Community Mental Health Journal最新文献

{"title":"Reducing Outpatient Psychiatry Wait Times Through Structured Triage and Telephone Consultation: A Quality Improvement Initiative.","authors":"Giuseppe Guaiana, Lorie Coffey, Erica Haykus","doi":"10.1007/s10597-026-01702-w","DOIUrl":"https://doi.org/10.1007/s10597-026-01702-w","url":null,"abstract":"<p><p>Prolonged wait times for outpatient psychiatric care are a persistent problem across health systems and have been exacerbated following the COVID-19 pandemic, particularly in community hospital settings with limited specialist capacity. Purpose. To describe and evaluate a psychiatrist-led telephone consultation triage pathway designed to optimize specialist time and reduce outpatient psychiatry wait times. A quality improvement initiative was implemented in November 2022 at a Canadian community hospital. A structured triage process was applied to all outpatient psychiatry referrals, with selected lower-complexity referrals redirected to alternative pathways or addressed through psychiatrist-led telephone consultations with primary care providers. Service-level metrics were examined descriptively. Between November 2022 and May 2023, 687 outpatient psychiatry referrals were reviewed. Of these, 495 (72%) were accepted for psychiatric assessment and 192 (28%) were redirected. Following implementation, psychiatrist-led telephone consultations increased from approximately one per month to 12-15 per month. Compared with standard 90-minute psychiatric assessments, telephone consultations averaged approximately 10 min. Average outpatient wait times decreased from approximately 10 months prior to implementation to approximately 6 weeks during the post-implementation period. A structured psychiatrist-led telephone consultation triage pathway was associated with improved access to outpatient psychiatric care in a community hospital setting. This pragmatic, low-cost approach may be relevant to other services facing similar post-pandemic pressures.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving Faith: Changes in Spiritual Experiences and Their Role in Recovery as Reported by Peer Support Workers.","authors":"Ofra Walter, Elizabeth C Thomas, Mickie Mitchell Bowe, Matthew Federici, Eric Larson, Jennifer Greenham, Mark Salzer","doi":"10.1007/s10597-026-01664-z","DOIUrl":"https://doi.org/10.1007/s10597-026-01664-z","url":null,"abstract":"<p><p>Faith and spirituality have long been recognized as important components of recovery from mental illness, yet little is known about how these experiences evolve over time or the extent to which individuals feel supported by mental health professionals in pursuing them. This study explored how peer support workers' experiences with spirituality and faith change over time, how they perceive the role of spirituality in their recovery, and how supported they feel by mental health professionals from whom they are receiving care in this aspect of their well-being. The study involved a cross-sectional online survey of 266 peer support workers in the United States, examining their experiences with faith and spirituality. Data were analyzed using paired-sample t-tests and descriptive statistics. Participants reported significantly more positive faith and spiritual experiences in the present compared to the past. Current experiences were largely positive (83%), with 92% reporting that faith/spirituality played a very positive or positive role in their recovery. Nonetheless, challenges persisted, including disagreement with family or friends about religious issues (62%) and feeling lonely or different from others because of religious or spiritual beliefs (40%). While most participants (63%) felt encouraged by healthcare providers to pursue spirituality, fewer than half (45%) reported receiving active support. Findings suggest faith and spirituality are a significant part of recovery for many peer support workers. However, inconsistent provider support underscores the need for more integrated, holistic models of mental health services that acknowledge spirituality as a dynamic, evolving dimension of recovery.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deprescribing Psychiatric Medications in Youth: A Feasibility Study.","authors":"Erin R Barnett, Jennifer L McLaren, Hannah B Leavitt, Stephanie C Acquilano, Rosemina Bazeghi, Stephanie Bizzari, Anthony Garami, James King, Ben Fehnert, Glyn Elwyn","doi":"10.1007/s10597-026-01697-4","DOIUrl":"https://doi.org/10.1007/s10597-026-01697-4","url":null,"abstract":"<p><p>Rates of psychiatric medications prescribed to U.S. youth have increased substantially and stakeholders are increasingly concerned. We tested the feasibility of a novel intervention that combines shared decision making and a structured deprescribing protocol during routine outpatient care with youth. Five clinicians delivered the intervention to youth 6 to 17 years old receiving three or more psychiatric medications or an off-label antipsychotic. Families completed assessments at baseline, 18- and 30-weeks. We collected data via surveys, medical records, and qualitative interviews. We enrolled 31 youth, 29 received the intervention, and 13 of the 29 (45%) chose to deprescribe. Eleven of those 13 reduced their dose or stopped completely; 2 returned to their original dose. Of the 13 that agreed to deprescribe, the mean dose-weighted medication use reduced from 3.9 (SD=1.38) to 2.9 (SD=1.41), and the mean number of medication reactions reduced from 1.3 (SD=2.21) to 0.3 (SD=0.48). In the 16 participants who chose not to deprescribe, the mean dose-weighted medication use and medication reactions reduced from 3.4 (SD=0.89) to 3.2 (SD=1.32) and 0.6 (SD=0.89) to 0.0 (SD=0.0), respectively. Youth functioning remained similar across groups. There were no study-related serious adverse events. Clinicians and caregivers considered the intervention feasible, valuable, and effective. Our intervention and procedures were feasible in real-world community settings. The intervention shows promising findings related to safety and effectiveness. Trial registration: Our study was retrospectively registered with ClinicalTrials.gov. NCT # pending.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and Experiences of Personal Recovery for Ethnic Minority People with Severe Mental Illness: A UK-informed Qualitative Systematic Review.","authors":"Shaquilla Linton, Sherifat Oduola, Bonnie Teague","doi":"10.1007/s10597-026-01676-9","DOIUrl":"10.1007/s10597-026-01676-9","url":null,"abstract":"<p><p>Research has shown that ethnic minority people living with severe mental illness (SMI) experience poor mental healthcare and outcomes. Mental health services are increasingly embedding recovery-focused approaches, informed by personal recovery models. Personal recovery focuses on creating social connections, building hope, establishing an identity, finding meaning and feeling empowered while living with SMI. However, how personal recovery is defined from the perspective of ethnic minority people with SMI is not well understood across the literature. To address this gap in knowledge, we conducted a qualitative systematic review to investigate how ethnic minority people with SMI perceive and experience personal recovery. Searches were completed through three databases (MEDLINE Ultimate, APA PsycINFO and CINAHL Ultimate). Studies that met the inclusion criteria were analysed using narrative synthesis. Twenty studies were included in the review, from which three themes were generated: i) The Family as a Supportive and Obstructive System; ii) Faith as the Foundation for Hopefulness and iii) Discovering Identity through Agency and Social Interactions. Across the three themes, facilitators and barriers of personal recovery were identified. The findings indicate the need for mental health professionals' to focus on minimising specific barriers to recovery for ethnic minority people with SMI. This review provides a robust account of personal recovery, that will serve to enhance healthcare professionals' knowledge regarding care initiatives and additional considerations for ethnic minority populations.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family Caregiver Experiences with Mobile Behavioral Health Crisis Services: A Qualitative Study.","authors":"Dani MacVicar, Mark D Fleming, Teja Pattabhiraman, Theodore Michaels, Steve Hahn-Smith, Amanda Dold, Chad Pierce, Amanda L Brewster","doi":"10.1007/s10597-026-01695-6","DOIUrl":"https://doi.org/10.1007/s10597-026-01695-6","url":null,"abstract":"<p><p>Mobile behavioral health crisis response services, staffed by clinicians and specialists, can support individuals experiencing urgent mental health or substance use issues. While Medicaid coverage for these services since 2021 has supported growth in their availability, research on family caregivers' experiences with mobile crisis services remains limited. Family caregivers often participate in encounters with crisis services when the person in crisis cannot seek help independently due to their symptoms. This study aimed to explore family members' experiences with a mobile crisis program in the US using qualitative methods. The study examined an expanding, county-level mobile crisis program designed according to SAMHSA guidelines and Medicaid-qualifying standards, staffed by clinicians and peer support workers. We used qualitative methods to understand family caregiver experiences with these services. Data was collected through in-depth interviews with family caregivers (N = 11), the primary source for this analysis, and ethnographic field observations of mobile crisis response teams (N = 29 observation days), which provided contextual information about service delivery and family involvement during crisis. Transcripts and field notes were analyzed for recurrent themes. Family members expressed feeling isolation and being overwhelmed while managing loved ones' constant care. Many worried that without their support, loved ones would face homelessness and worsened mental health. Families identified the mobile crisis service as a substantial improvement over the other options they could turn to for help. They reported that crisis services alleviated isolation, appreciated providers who understood home dynamics, and found comfort in having a safe and responsive resource to call when needed. Families identified the availability mental health responders as a source of relief both during and after crisis episodes. Understanding how features of crisis response service are experienced by family caregivers can inform impact studies by highlighting potential mechanisms of effectiveness.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Matters in Sustaining Peer Support for Adults in Mental Health Services? Exploring the Perceptions of Diverse Actors.","authors":"Eleni Sofouli, Myra Piat, Shannon Wiltsey Stirman","doi":"10.1007/s10597-026-01691-w","DOIUrl":"https://doi.org/10.1007/s10597-026-01691-w","url":null,"abstract":"<p><p>Peer support is a prominent recovery-oriented innovation in mental healthcare, with implementation efforts to integrate peer support workers reported worldwide. However, its sustainment, including the factors that shape it, remains underexplored. Sustaining evidence-informed innovations and their associated benefits is a global policy priority and a complex challenge for health care systems. Although recent research has advanced theoretical frameworks and tools to support sustainability planning and assessment, there is a growing need for empirical studies that examine how sustainment unfolds in practice. Drawing on qualitative interviews, this study explores the sustainment of peer support two years post-implementation in a mental health service overseeing community housing for adults with mental health challenges in Canada. During 2022 and 2023, nineteen individuals including managers, service providers and peers, and housing proprietors involved in implementing and sustaining peer support were interviewed. Data collection and analysis were guided by the Consolidated Framework for Sustainability Constructs in Healthcare to explore determinants influencing sustainment. Sustainment was influenced by a constellation of factors spanning the design and delivery of peer support, organisational setting and processes, involved actors, available resources, and external contextual conditions. These factors exerted positive, constraining, or ambivalent influences on sustainment. Positive influences included staff belief in peer support values, funding availability, perceived effectiveness of peer support, peer workers' expertise, integration of peer support innovation and peers into organisational policies and routine practices, organisational leadership, and participant satisfaction with being involved in peer support implementation. Key challenges included limited human resources, high staff workload, and union and administrative constraints, particularly those related to the lack of formal employment regulation of peer support workers. The interplay of additional contextual factors, such as provincial (regional) policy guidelines, training efforts, and organisational culture, highlights the context-dependent nature of sustaining peer support. This study advances understanding of peer support sustainment by demonstrating that it emerges from a dynamic interplay of influences across multiple and interrelated levels. By conceptualising sustainability determinants as context-dependent and evolving influences rather than fixed barriers or facilitators, the study offers a refined lens for examining peer support sustainment in practice. These findings have important implications for policy, research and practice in supporting the long-term integration of peer support workers in mental healthcare.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric Care Pathways and the Use of Coercion: From Pre-Hospital to Inpatient Settings.","authors":"Benjamin Emery, Laurent Suppan, Stefan Kaiser, Julia Ambrosetti, Alexandre Wullschleger","doi":"10.1007/s10597-026-01693-8","DOIUrl":"https://doi.org/10.1007/s10597-026-01693-8","url":null,"abstract":"<p><p>The use of coercive measures in psychiatry raises ethical and clinical concerns, particularly given their potential psychological harm and long-term consequences. While most studies focus on inpatient settings, little is known about coercion applied earlier in the care pathway.This retrospective observational study included all patients (N = 695) admitted through the psychiatric emergency department (ED) to the adult psychiatry division of Geneva University Hospitals in 2019. Data were extracted from electronic medical records and included sociodemographic variables, clinical characteristics, and the use of coercion (seclusion, restraint, or forced medication) in three settings: ambulance, ED, and inpatient wards. Bivariate analyses and logistic regressions were conducted to identify predictors of inpatient coercion.Overall, 33.7% of patients experienced coercion in at least one setting: 22.4% during hospitalization, 20.7% in the ED, and 4% during ambulance intervention. Logistic regression identified several factors independently associated with inpatient coercion: coercion in the ED (p < .001), involuntary admission (p= .009), ambulance intervention (p = .035), younger age (p = .039), higher aggression score at admission (HoNOS item 1; p < .001), and a diagnosis of psychotic or bipolar disorder (p = .001).This study highlights that coercion often begins before psychiatric hospitalization and that early coercive experiences significantly predict subsequent inpatient coercion. A comprehensive evaluation of the entire psychiatric care trajectory is essential to better understand and reduce coercion. Targeted preventive strategies-such as pre-hospital crisis interventions, ED de-escalation protocols, and early pharmacological treatments-may help promote more ethical and patient-centered care.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Responders' Knowledge of and Training Needs in Autism: An Integration of Key Perspectives and Evidence-Based Practice.","authors":"Rose Nevill, Bridgett Kiernan, Leah Richardson, Katiana Estrada, Micah Mazurek, R D Peppy Winchel","doi":"10.1007/s10597-026-01689-4","DOIUrl":"https://doi.org/10.1007/s10597-026-01689-4","url":null,"abstract":"<p><p>Autistic people require frequent support from first responders (FRs) as a function of the core and associated features of their diagnosis; however, they often report negative experiences with FRs and avoid contacting 911. The goals of this study were to generate sustainable, community-informed training standards on autism that are applicable across branches of emergency response to address this concern. Autistic adults, caregivers of autistic people, and first responders were interviewed and surveyed to generate core recommendations, which were cross-referenced with evidence-based practices. Multiple recommendations emerged: FRs should be trained in autism identification and strategies focused on supporting sensory needs and communication; streamlining response efforts across responding units; identifying and involving the person's best advocate to guide interactions; using special interests to support the person; and sharing resources to improve future interactions. FRs should be flexible in their implementation of procedures given the unique challenges many autistic people face. An Autism Response Protocol is proposed that outlines these key strategies to inform future first responder training in autism. This study has important practice implications for future autism training program standards in policing as well as across partnering FR disciplines.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"We Must be the Thorn in the Side\": Experiences with Implementing Family Peer Support Workers in Adult Mental Health Care.","authors":"Aline Pouille, Dries Leclercq, Elke Van Lierde, Nele Feryn, Kim Steeman, Sara Rowaert","doi":"10.1007/s10597-026-01692-9","DOIUrl":"https://doi.org/10.1007/s10597-026-01692-9","url":null,"abstract":"<p><p>While family peer support workers are increasingly put forward as a means of enhancing family involvement in adult mental health care, research on their impact and implementation remains scarce. This study explores both the added value of, and the preconditions for, the successful implementation of family peer support workers in adult mental health care. A qualitative design was employed, consisting of semi-structured interviews with four family peer support workers, six hospital policymakers, and ten mental health professionals from two psychiatric hospitals in Flanders, Belgium, that recently employed family peer support workers. Participants perceived family peer support workers as contributing to improved family engagement and more family-sensitive care. However, successful implementation was found to depend on a set of interrelated macro-, meso-, and micro-level preconditions, including: (1) a co-created and well-considered policy vision and implementation framework; (2) a clear yet flexible role description and competency profile; (3) a conducive organisational culture and departmental climate, as well as supportive professional attitudes; and (4) adequate time and resources. These preconditions provide a foundation for the everyday legitimacy of family peer support workers, which is realised through relational trust and collaborative practice. At the same time, their implementation remains pioneering work, characterised by ongoing negotiation, with stigma still surrounding both family involvement and experiential knowledge.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depressive Symptoms and Anticipated Help-seeking Stigma as Mental Healthcare Navigation Barriers Among People Who Use Opioids.","authors":"Antoine Khati, Md Safaet Hossain Sujan, Ran Xu, Jeffrey A Wickersham, Kamal Gautam, Kiran Paudel, Michael M Copenhaver, Pablo K Valente, Roman Shrestha","doi":"10.1007/s10597-026-01684-9","DOIUrl":"https://doi.org/10.1007/s10597-026-01684-9","url":null,"abstract":"<p><p>Depression is prevalent among people who use opioids (PWUO) and may hinder mental healthcare access not only through reduced engagement but also through difficulty identifying where to obtain services. Information about available mental health care is often obtained through disclosure of symptoms and help-seeking interactions with providers or others. Concerns about how others may react to seeking care may discourage these interactions and limit guidance opportunities for care. However, few studies have examined whether depressive symptoms and anticipated stigma related to help-seeking perceived as a barrier to care are associated with reporting a mental health care service navigation knowledge barrier among PWUO. We analyzed data from a cross-sectional survey of 199 PWUO conducted in New Haven, Connecticut. Participants reported whether \"being unsure where to go to get mental healthcare\" was perceived as a barrier (mental health care service navigation knowledge barrier) and whether \"being concerned about what others might think, say, or do\" was perceived as a barrier (anticipated stigma related to help-seeking perceived as a barrier). Depressive symptoms were assessed with the PHQ-9 (score ≥ 10). Using adjusted multivariable logistic regression models, we examined separate and jointly adjusted associations and tested an interaction by depression screening status. Nearly 59% of participants screened positive for depressive symptoms. Depressive symptoms were associated with higher odds of reporting the service navigation knowledge barrier (aOR = 4.00; 95% CI: 2.10-7.88). Anticipated stigma related to help-seeking perceived as a barrier was also associated with higher odds of reporting the service navigation knowledge barrier (aOR = 5.16; 95% CI: 2.75-10.00). In a jointly adjusted model, both depressive symptoms (aOR = 3.50; 95% CI: 1.77-7.15) and anticipated stigma related to help-seeking perceived as a barrier (aOR = 4.67; 95% CI: 2.43-9.26) remained independently associated with the outcome. The interaction was not statistically significant (p = 0.052). Findings suggest that improving mental healthcare access for PWUO may require attention to both depressive symptoms and anticipated stigma related to help-seeking perceived as a barrier to care, alongside practical navigation and linkage supports embedded in harm reduction and substance use treatment settings.</p>","PeriodicalId":10654,"journal":{"name":"Community Mental Health Journal","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}