3><div>Barriers to evidence-based prescribing, including tradition, convenience, and lacking expertise, should be addressed to optimize analgesia and mitigate opioid-related harms.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"252 ","pages":"Article 116756"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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