Best practices

最佳做法
  • 文章类型: Journal Article
    2023年9月,美国食品和药物管理局(FDA)发布了指南草案,以就如何获得伴侣动物临床试验的知情客户同意发表评论。本指南有可能大幅改变兽医社区知情同意书的编写和提交给客户的方式。它不仅提供了有关如何获得所有者的知情同意的细节,而且还提供了应获得同意的时间表,同意书中的格式和语言,以及这些同意书中所需要素的详细信息。这些变化将涉及调查人员的额外努力,以确保合规性,但可能导致所有者依从性增加,并增加临床研究的入学率,并为所有人带来后续益处。
    In September 2023 the United States Food and Drug Administration (FDA) released draft guidance for comment about how informed client consent for companion animal clinical trials should be obtained. This guidance has the potential to substantially change how informed consent documents are written and presented to clients in the veterinary community. It provides specifics not only about how to obtain informed consent from owners but also the timeframe within which consent should be obtained, the formatting and language in the consent forms, and details on elements that are required to be in these consent forms. These changes will involve additional efforts by investigators to ensure compliance yet might lead to increased owner compliance and higher enrollment in clinical studies with subsequent benefits for all.
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  • 文章类型: Journal Article
    物质使用与亲密伴侣暴力(IPV)密切相关,并且是IPV的可修改风险因素。然而,缺乏对同时发生的IPV和物质使用的全面筛查和转诊,以及他们的精神后遗症,限制了与物质相关的IPV的有效干预措施的识别和实施。这篇叙述性综述(1)调查了IPV筛查和转诊实践的文献,如果这些包括筛查物质使用或其他精神病合并症,(2)为当前的最佳实践提供建议,(3)提出了旨在识别和减少与物质相关的IPV的研究和实践的未来方向。
    一篇叙述性文献综述审查了在诊所中调查IPV筛查和转诊计划的研究。部分研究进行了回顾:(1)有效性,(2)实施和可持续性的障碍,和(3)对精神病共病的反应,包括物质使用和物质使用障碍(SUD)。
    研究结果表明,已经制定了有效的IPV筛查和转诊计划,但是IPV筛查存在差异,许多程序仅筛查IPV受害情况。IPV筛查计划的实施和可持续性的障碍包括缺乏持续的提供者培训,资金或机构支持,并直接连接到转介服务。Further,许多IPV筛查计划缺乏共患精神病的评估和转诊,包括物质使用,并且往往不在SUD诊所常规实施。
    需要开展额外的系统性工作,以制定与物质相关的IPV的普遍和全面的筛查和转诊计划,并解决长期可持续性问题。特别是在SUD治疗设置内。
    UNASSIGNED: Substance use is strongly associated with intimate partner violence (IPV) and is a modifiable risk factor for IPV. However, lack of comprehensive screening and referral for co-occurring IPV and substance use, along with their psychiatric sequalae, limits the identification and implementation of effective interventions for substance-related IPV. This narrative review (1) investigates the literature on screening and referral practices for IPV, and if these include screening for substance use or other psychiatric comorbidities, (2) provides recommendations for current best practices, and (3) suggests future directions for research and practice aimed at identifying and reducing substance-related IPV.
    UNASSIGNED: A narrative literature review examined studies investigating IPV screening and referral programs in clinics. Selected studies were reviewed for: (1) effectiveness, (2) barriers to implementation and sustainability, and (3) responsivity to psychiatric comorbidity, including substance use and substance use disorders (SUD).
    UNASSIGNED: Findings suggest that effective IPV screening and referral programs have been developed, but disparities in IPV screening exist and many programs only screen for IPV victimization. Barriers to the implementation and sustainability of IPV screening programs include lack of ongoing provider training, funding or institutional support, and direct connection to referral services. Further, many IPV screening programs lack assessment of and referral for comorbid psychiatric conditions, including substance use, and tend not to be routinely implemented in SUD clinics.
    UNASSIGNED: Additional systematic work is needed to develop universal and comprehensive screening and referral programs for substance-related IPV and address issues of long-term sustainability, particularly within SUD treatment settings.
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  • 文章类型: Journal Article
    输精管结扎术是美国最常见的泌尿外科手术,是一种非常有效的男性避孕方式。泌尿外科学会引入的指南已经标准化了输精管切除术护理。供应商应该意识到这些指导方针背后的理由,以及它们之间的主要差异。虽然在过去的40年中,输精管切除术技术几乎没有重大变化,新,可逆血管闭塞技术可能会影响未来男性避孕护理的实施。这里,我们对来自全球6个泌尿外科学会的输精管结扎术指南进行了比较回顾.此外,我们报告了在未来十年内可能出现的几种实验性血管闭塞方法的现状.
    Vasectomy is the most commonly performed urologic procedure in the United States and is a highly effective form of male contraception. The introduction of guidelines by urological societies has standardized vasectomy care. Providers should be awadre of the rationale behind these guidelines, as well as key differences among them. While few major changes to vasectomy technique have been adopted over the past 40 years, new, reversible vasal occlusive technologies may affect delivery of male contraceptive care in the future. Here, we perform a comparative review of vasectomy guidelines from six urological societies worldwide. In addition, we report on the status of several experimental vasal occlusion methods that may be available in the next decade.
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  • 文章类型: Journal Article
    所有理论碎片离子谱(SWATH)的顺序窗口采集是一种使用独立于数据的采集的高分辨率质谱。与更有针对性的收购方案相比,这种独立于数据的采集技术背后的力量来自于它能够通过使用SWATH采集窗口(Q1四极隔离窗口)来减轻干扰,同时仍然获得所有准确的质量信息.然而,与高分辨率质谱技术一致,由于有效管理大量采集数据所需的复杂处理能力,其在法医毒理学中的常规和高通量实施受到限制。因此,创建一个有效和经过验证的识别标准至关重要,该标准可以自信地报告可疑的阳性检测,作为最终报告的确认技术。这篇综述审查了所有在法医毒理学框架中实施SWATH的出版物,并提出了最佳实践和常用标准。审查了17份出版物进行提取,液相色谱和质谱参数,更具体地说,对于所有SWATH适用特性,包括喷雾电压,碰撞能量和传播,质量误差,同位素比差,保留时间误差,和图书馆得分阈值。尽管SWATH实施面临实验室的挑战,该技术证明了其在常规法医毒理学测试制度中的潜力,并有助于同时检测常见和新兴新药。
    Sequential window acquisition of all theoretical fragment ion spectra (SWATH) is a type of high-resolution mass spectrometry that uses data-independent acquisition. Compared with more targeted acquisition schemes, the power behind this data-independent acquisition technique comes from its ability to mitigate interferences via the use of SWATH acquisition windows (Q1 quadrupole isolation windows) while still obtaining all accurate mass information. However, consistent with high-resolution mass spectrometry techniques, its routine and high throughput implementation in forensic toxicology is limited due to the complex processing power required to effectively manage the large amount of acquired data. It is therefore pivotal to create an efficient and validated identification criterion that confidently reports suspected positive detections as a confirmational technique for final reporting. This review examines all publications that implemented SWATH in a forensic toxicological framework with suggestive best practices and commonly used criteria. Seventeen publications were reviewed for extraction, liquid chromatography and mass spectrometry parameters, and more specifically for all SWATH applicable characteristics including spray voltages, collision energies and spreads, mass error, isotopic ratio difference, retention time error, and library score thresholds. Notwithstanding the challenges SWATH implementation faces for a laboratory, the technique demonstrates its potential to be utilized in routine forensic toxicology testing regimes and aids in the detection of both common and emerging novel drugs simultaneously.
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  • 文章类型: Systematic Review
    相当数量的大学生不符合世界卫生组织建议的体育活动指南。这些指南建议大学生应瞄准150-300分钟的中度或75-150分钟的剧烈体育锻炼。需要实施战略干预措施来解决这一全球公共卫生问题。这项研究的目的是回顾提高大学生体育锻炼水平的策略和最佳实践。利用PRISMA准则,电子数据库-PubMed,科学直接,学术搜索完成,ERIC,WebofScience,CINAHL,Sage,和SPORTDiscus-在2022年9月至2023年2月之间使用与身体活动相关的术语和同义词进行搜索,战略,最佳实践,和本科生。使用CASP和RE-AIM框架的改编版本对研究的质量进行了严格评估。11篇文章符合审查的纳入标准。这些研究报告了社交媒体平台的使用,手机应用程序,基于网络的技术,在线短信,亲自上课,和“exergame”作为增加体育活动参与度的方法。这项审查的结果表明,经过验证的问卷成为主要的测量工具。此外,频繁使用社交网站是实施和推广体育活动干预措施的最佳做法.建议大学根据目前的趋势和策略,提倡增进健康的体育活动,例如基于技术的干预和社交媒体的使用,这与当代大学生有关。
    Significant numbers of undergraduate university students are not meeting the physical activity guidelines recommended by the World Health Organisation. These guidelines suggest that university students should aim for 150-300 min of moderate or 75-150 min of vigorous physical activity. Strategic interventions need to be implemented to address this global public health concern. The aim of this study was to review the strategies and best practices to enhance the physical activity levels of undergraduate university students. Utilising the PRISMA guidelines, electronic databases-PubMed, Science Direct, Academic Search Complete, ERIC, Web of Science, CINAHL, SAGE, and SPORTDiscus-were searched between September 2022 and February 2023 using terms and synonyms related to physical activity, strategies, best practices, and undergraduate university students. Studies were critically assessed for their quality using an adapted version of the CASP and RE-AIM frameworks. Eleven articles met the inclusion criteria for the review. The studies reported the use of social media platforms, mobile phone applications, web-based technology, online text messages, in-person classes, and an \"exergame\" as methods to increase engagement in physical activity. Findings from this review indicated that validated questionnaires emerged as the predominant measurement tool. Furthermore, the frequent use of social network sites served as a best practice for implementing and promoting physical activity interventions. It is recommended that universities promote health-enhancing physical activities based on current trends and strategies, such as technology-based interventions and the use of social media, that are relevant to contemporary university students.
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  • 文章类型: Journal Article
    背景:区块链已被提出作为促进更多以患者为中心的研究和健康信息共享的关键技术。例如,它可以应用于协调和记录动态知情同意,允许个人不断审查和续签对收集的同意的程序,使用,或分享他们的私人健康信息。有人建议这样做是为了促进道德,顺应纵向研究,和病人的参与。然而,基于区块链的动态同意是一个相对较新的概念,目前尚不清楚建议的实现在实践中的效果如何。在健康研究环境中批判性评估实施的努力是有限的。
    目的:本协议的目的是指导在健康研究环境中识别和评估基于区块链的动态同意的实施。从而促进未来研究的最佳实践的发展,创新,和执行。
    方法:该方案描述了综合审查的方法,以评估广泛的定量和定性研究设计。PRISMA-P(系统审查和荟萃分析方案的首选报告项目)框架指导了审查的结构和报告结果的性质。我们在学术图书馆员的帮助下开发了搜索策略和语法。选择了多个数据库来识别相关的学术文献(CINAHL,Embase,OvidMEDLINE,PubMed,Scopus,和WebofScience)和灰色文献(电子论文在线服务,ProQuest论文和论文,开放获取论文和论文,和谷歌学者)全面了解该领域的进展。资格标准是根据PROSPERO(国际前瞻性系统审查登记册)要求和技术准备标准框架定义的。共有2名评审员独立评审和提取数据,而第三位审稿人将裁定差异。文章的质量评估和讨论的实施将基于经过验证的混合方法评估工具进行,主题将通过专题数据综合来确定。
    结果:进行了文献检索,在删除重复项之后,492篇文章符合筛选条件。标题和摘要筛选允许删除312篇文章,根据纳入标准,留下180篇符合条件的文章进行全文审查,并确认项目可行性的足够文献。结果将综合基于区块链的动态同意的证据质量,以患者为中心的研究和健康信息共享,涵盖有效性,效率,满意,法规遵从性,以及管理身份的方法。
    结论:该审查将全面介绍新兴的基于区块链的动态同意技术的进展以及实施的严格性。由此产生的见解有望为未来的研究提供最佳实践,创新,和实施有利于以患者为中心的研究和健康信息共享。
    背景:PROSPEROCRD42023396983;http://tinyurl.com/cn8a5x7t。
    DERR1-10.2196/50339。
    BACKGROUND: Blockchain has been proposed as a critical technology to facilitate more patient-centric research and health information sharing. For instance, it can be applied to coordinate and document dynamic informed consent, a procedure that allows individuals to continuously review and renew their consent to the collection, use, or sharing of their private health information. Such has been suggested to facilitate ethical, compliant longitudinal research, and patient engagement. However, blockchain-based dynamic consent is a relatively new concept, and it is not yet clear how well the suggested implementations will work in practice. Efforts to critically evaluate implementations in health research contexts are limited.
    OBJECTIVE: The objective of this protocol is to guide the identification and critical appraisal of implementations of blockchain-based dynamic consent in health research contexts, thereby facilitating the development of best practices for future research, innovation, and implementation.
    METHODS: The protocol describes methods for an integrative review to allow evaluation of a broad range of quantitative and qualitative research designs. The PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) framework guided the review\'s structure and nature of reporting findings. We developed search strategies and syntax with the help of an academic librarian. Multiple databases were selected to identify pertinent academic literature (CINAHL, Embase, Ovid MEDLINE, PubMed, Scopus, and Web of Science) and gray literature (Electronic Theses Online Service, ProQuest Dissertations and Theses, Open Access Theses and Dissertations, and Google Scholar) for a comprehensive picture of the field\'s progress. Eligibility criteria were defined based on PROSPERO (International Prospective Register of Systematic Reviews) requirements and a criteria framework for technology readiness. A total of 2 reviewers will independently review and extract data, while a third reviewer will adjudicate discrepancies. Quality appraisal of articles and discussed implementations will proceed based on the validated Mixed Method Appraisal Tool, and themes will be identified through thematic data synthesis.
    RESULTS: Literature searches were conducted, and after duplicates were removed, 492 articles were eligible for screening. Title and abstract screening allowed the removal of 312 articles, leaving 180 eligible articles for full-text review against inclusion criteria and confirming a sufficient body of literature for project feasibility. Results will synthesize the quality of evidence on blockchain-based dynamic consent for patient-centric research and health information sharing, covering effectiveness, efficiency, satisfaction, regulatory compliance, and methods of managing identity.
    CONCLUSIONS: The review will provide a comprehensive picture of the progress of emerging blockchain-based dynamic consent technologies and the rigor with which implementations are approached. Resulting insights are expected to inform best practices for future research, innovation, and implementation to benefit patient-centric research and health information sharing.
    BACKGROUND: PROSPERO CRD42023396983; http://tinyurl.com/cn8a5x7t.
    UNASSIGNED: DERR1-10.2196/50339.
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  • 文章类型: Journal Article
    COVID-19大流行突显了全球应对全球健康威胁迅速增长的需求的准备程度。这个问题伴随着治理危机,并在全球气候危机和灾难的背景下出现。尽管由于人类干预对周围环境的已知影响及其破坏性的次要影响,这种大流行是可以预测的,比如气候变化和人畜共患病增加,大多数国家没有准备好应对大流行的规模和范围。在这种情况下,比如气候危机,全球北方和全球南方面临着几个共同的挑战,包括,首先,卫生所需资源的稀缺,政策,福祉和社会经济健康。在本文中,我们回顾了文献中与大流行准备和治理有关的最新证据,重点关注COVID-19大流行期间使用的原则和做法,我们将其置于欧洲议会利益集团会议的背景下(该活动于2023年3月21日在“欧洲卫生技术峰会”期间举行),以将其纳入正在进行的政策和实践讨论和叙述中。审查确定了更好地应对未来健康威胁和紧急情况所需的关键做法和原则。除了依靠技术和创新的健康实践之外,提到将反应情境化并将它们与明确的目标联系起来的重要性是有用的,改善科学与决策之间的协议,从而建立信任,并基于明确的道德框架与公众进行透明的沟通。
    The COVID-19 pandemic highlighted the scale of global unpreparedness to deal with the fast-arising needs of global health threats. This problem was coupled with a crisis of governance and presented in the context of globally hitting climate crisis and disasters. Although such a pandemic was predictable due to the known effects of human intervention on the surrounding environment and its devastating secondary effects, such as climate change and increased zoonoses, most countries were unprepared to deal with the scale and scope of the pandemic. In this context, such as that of the climate crisis, the Global North and Global South faced several common challenges, including, first and foremost, the scarcity of resources required for health, policy, wellbeing and socioeconomic wellness. In this paper, we review the most recent evidence available in the literature related to pandemic preparedness and governance, focusing on principles and practices used during the COVID-19 pandemic, and we place it in the context of a European Parliament Interest Group meeting (this event took place on 21 March 2023 during the \"European Health Tech Summit\") to ground it within ongoing discussions and narratives of policy and praxis. The review identified key practices and principles required to better face future health threats and emergencies. Beyond health practices relying on technology and innovation, it is useful to mention the importance of contextualising responses and linking them to clear goals, improving the agreement between science and policymaking, thus building trust and enabling transparent communication with the general public based on clear ethical frameworks.
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  • 文章类型: Journal Article
    人工智能(AI)和机器学习(ML)是塑造医疗保健行业的强大工具。这篇综述考虑了人工智能在临床实践中的十二个关键方面:1)道德人工智能;2)可解释的人工智能;3)人工智能中的健康公平和偏见;4)赞助偏见;5)数据隐私;6)基因组学和隐私;7)样本量不足和自我服务偏见;8)弥合培训数据集和现实世界场景之间的差距;9)数据制作中的开源和协作开发)这些类别代表了人工智能在医疗保健中实施的挑战和机遇。虽然AI在改善患者护理方面具有巨大潜力,它也带来了风险和挑战,比如确保隐私,打击偏见,保持透明度和道德。审查强调了为医疗机构制定全面的最佳实践并促进数据科学家参与的多样化对话的必要性。临床医生,耐心的倡导者,伦理学家,经济学家,和政策制定者。我们正处于由人工智能驱动的医疗保健重大变革的边缘。通过继续重新评估和完善我们的方法,我们可以确保人工智能以负责任和道德的方式实施,最大限度地提高其对患者护理和公共卫生的利益。
    Artificial Intelligence (AI) and Machine Learning (ML) are powerful tools shaping the healthcare sector. This review considers twelve key aspects of AI in clinical practice: 1) Ethical AI; 2) Explainable AI; 3) Health Equity and Bias in AI; 4) Sponsorship Bias; 5) Data Privacy; 6) Genomics and Privacy; 7) Insufficient Sample Size and Self-Serving Bias; 8) Bridging the Gap Between Training Datasets and Real-World Scenarios; 9) Open Source and Collaborative Development; 10) Dataset Bias and Synthetic Data; 11) Measurement Bias; 12) Reproducibility in AI Research. These categories represent both the challenges and opportunities of AI implementation in healthcare. While AI holds significant potential for improving patient care, it also presents risks and challenges, such as ensuring privacy, combating bias, and maintaining transparency and ethics. The review underscores the necessity of developing comprehensive best practices for healthcare organizations and fostering a diverse dialogue involving data scientists, clinicians, patient advocates, ethicists, economists, and policymakers. We are at the precipice of significant transformation in healthcare powered by AI. By continuing to reassess and refine our approach, we can ensure that AI is implemented responsibly and ethically, maximizing its benefit to patient care and public health.
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  • 文章类型: Systematic Review
    背景:死亡报告是一项微妙的任务。它的实施方式可以对接受者和通知者产生重大影响,特别是在突然的情况下,暴力,创伤性死亡。善解人意,敏感,与幸存者的认真沟通可以代表支持丧亲过程的第一个机会。对于进行沟通的专业人员来说,获得特定的技能来传递死亡通知是必要的,以提高自我效能,知识,以及对这一领域能力的认知。
    目的:为了绘制有关意外通知的最佳实践主题的文献,暴力,并为制定适当的最佳做法和制定有效的教育方案提供指导。
    方法:使用1966年至2022年之间发表的关于英语文献的PRISMA范围审查扩展进行了审查。
    结果:从最初的3781个标题开始,共入选67篇。从主题的角度来看,通过对内容的分析,可以确定五个方面:(1)与各种专业人员有关的一般准则;(2)具体协议;(3)向儿童通知死亡的准则;(4)电话通知死亡的准则;(5)死亡通知培训计划的建议和建议。
    结论:死亡通知配置为进程,分为连续阶段。通知行为构成进行通信的中心阶段。死亡的交流是特定于上下文的;因此,它应该要求为参与任务的各种专业创建具体的协议,以及有针对性的理论和实践培训。
    结论:为各种专业人员和标准化的理论和实践培训计划制定具体指南的重要性显现出来。未来部门研究的实施将允许评估这些协议和计划的有效性。
    Death reporting is a delicate task. The ways in which it is carried out can have a significant impact on both the recipient and the notifier, especially in the event of a sudden, violent, and traumatic death. Empathetic, sensitive, and attentive communication with survivors can represent a first opportunity to support the bereavement process. The acquisition of specific skills for the delivery of the death notification is necessary for the professional who carries out the communication to increase self-efficacy, knowledge, and perception of competence in this area.
    To map what the literature has produced on the theme of best practices for the notification of unexpected, violent, and traumatic deaths and to provide guidance for the formulation of appropriate best practices and the development of effective educational programs.
    A review was conducted using the PRISMA Scoping Review extension on English language literature published between 1966 and 2022.
    Starting from the initial 3781 titles, 67 articles were selected. From a thematic point of view, the analysis of the contents made it possible to identify five dimensions: (1) general guidelines in relation to various professional figures; (2) specific protocols; (3) guidelines for notifying death to children; (4) guidelines for notification of death by telephone; and (5) recommendations and suggestions for death notification training programs.
    Death notification is configured as a process, divided into sequential phases. The act of notification constitutes the central phase during which communication is carried out. The communication of death is context-specific; therefore, it should require the creation of specific protocols for the various professions involved in the task, along with targeted theoretical and practical training.
    The importance of defining specific guidelines for the various professionals and standardized programs of theoretical and practical training emerges. The implementation of future sectoral studies will allow evaluations of the effectiveness of these protocols and programs.
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  • 文章类型: Journal Article
    对法医专家来说,估计死亡时间可能是一个挑战,是法医界最具挑战性的活动之一。已经评估了各种方法来计算分解不同阶段的尸体的死后间隔,目前正在广泛使用。如今,唯一公认的测年技术是碳14放射性同位素测量,而其他方法多年来一直在测试,涉及不同的学科,具有不同的,有时不是明确的结果。今天,没有精确和安全的方法来精确地确定死亡以来的时间,死后后期间隔估计仍然是法医病理学中最有争议的话题之一。许多提出的方法已经显示出有希望的结果,并且希望通过进一步的研究,其中一些可能成为解决如此困难和重要挑战的公认技术。本综述旨在介绍有关已测试的不同技术的研究,以找到一种有价值的方法来估计骨骼遗骸死亡后的时间。通过提供全面的概述,这项工作的目的是为读者提供有关死后间隔估计的新观点,并改善目前在骨骼遗骸和分解尸体管理方面的实践。
    Estimating time since death can be challenging for forensic experts, and is one of the most challenging activities concerning the forensic world. Various methods have been assessed to calculate the postmortem interval on dead bodies in different stages of decomposition and are currently widely used. Nowadays, the only well-recognized dating technique is carbon-14 radioisotope measurement, whereas other methods have been tested throughout the years involving different disciplines with different and sometimes not univocal results. Today, there is no precise and secure method to precisely determine time since death, and late postmortem interval estimation remains one of the most debated topics in forensic pathology. Many proposed methods have shown promising results, and it is desirable that with further studies some of them might become acknowledged techniques to resolve such a difficult and important challenge. The present review aims at presenting studies about the different techniques that have been tested in order to find a valuable method for estimating time since death for skeletal remains. By providing a comprehensive overview, the purpose of this work is to offer readers new perspectives on postmortem interval estimation and to improve current practice in the management of skeletal remains and decomposed bodies.
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