Contraception最新文献

{"title":"Society of Family Planning Research Practice Support: Researcher and institutional review board considerations for sexual and reproductive health research with minor adolescents","authors":"Maureen K. Baldwin ,&nbsp;April J. Bell ,&nbsp;Andrea J. Hoopes ,&nbsp;Subasri Narasimhan ,&nbsp;Mary A. Ott","doi":"10.1016/j.contraception.2025.110935","DOIUrl":"10.1016/j.contraception.2025.110935","url":null,"abstract":"<div><div>This guidance document provides sexual and reproductive health (SRH) researchers, Institutional Review Boards (IRBs), research ethics committees, and funders with the knowledge and tools necessary for the appropriate inclusion of minor adolescents in SRH research. We provide an overview of the importance of explicit inclusion of adolescent minors in sexual and reproductive health research. We interpret ethical guidelines for researchers and IRBs. We urge researchers to avoid using age 18 as a cutoff for research inclusion since, in many jurisdictions, youth less than age 18 may provide self-consent for SRH care and research. We describe options for waiver of parental consent, waiver of signed consent, and Certificate of Confidentiality, when needed for protection of privacy or confidentiality. We define routine clinical care for adolescent minors to aid determinations about minimal risk research. Finally, we promote a research consent environment that considers developmental capacity for understanding research participation. Inclusion of adolescent minors in research is crucial to promote health equity and reproductive justice.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"148 ","pages":"Article 110935"},"PeriodicalIF":2.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motivations to use a novel hormonal male contraceptive: Perspectives from male contraceptive clinical trial participants","authors":"Jessica D. Gipson ,&nbsp;Marta Bornstein ,&nbsp;Andrew Duong ,&nbsp;Brian T. Nguyen","doi":"10.1016/j.contraception.2025.110932","DOIUrl":"10.1016/j.contraception.2025.110932","url":null,"abstract":"<div><h3>Objective</h3><div>Most existing studies on men’s willingness to use novel hormonal male contraceptives (HMCs) rely on survey data and focus on the hypothetical use of HMCs. The aim of this in-depth, qualitative study was to elicit the perspectives of HMC clinical trial participants – men who have actually used an HMC – to describe their motivations for using HMCs.</div></div><div><h3>Study design</h3><div>In 2017–18 we conducted 30 in-depth, semi-structured interviews with a sample of men who participated in early-stage HMC clinical trials in Los Angeles or Seattle to explore their experiences with and motivations for trialing a HMC. Using thematic analysis, we analyzed deidentified transcripts using deductive and inductive codes, summarizing key themes using a socioecological framework.</div></div><div><h3>Results</h3><div>Participants averaged 35 years old (range: 22–52) and were ethnically and sociodemographically diverse. Men’s motivations for using an HMC centered on <em>societal-level factors</em> (i.e., concerns regarding ‘overpopulation’ and responsible childbearing), <em>partnership factors</em> (concerns regarding entrapment; desire to share in contraceptive responsibility), and <em>individual-level factors</em> (i.e., contraceptive options that maximized pleasure and intimacy; beliefs in men’s contraceptive and bodily autonomy).</div></div><div><h3>Conclusions</h3><div>This study provides the first U.S.-based, in-depth qualitative insights from men who have used HMCs. Men’s motivations for participating in HMC clinical trials and wanting to use novel male contraceptives are both numerous and multi-faceted, supporting prevailing survey data on men’s willingness to use them once on the market. These data offer insights on how male contraceptives could be marketed to the general public.</div></div><div><h3>Implications</h3><div>Men’s motivations vary with respect to participation in hormonal male clinical trials and desire to use HMCs when they become available. All of these motivations – from the broader, societal level, to the individual and partnership level – are critical to assessing the demand for and subsequent marketing of HMCs.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"148 ","pages":"Article 110932"},"PeriodicalIF":2.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Future reproductive outcomes and contraceptive access in the first year postpartum after non-receipt of postpartum permanent contraception","authors":"Jonas J. Swartz ,&nbsp;Tracy Truong ,&nbsp;Maria I. Rodriguez ,&nbsp;Geeta K. Swamy ,&nbsp;Keisha Bentley-Edwards ,&nbsp;Kavita S. Arora ,&nbsp;Emily Chen ,&nbsp;Nicola Young ,&nbsp;Esmé D. Trahair ,&nbsp;Megan Happ ,&nbsp;Kamryn Locklear ,&nbsp;Alaattin Erkanli ,&nbsp;Evan R. Myers","doi":"10.1016/j.contraception.2025.110933","DOIUrl":"10.1016/j.contraception.2025.110933","url":null,"abstract":"<div><h3>Objective</h3><div>Our objective was to compare pregnancy, contraceptive uptake, and health care utilization in the 365 days following delivery, between those who requested and did not receive permanent contraception and those who requested other types of postpartum contraception.</div></div><div><h3>Study design</h3><div>This was a retrospective cohort study of 1412 patients among 5688 delivering in 2018 at one health system. Our primary outcome was pregnancy within 365 days postpartum and we compared 207 individuals who requested and did not receive permanent contraception, with 956 who requested other types of contraception. Secondary outcomes included care utilization and contraceptive uptake in the year postpartum.</div></div><div><h3>Results</h3><div>Individuals with unfulfilled permanent contraception requests had similar incidence of pregnancy by 365 days postpartum as those planning other types of contraception (9.2% vs 8.6%, <em>p</em> = 0.79), a difference which persisted after adjusting for parity and insurance type. Those with unfulfilled requests returned for postpartum care somewhat less frequently (58.5% vs 66.1%, <em>p</em> = 0.04) but were more likely to use more effective contraception (35.3% vs 17.6%, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>We report future pregnancy incidence among those with unfulfilled permanent contraception similar to patients not requesting permanent contraception. Patients had relatively high rates of postpartum visits and use of highly-effective contraception, demonstrating the value of these services.</div></div><div><h3>Implications</h3><div>Policies facilitating access to contraception and postpartum follow up could help reduce the risk of future pregnancy, even among those unable to access preferred contraception at the time of delivery.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"148 ","pages":"Article 110933"},"PeriodicalIF":2.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacy deserts: A complexity that worsens contraception access in the United States","authors":"Natalie DiPietro Mager ,&nbsp;Theresa Schroeder Hageman ,&nbsp;David R. Bright","doi":"10.1016/j.contraception.2025.110931","DOIUrl":"10.1016/j.contraception.2025.110931","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"148 ","pages":"Article 110931"},"PeriodicalIF":2.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping access to medication abortion in Maputo, Mozambique","authors":"Christine M. Zachek ,&nbsp;Santos Guilherme M. Santos ,&nbsp;Maimuna Marenah ,&nbsp;Nafissa Bique Osman ,&nbsp;Sierra Washington","doi":"10.1016/j.contraception.2025.110911","DOIUrl":"10.1016/j.contraception.2025.110911","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize access to co-packaged mifepristone and misoprostol (“combi-pack”) for medication abortion in Maputo, Mozambique.</div></div><div><h3>Study design</h3><div>A cross-sectional, secret shopper study was conducted among pharmacies in Maputo between June and September 2022. Students were trained to act as patients seeking abortion. Shoppers visited all commercial pharmacies in Maputo to obtain information about combi-pack availability, administration, and side effects. Pharmacies were visited by two shoppers; one with a prescription and one without. Cost and availability were evaluated according to neighborhood socioeconomic status.</div></div><div><h3>Results</h3><div>We conducted 250 visits among 155 pharmacies. Combi-pack was available at 80.6% of pharmacies; only 8.4% required a prescription. Median cost was 1000 meticais ($15.65 USD) (range 350–1700 MT, $5.48–26.60 USD). Pharmacy worker instructions on combi-pack administration were fully accurate at only 3.7% of visits, while 45.2% gave partially correct instructions and 47.9% gave no instructions at all. Side effects and hospital precautions were discussed at 48.9% and 22.9% of pharmacy visits, respectively. Low-income neighborhoods were more likely to dispense combi-pack compared to high-income neighborhoods (94.9% vs. 68.9%, <em>p</em> = 0.001). Yet, combi-pack cost significantly more in low-income compared to high-income neighborhoods (median cost 1300 MT [$20.35 USD] vs. 950 MT [$14.87 USD], <em>p</em> &lt; 0.001). Dispensing combi-pack with or without a prescription was not significantly correlated with neighborhood income level.</div></div><div><h3>Conclusions</h3><div>Overall, combi-pack is widely available in Maputo with significant variations in dispensing practices and cost by neighborhood income level. Interventions to improve pharmacy-based counseling, specifically targeted towards low-income neighborhoods, are needed to increase access to safe abortion services.</div></div><div><h3>Implications</h3><div>Co-packaged mifepristone-misoprostol was widely available at commercial pharmacies in Maputo, Mozambique. Most pharmacies dispensed medication abortion without a prescription and provided limited information on medication administration and potential side effects, particularly in lower income neighborhoods. Improving pharmacist counseling and focusing interventions in low-income neighborhoods can promote safety of medication abortion.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"147 ","pages":"Article 110911"},"PeriodicalIF":2.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mystery caller study on pain management options for intrauterine device placement","authors":"Mitali Sharma ,&nbsp;Francesca Selmoni ,&nbsp;Lynn L. Ngo ,&nbsp;Maya P. Pai ,&nbsp;Sheila K. Mody","doi":"10.1016/j.contraception.2025.110913","DOIUrl":"10.1016/j.contraception.2025.110913","url":null,"abstract":"<div><h3>Objectives</h3><div>To understand whether clinics present pain management options for intrauterine device (IUD) placement over the phone and whether these options align with current evidence for effective pain control during placement.</div></div><div><h3>Study design</h3><div>We used a mystery shopper approach and a standardized call script to collect information from a diverse, purposive sample of 100 clinics listed on <span><span>www.bedsider.org</span><svg><path></path></svg></span>.</div></div><div><h3>Results</h3><div>We reached responsive personnel at 90 of the 100 selected clinics, of whom 32 (36%) would not provide information about pain control for IUD placement by phone or to non-established patients. Of the 58 clinics that provided information, four (6.9%) reported that they did not provide any options for pain management, and 54 (93.1%) presented at least one pharmaceutical option. The most common was ibuprofen, which was mentioned by 49 clinics (84.5%). Lidocaine, misoprostol, and naproxen were mentioned by 16 (27.6%), 14 (24.1%), and three (5.2%) clinics, respectively.</div></div><div><h3>Conclusions</h3><div>More than one third of clinics were unable to present pain control options over the phone. Among the 58 clinics that presented options to simulated patients calling to request an IUD placement, evidence-based pain control methods, such as lidocaine blocks, 10% lidocaine spray, or naproxen, were not often presented.</div></div><div><h3>Implications</h3><div>Given the barriers that pain and pre-procedure anxiety pose to uptake of IUDs, it is important for clinic staff to understand current guidelines for pain management during IUD placement as well as the pain control options offered for IUD placements at their clinic.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"147 ","pages":"Article 110913"},"PeriodicalIF":2.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procedural abortion in individuals with opioid dependence: Patient characteristics and pain experience","authors":"Kari P. Braaten ,&nbsp;Alisa B. Goldberg ,&nbsp;Isabel R. Fulcher ,&nbsp;Jennifer Fortin ,&nbsp;Alischer A. Cottrill ,&nbsp;Elizabeth Janiak","doi":"10.1016/j.contraception.2025.110912","DOIUrl":"10.1016/j.contraception.2025.110912","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the prevalence and characteristics of individuals with opioid-dependence who have procedural abortions, and to compare their experience of procedural pain to individuals without opioid-dependence.</div></div><div><h3>Study design</h3><div>Cross-sectional study of procedural abortion patients at a high-volume ambulatory abortion practice. We offered an anonymous survey to all procedural abortion patients which included medical and demographic information, assessment of opioid dependence with the Rapid Opioid Dependence Screen (RODS), measurement of procedural pain, and satisfaction with pain control.</div></div><div><h3>Results</h3><div>We approached 1888 individuals, 1553 (82%) completed the survey and 1525 were included in analysis. Eighty-eight participants screened positive for opioid-dependence (5.9%). Opioid-dependent participants were older, more likely to use other drugs, pay for abortion with insurance, report chronic pain, disability, anxiety, depression, prior abortion, and more frequently presented at 15+ weeks. Opioid-dependent patients reported higher mean pain scores (35 vs. 22.5, <em>p</em> = 0.002), with a mean difference of 7.73 in logistic regression analysis accounting for relevant demographic and medical characteristics (<em>p</em> = 0.041). No interaction was seen between opioid-dependence and effect of intravenous (IV) moderate sedation, with reduction in mean pain scores of 13.76 points in opioid-dependent patients versus 14.54 among those without (<em>p</em> = 0.937). The odds unacceptable pain control did not differ between opioid-dependent and non-dependent individuals (OR 1.73, <em>p</em> = 0.18).</div></div><div><h3>Conclusions</h3><div>Procedural abortion patients with opioid-dependence differ from those without along several reproductive and demographic factors. They have higher mean pain scores but similar improvement in pain with IV moderate sedation. Satisfaction with pain control is similar for patients with and without opioid dependence.</div></div><div><h3>Implications</h3><div>Intravenous moderate sedation is effective in reducing pain in patients with opioid-dependence, despite their overall higher pain scores. It should not be restricted in these patients due to concerns for ineffectiveness as it may be an important factor in improving the abortion experience for these marginalized patients.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"147 ","pages":"Article 110912"},"PeriodicalIF":2.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to providing procedural abortion care among trained clinicians: An evaluation of an abortion training program","authors":"Julia Rollison ,&nbsp;Skye A. Miner ,&nbsp;Zachary Predmore","doi":"10.1016/j.contraception.2025.110901","DOIUrl":"10.1016/j.contraception.2025.110901","url":null,"abstract":"<div><h3>Objectives</h3><div>Understand the barriers and facilitators that clinicians face in delivering procedural abortion care following participation in an abortion training program and how these barriers may differ based on professional characteristics (e.g. specialty, career stage) and institutional factors (e.g., clinic policies).</div></div><div><h3>Study design</h3><div>This analysis is part of a larger evaluation of a clinical training program focused on equipping clinicians with procedural abortion skills. Data collection occurred 07/2020−01/2024 and included semi-structured interviews and post-program surveys collected annually following program completion. Program participants who completed at least two surveys are included.</div></div><div><h3>Results</h3><div>Forty-four ob-gyn and family medicine physicians met the inclusion criteria for this study. About one-third of program participants provided procedural abortion care 6 months following training and at their last survey (18-, 30- or 42 months post-training), and one-third did not provide at either time point. Barriers and facilitators for those providing abortion care often changed as program participants became more established in their practices (particularly post-residency). While local and state policies influenced the ability to provide care, other institutional and professional factors, including career stage, were often reported with some differences by specialty and career stage.</div></div><div><h3>Conclusions</h3><div>Structural and institutional barriers proved significant to those seeking to provide care post-training. Institutions looking to support abortion care should also ensure that this support is given to family medicine physicians. As program participants often had challenges finding work, training programs should focus on helping program participants build networks of providers to provide comprehensive training and job placement support.</div></div><div><h3>Implications</h3><div>Institutional, career and personal factors have compounding effects on individuals’ ability to utilize their abortion training. While abortion training programs are helpful in training providers, program participants from these programs need additional networking and institutional supports to be able to provide procedural abortion care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"147 ","pages":"Article 110901"},"PeriodicalIF":2.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Copyright info/Contents","authors":"","doi":"10.1016/S0010-7824(25)00073-3","DOIUrl":"10.1016/S0010-7824(25)00073-3","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110882"},"PeriodicalIF":2.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change in hCG levels after very early medication abortion for pregnancy of unknown location or probable intrauterine pregnancy","authors":"Tagrid Jar-Allah ,&nbsp;Karin Brandell ,&nbsp;Frida Gyllenberg ,&nbsp;Janina Kaislasuo ,&nbsp;Helena Kopp-Kallner ,&nbsp;Kristina Cederblad ,&nbsp;Oskari Heikinheimo ,&nbsp;Kristina Gemzell-Danielsson ,&nbsp;Helena Hognert ,&nbsp;On behalf of the VEMA (Very Early Medication Abortion) Study Group","doi":"10.1016/j.contraception.2025.110902","DOIUrl":"10.1016/j.contraception.2025.110902","url":null,"abstract":"<div><h3>Objective(s)</h3><div>To evaluate changes in serum/plasma human chorionic gonadotropin (hCG) from baseline levels in very early medication abortion (VEMA) in pregnancies of unknown location (PUL) and probable intrauterine pregnancy (IUP) to confirm treatment success.</div></div><div><h3>Study design</h3><div>A prospective cohort was selected from the VEMA randomized controlled trial conducted at 26 sites across nine countries. Patients with a gestational age ≤42 days without confirmed IUP on ultrasound (<em>n</em> = 741) received medication abortion according to WHO guidelines, hCG was measured at mifepristone intake and repeated on day 7 (+/-2). Changes in hCG were analyzed to distinguish the trends associated with complete abortion versus ectopic pregnancy, ongoing pregnancy, and incomplete abortion.</div></div><div><h3>Results</h3><div>Among 533 cases with complete abortion, a decline in hCG level of ≥80% was observed in 96.8 of cases 7 (+/-2) days post-abortion. The mean hCG decline for complete abortions was 94% (CI: 93.2–94.9). None of the ectopic pregnancies 8 (1.7%) or ongoing pregnancies 21 (2.9%), showed a decline of ≥80%. Rising or insufficient decline (&lt;80%) indicated ectopic and ongoing pregnancy. The hCG trend following complete abortion was significantly different from all other outcomes (<em>p</em> &lt; 0.001), but trends did not distinguish between ectopic, ongoing pregnancy, or incomplete abortion.</div></div><div><h3>Conclusion(s)</h3><div>A hCG decline of ≥80% within 7 (+/-2) days can effectively confirm complete abortion and rule out ectopic and ongoing pregnancies in early medication abortion. These results highlight the effectiveness of hCG monitoring as a reliable follow-up tool for managing VEMA without confirmed IUP.</div></div><div><h3>Implications</h3><div>This study highlights the value of hCG monitoring in early medication abortions in pregnancy of unknown location to differentiate between complete or incomplete abortion, ectopic, or ongoing pregnancy. An hCG decline of ≥80% within 7 (+/-2) days post-mifepristone can confirm complete abortion and help exclude ectopic and ongoing pregnancy.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"147 ","pages":"Article 110902"},"PeriodicalIF":2.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}