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1.
Risk Manag Healthc Policy ; 17: 1437-1449, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38835953

RESUMO

Background: Public health emergencies not only threaten the physical and mental health of the public but also trigger a series of risky behaviors of the public, which in turn lead to the emergence or intensification of risk events, disrupting existing economic and social order. Purpose: Based on construal level theory, cognitive appraisal theory of emotions and mood maintenance hypothesis, the study aims to investigate the collectively effect of risk perception and psychological insecurity in the connection between psychological distance and public risky behavior. Participants and Methods: Cross-sectional data was derived from 257 China urban residents. All participants finished the psychological distance scale, risk perception scale, psychological insecurity scale, and risky behavior scale. The research hypothesis was tested using the PROCESS macro. Results: The direct impact of psychological distance on risky behavior was not significant (ß=-0.018, p>0.05). The indirect impact of psychological distance on risky behavior was significant. In other words, the impact of psychological distance on risky behavior was serially mediated via risk perception and psychological insecurity (ß=0.011, 95% CI= [0.0013, 0.025]). Conclusion: Risk perception and psychological insecurity play serial mediating roles in the relationship between psychological distance and public risky behavior. We conclude that during public health emergencies, public health managers should pay extra attention to the risk perception and psychological insecurity level of the public with closer psychological distance, take measures to reduce their risk perception, enhance their psychological security, and reduce their risky behavior, thereby ensuring the physical and mental health of the public and maintaining the stability of economic and social order.

2.
Psychol Res Behav Manag ; 17: 1787-1801, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38707961

RESUMO

Background: In the digital age, people's attitudes and psychological security towards public health emergencies will be shared. Similar or identical psychological security states are prone to clustering and differentiation, while differentiated group psychological security is more prone to polarization, leading to group psychological security risks and then posing a threat to social stability and national security. However, existing studies mostly use qualitative analysis methods to study group emotional risks. There are still limitations in the study of dynamics of group psychological security risks through mining real data of social media. Purpose: The study aims to use intelligent analysis methods to understand how group psychological security risks dynamically change. Methods: The study draws on text sentiment analysis, Markov chains and time series analysis to construct a framework for the evolution of group psychological security risks. Based on this framework, text data was crawled on Sina Weibo platform, mainly consisting of posts during public health emergencies (March 1st to June 30th, 2022) in Shanghai, and a psychological security lexicon in the field of public health emergencies was constructed. This laid the foundation for identifying the tendencies, intensity, and transitions of individual text psychological security, and then exploring the evolution trend of group psychological security risks. Results: Compared with the generation and reduction periods, group psychological security risks are more likely to occur during the outbreak and recovery periods, and the intensity level is also higher. The overall intensity of group psychological security risks shows an evolution trend of first increasing, then decreasing, and then increasing again. Conclusion: The paper provides an opportunity to explore the dynamics of psychological security in the digital space. Meanwhile, we call on the government and relevant management departments to pay more attention to the group psychological security risks formed during the outbreak and recovery periods of public health emergencies, and take corresponding measures in a timely manner to guide the public to transform the extreme psychological security state into the normal psychological security state, in order to prevent and resolve group psychological security risks, promote social stability and national security.

4.
J Environ Manage ; 336: 117611, 2023 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-36871446

RESUMO

Production restriction is an environmental regulation adopted in China to curb the air pollution of industrial enterprises. Frequent production restrictions may cause economic losses for enterprises and further hinder their green transformation. Polluting enterprises are faced with the dilemma of choosing environmental protection or economic development. Using panel data on industrial enterprises in China from 2016 to 2019, this paper evaluates the impact of production restrictions on both enterprises' environmental and economic performance with regression models. The results show that production restrictions significantly drop the concentrations of SO2 and NOx emitted from polluting enterprises. Meanwhile, production restrictions have significant negative effects on operating income, financial expenses, net profit, and environmental protection investment. The mechanism analysis reveals that production restrictions mitigate air pollutant concentrations by increasing the number of green patents and improving total factor productivity, which also verifies the Porter hypothesis. However, there is a masking mediating effect of environmental investment, which indicates that the reduction of environmental investment hinders the enterprise's efforts to control air pollution. In addition, heterogeneous analysis shows that the economic shock on microenterprises is larger than that on small enterprises. Implementing production restrictions for microenterprises may be a way to eliminate their backwards production capacity.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Desenvolvimento Econômico , Conservação dos Recursos Naturais , Investimentos em Saúde , Poluição do Ar/prevenção & controle , China , Poluição Ambiental
5.
Heliyon ; 9(2): e13384, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36852044

RESUMO

Customer lifetime value is one of the most important tasks for enterprises to maintain customer relationships. However, due to the limitations of using a single data mining method, the measurement of customer lifetime value under the condition of noncontractual relationship has always been a research difficulty. This paper focuses on customer value measurement and customer segmentation based on customer lifecycle value theory, and carries out customer value measurement and customer segmentation research from the perspective of customer value, and constructs customer segmentation model. This paper first conducts feature engineering, such as data selection, data preprocessing, data transformation, and knowledge discovery, and then conducts customer value segmentation based on machine learning algorithms and customer relationship management analysis models and builds a customer value segmentation identification model under the condition of noncontractual relationship. Finally, empirical analysis is carried out with the real customer transaction data of the actual online shopping platform, which verifies the validity and applicability of the customer segmentation method and value calculation method proposed in this paper.

6.
Psychol Res Behav Manag ; 15: 1649-1663, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35818406

RESUMO

Purpose: Based on social information processing (SIP) model and conservation of resources (COR) theory, this paper is to examine the mediating and moderating roles of psychological safety (PS) in the relationship between work-related leader-member exchange (LMX)/non-work-related supervisor-subordinate guanxi (SSG) and employee affective commitment (AC). Participants and Methods: Cross-sectional data came from 213 enterprise employees in China. The participants completed the LMX scale, SSG scale, PS scale, and AC scale. SPSS PROCESS macro and RWA-Web were used to test the research hypothesis. Results: Both LMX and SSG were positively related to employee AC. LMX was more strongly associated with AC than SSG. PS partially mediated the influence of LMX/SSG on AC. PS negatively moderated the influence of LMX on AC, whereas it did not moderate the influence of SSG on AC. Conclusion: Different types of supervisor-subordinate relationships (SSR) were both beneficial to employee AC, and work-related LMX was more closely related to employee AC. Different types of SSR could both affect employee AC through PS. In addition, high PS also reduced the relationship between LMX and employee AC. Therefore, in the context of Chinese culture, enhancing employees' AC within an enterprise can not only pay attention to the work-related LMX and non-work-related SSG but also the appropriate cultivation of employees' PS.

7.
J Clin Rheumatol ; 27(2): 50-55, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33617165

RESUMO

BACKGROUND/OBJECTIVE: The neurological involvement associated with primary Sjögren's syndrome (pSS) can be life threatening. However, the specific characteristics of pSS-related neurological involvement remain obscure. This study aimed at determining the clinical characteristics of this neurological involvement in patients with pSS. METHODS: The clinical data of 205 patients with pSS who were admitted to our department between January 2015 and June 2017 were studied. Characteristics and laboratory findings of pSS patients with neurological abnormalities were compared with pSS patients without. RESULTS: Forty of the 205 patients with pSS exhibited neurological abnormalities (19.51%); of these, 13 patients exhibited central nervous system (CNS) involvement only, 20 patients exhibited peripheral nervous system (PNS) involvement only, and 7 patients exhibited both, yielding a total of 20 (9.76%) patients with CNS involvement and 27 (13.17%) patients with PNS involvement. The titers of anti-Sjögren's syndrome type A (SSA) antibodies were significant higher while the presence of anti-Sjögren's syndrome type B (SSB) antibodies was significant lower in patients with vs. without neurological involvement. Similar results were found in patients with CNS involvement. No significant differences between patients with and without neurological involvement were found for the other clinical parameters examined. CONCLUSIONS: Neurological involvement in patients with pSS is common and needs to be carefully evaluated. Patients with pSS with a high titer of anti-SSA and low presence of anti-SSB antibodies might have a relatively high risk of developing neurological involvement. Future studies should focus on identifying biomarkers that may aid in the early diagnosis of neurological involvement in patients with pSS.


Assuntos
Anticorpos Antinucleares/sangue , Doenças do Sistema Nervoso/imunologia , Síndrome de Sjogren , Adulto , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/sangue , Doenças do Sistema Nervoso/etiologia , Síndrome de Sjogren/sangue , Síndrome de Sjogren/complicações , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/imunologia
8.
Front Med (Lausanne) ; 7: 138, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32363196

RESUMO

Objective: Clinical characteristics of immune thrombocytopenia (ITP) associated with primary Sjögren's syndrome (pSS) have not been clearly defined. This study aimed to evaluate the prevalence and clinical characteristics of secondary ITP in patients with pSS. Methods: 291 pSS patients in our hospital were retrospectively analyzed. Clinical manifestations and laboratory findings were compared between pSS patients with and without ITP. Results: The prevalence of secondary ITP in pSS patients was 12.03%. Compared to pSS patients without ITP, pSS patients with ITP were younger and had higher disease activity. The prevalence of interstitial lung diseases (ILD) was significantly lower in pSS patients with ITP (30.43 vs. 54.95%; P = 0.029), and it was the same with arthritis (17.14 vs. 3.9.11%; P = 0.014) and dry eye (33.33 vs. 54.17%, P = 0.027) compared with those without ITP. Serum creatinine level was lower in pSS patients with ITP (P = 0.009), while positivity of anti-histone autoantibodies was higher in pSS patients with ITP (P = 0.025). Conclusion: This study is an initial report describing clinical features of ITP in pSS. The lower incidence of ILD and arthritis among pSS patients with ITP indicated potential active roles of platelets in the pathogenesis of fibrosis or inflammatory arthritis, which may open the way for further experimental and clinical work.

9.
Semin Arthritis Rheum ; 50(4): 534-543, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32442739

RESUMO

OBJECTIVE: Immunologic mechanisms have been proposed as part of the pathogenesis mechanisms involved in recurrent pregnancy loss (RPL). Presence of positive antinuclear antibodies (ANA) is regarded as a typical feature of autoimmunity. Many studies had tried to clarify the association of ANA with RPL, but the conclusions were controversial. The aim of this meta-analysis was to assess whether ANA was positively associated with increased RPL risk. METHODS: We searched PubMed and Embase databases for relevant literatures on the association between ANA positivity and RPL. The odds ratios (OR) with 95% confidence intervals (95%CI) were pooled using meta-analysis, and either fixed-effect or random-effect model was used based on heterogeneity across the included studies. RESULTS: Twenty-one studies with 5038 participants (including 2683 RPL patients and 2355 controls) met the inclusion criteria were included. The total positive rate of ANA was 22.0% (591/2683) in RPL group, and 8.3% (196/2355) in the control group. RPL patients had a significantly higher ANA positive rate than controls (OR = 2.97, 95%CI 1.91-4.64, P<0.00001; I² = 75%), and a significant association between positive ANA and unexplained RPL was also observed (OR = 3.27, 95%CI 2.01-5.31, P<0.00001; I² = 70%). ANA positivity was also significantly associated with increased risk of RPL in women without defined autoimmune diseases (OR = 2.23, 95%CI 1.40-3.55, P=0.0007). Subgroup analysis demonstrated low titers of ANA (1:40≤ANA≤1: 80) were not associated with RPL (OR = 2.44, 95%CI 0.42-14.06, P=0.32), while higher ANA titer (≥1:160) had a significant association with RPL (OR = 45.89, 95%CI 8.44-249.45, P<0.00001). A higher rate of homogenous pattern in RPL patients was observed (OR = 4.89, 95%CI 2.20-10.87, P<0.001), and no significant difference in speckled pattern or nucleolar pattern was found. CONCLUSIONS: This study demonstrated that ANA positivity was positively associated with increased RPL risk. ANA positivity is an important risk factor for RPL which needed to be screened among women with RPL.


Assuntos
Aborto Habitual/etiologia , Anticorpos Antinucleares/sangue , Aborto Habitual/sangue , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Gravidez , Fatores de Risco
10.
Front Med (Lausanne) ; 6: 239, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31781564

RESUMO

Interstitial lung disease (ILD) is a life-threating complication, commonly associated with polymyositis (PM), and dermatomyositis (DM). A subset of acute ILD associated with PM/DM patients are refractory to conventional treatment, and leads to a high rate of mortality. The efficacy of therapeutic plasma-exchange (TPE) as a PM/DM treatment to improve muscle involvement is controversial due to a lack of evidence. However, in recent reports, TPE has been effective in improving lung involvement. To evaluate the efficacy of this therapy, we retrospectively studied TPE treatment outcomes for in 18 acute PM/DM-ILD patients who were resistant to conventional therapies. Five patients were diagnosed with DM (27.8%), 11 with CADM (61.1%), and two with PM (11.1%). Among 18 patients, 11 (61.1%) achieved satisfactory improvement after four or more rounds of TPE, whereas seven died due to respiratory failure. We also analyzed risk factors to predict unresponsiveness to TPE in these patients. Notably, the prevalence of subcutaneous/mediastinal emphysema was significantly higher in the non-responsive group (6/7, 85.7%) than in the responsive group (2/11, 18.2%; P = 0.013); moreover, patients with this complication were mainly in the CADM subgroup (6/8, 75%). Subcutaneous/mediastinal emphysema and increased serum ferritin levels were shown to be poor prognostic factors, predictive of unresponsiveness to TPE, in PM/DM patients. No autoantibodies were found to be associated with TPE outcome, although we only investigated anti-Jo-1 and anti-Ro antibodies; the clinical significance of other myositis-specific autoantibodies, especially anti-melanoma differentiation-associated gene 5 (MDA5) antibody, is not known. Our results indicate that TPE might be an alternative treatment for acute PM/DM-ILD patients resistant to conventional therapies, except for those with subcutaneous/mediastinal emphysema and high serum ferritin levels.

11.
J Immunol Res ; 2018: 8212641, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29977933

RESUMO

Primary Sjögren's syndrome (pSS) is a rheumatic disease characterized by the destruction of salivary and lacrimal glands, and its pathogenesis mechanism remains unclear. Gαq is the α-subunit of the heterotrimeric Gq protein. Researches demonstrated that Gαq was involved in the pathogenesis regulation of several rheumatic diseases. This study explored the role of Gαq in pSS. Gαq mRNA levels in peripheral blood mononuclear cells (PBMCs) from 39 patients and 26 healthy controls (HCs) were investigated using real-time PCR. IL-17A serum concentrations in 22 pSS patients and 23 HCs were tested by ELISA, and the clinical significance of Gαq was analyzed. The association of Gαq with interleukin-17A (IL-17A) expression was also analyzed in patients with pSS. We showed that Gαq expression in PBMCs from patients with pSS was significantly lower than that in PBMCs from HCs. Gαq expression level was closely associated with pSS disease activity. Furthermore, a negative association was also found in IL-17A and Gαq expression level. These data suggest that Gαq is involved in pSS pathogenesis regulation, possibly due to its regulation of Th17. These results provide new insights into the pSS pathogenesis mechanism involving abnormal Th17 regulation.


Assuntos
Subunidades alfa Gq-G11 de Proteínas de Ligação ao GTP/metabolismo , Interleucina-17/metabolismo , Leucócitos Mononucleares/metabolismo , Síndrome de Sjogren/imunologia , Adulto , Biomarcadores , Estudos de Casos e Controles , Feminino , Subunidades alfa Gq-G11 de Proteínas de Ligação ao GTP/sangue , Subunidades alfa Gq-G11 de Proteínas de Ligação ao GTP/genética , Humanos , Interleucina-17/sangue , Leucócitos Mononucleares/imunologia , Masculino , Pessoa de Meia-Idade , RNA Mensageiro/metabolismo , Síndrome de Sjogren/genética , Síndrome de Sjogren/metabolismo , Células Th17/imunologia
12.
Oncotarget ; 8(9): 14306-14313, 2017 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-28147328

RESUMO

INTRODUCTION: Primary Sjogren's Syndrome (pSS) is one of the autoimmune diseases characterized by polyclonal autoantibody production. The human homologue of the mouse double minute 2 (MDM2) is an important negative regulator of p53. Our previous study indicated that autoantibody to MDM2 can be detected in systemic lupus erythematosus patients. The purpose of this study is to study anti-MDM2 autoantibody in pSS patients. METHODS: Anti-MDM2 autoantibody in sera from 100 pSS patients and 74 normal controls was investigated by ELISA. Positive samples were further confirmed by western blotting. Expression of MDM2 in labial gland tissue from pSS patients and normal controls was checked by immunohistochemistry. The difference in clinical characteristics and laboratory findings between anti-MDM2 positive and anti-MDM2 negative pSS patients was analyzed. RESULTS: The presence of anti-MDM2 autoantibody in pSS patients was 21.0%, significantly higher than normal controls (5.40%). MDM2 was overexpressed in labial gland from pSS patients. pSS patients with positive anti-MDM2 were characterized by longer disease duration and more lymphocytes focal gathering in labial gland. Prevalence of anemia, thrombocytopenia and anti-SSB was significantly higher in pSS patients with anti-MDM2 autoantibody. Titer of anit-MDM2 was negatively associated with hemoglobin level, platelet count, complement 3 level and complement 4 level, positively associated with European Sjogren's syndrome disease activity index (ESSDAI) and level of IgG. CONCLUSIONS: Anti-MDM2 autoantibody may be used as a potential serological biomarker in pSS disease activity evaluation. Study on the role of anti-MDM2 or MDM2 in pSS may help us know the pathogenesis mechanism of pSS better.


Assuntos
Autoanticorpos/sangue , Biomarcadores/sangue , Proteínas Proto-Oncogênicas c-mdm2/imunologia , Síndrome de Sjogren/sangue , Autoanticorpos/imunologia , Western Blotting , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/imunologia
13.
Medicine (Baltimore) ; 95(50): e5565, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27977588

RESUMO

To clarify clinical characteristics of immune thrombocytopenia (ITP) subsets associated with autoimmune diseases (AIDs).Five thousand five hundred twenty patients were reviewed retrospectively. One hundred four ITP patients were included for analysis. Clinical manifestations at first thrombocytopenic episode were recorded.Systemic lupus erythematosus (SLE) and primary Sjogren syndrome (pSS) accounted for a large part in AIDs associated with secondary ITP. SLE-ITP, pSS-ITP, and primary ITP (pITP) patients were different in several aspects in clinical and immunological characteristics. A subgroup of patients in pITP patients with some obvious autoimmune features (defined as AIF-ITP) such as positive ANA but failing to meet the diagnosis criteria now used for a specific kind of connective tissue diseases were also different with other pITP patients in some immunological features, indicating the difference in the pathogenesis mechanism of those autoimmune featured ITP patients.ITP patients were heterogeneous in clinical characteristics. Further study about the different pathogenesis of ITP subsets especially those AIF-ITP patients who only presented with thrombocytopenia will help us have a better understanding of pathogenesis of ITP and a better management of ITP patients.


Assuntos
Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/epidemiologia , Púrpura Trombocitopênica Idiopática/diagnóstico , Púrpura Trombocitopênica Idiopática/epidemiologia , Síndrome de Sjogren/epidemiologia , Adulto , Anticorpos Antinucleares/imunologia , China/epidemiologia , Estudos de Coortes , Comorbidade , Bases de Dados Factuais , Feminino , Humanos , Lúpus Eritematoso Sistêmico/terapia , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Púrpura Trombocitopênica Idiopática/terapia , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Síndrome de Sjogren/diagnóstico , Adulto Jovem
14.
Curr Pharm Biotechnol ; 15(6): 521-4, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25213360

RESUMO

Interstitial lung disease (ILD) is one of the most common complications of polymyositis (PM) and dermatomyositis (DM). It is always progressive and does not respond to conventional immunosuppressive agent treatment. Biologics are commonly used in treatment of rheumatic diseases. They are also used in polymyositis and dermatomyositis associated interstitial lung disease. This review will focus on the updated use of biologics in PM/DM-ILD.


Assuntos
Produtos Biológicos/uso terapêutico , Dermatomiosite/tratamento farmacológico , Doenças Pulmonares Intersticiais/tratamento farmacológico , Polimiosite/tratamento farmacológico , Anticorpos Monoclonais/uso terapêutico , Antígenos CD/imunologia , Antígenos CD20/imunologia , Antígenos de Neoplasias/imunologia , Antígeno CD52 , Dermatomiosite/complicações , Glicoproteínas/imunologia , Humanos , Interleucina-6/antagonistas & inibidores , Interleucina-6/imunologia , Doenças Pulmonares Intersticiais/etiologia , Polimiosite/complicações , Receptores de Interleucina-1/antagonistas & inibidores , Receptores de Interleucina-1/imunologia , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Fator de Necrose Tumoral alfa/imunologia
15.
Rheumatol Int ; 33(5): 1295-302, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23143553

RESUMO

To study the clinical features and associated risk factors of interstitial lung disease (ILD) in clinically amyopathic dermatomyositis (CADM) in Chinese patients. Forty-one Chinese Han patients with a diagnosis of CADM in West China Hospital from August 2008 to 2011 were retrospectively analyzed. The prevalence of ILD in CADM patients is 60.98 %, in which 26.83 % for acute/subacute interstitial pneumonia (A/SIP) and 34.15 % for chronic interstitial pneumonia (CIP). Mortality of A/SIP is 63.64 %, with a 6-month survival rate of 54.50 %. Levels of erythrocyte sedimentation rate, serum ferritin, alanine aminotransferase, aspartate aminotransferase, creatine kinase, lactate dehydrogenase, hydroxybutyric dehydrogenase, and immunoglobulin A (IgA) are higher in CADM-ILD patients than CADM patients without ILD. Levels of serum ALB and lymphocyte count in peripheral blood are significant lower in A/SIP than in CIP group. Sign of ground glass opacities in high-resolution computed tomography (HRCT) images is more common in A/SIP group, and diffusion function is worse in these patients compared with CIP group. The prevalence of ILD in Chinese CADM patients is strikingly high, and A/SIP is a major cause of death in CADM patients. Laboratory findings combined with HRCT examination and pulmonary function tests can provide valuable predictive information of ILD or A/SIP in CADM patients.


Assuntos
Povo Asiático , Dermatomiosite/etnologia , Doenças Pulmonares Intersticiais/etnologia , Doença Aguda , Adulto , Biomarcadores/sangue , Sedimentação Sanguínea , Distribuição de Qui-Quadrado , China/epidemiologia , Dermatomiosite/sangue , Dermatomiosite/diagnóstico , Dermatomiosite/mortalidade , Feminino , Humanos , Estimativa de Kaplan-Meier , Doenças Pulmonares Intersticiais/sangue , Doenças Pulmonares Intersticiais/diagnóstico , Doenças Pulmonares Intersticiais/mortalidade , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prevalência , Prognóstico , Testes de Função Respiratória , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Tomografia Computadorizada por Raios X
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