Health Research Policy and Systems最新文献

{"title":"Direct health facility financing and its influence on quality compliance in primary healthcare: evidence from Tanzania.","authors":"Syabo M Mwaisengela, Patricia A Materu, Chrisogone J German, Novatus Tesha, Raymond R Kiwesa, Joseph C Hokororo, Godfrey Kacholi, Henry A Mollel, Stephen Kibusi, Mackfallen G Anasel, Albino Kalolo, Ntuli A Kapologwe, Eliudi S Eliakimu, George M Ruhago","doi":"10.1186/s12961-025-01361-5","DOIUrl":"10.1186/s12961-025-01361-5","url":null,"abstract":"<p><strong>Background: </strong>Globally, health systems focus on improving the quality of healthcare services through policy changes. Sub-Saharan African countries have been enacting reforms to strengthen their primary healthcare and referral systems including devolution of authority to healthcare facilities. Devolving health facility financing to primary healthcare providers is a crucial strategy to enhance autonomy in planning, management and resource utilization. In Tanzania, this strategy is called Direct Health Facility Financing (DHFF), and is envisaged to impact on the quality of health services in primary healthcare facilities. This study aimed to determine the effect of DHFF on quality of health services after 3 years of its implementation.</p><p><strong>Methods: </strong>This study employed a before-after noncontrolled analysis of the quality scores by considering compliance of public primary health facilities with healthcare quality standards by using star rating assessment data before and after DHFF implementation. Quality scores were established by performance of service areas, namely organization of services, emergencies and referrals; infrastructure, infection prevention and control; clinical services; and clinical support services. Distribution normality of compliance scores was determined through the Shapiro-Wilk test for normal data and were observed to be non-normal. Median change in quality compliance scores were established, Wilcoxon matched pairs sum rank tests estimated probabilities of the change (α = 0.05) and Cohen's d estimator (d) calculated the effect size of DHFF.</p><p><strong>Findings: </strong>This study involved 1216 primary healthcare (PHC) facilities from 10 regions of Tanzania's mainland, the majority of which were dispensaries (88.8%) and rurally located (86.3%). Findings showed significant positive median change in compliance with quality standards from 0.53 to 0.57 (P < 0.001). However, effect size of DHFF as an intervention is small (d = 0.27).</p><p><strong>Conclusions: </strong>Direct health facility financing has impacted a small change in quality of health services. As evidenced by several studies, challenges regarding fidelity to its implementation process including lower spending on health commodities, dependence on and delayed disbursement of Health Sector Basket Funds (HSBF), poor facilities' planning capacity and shortage of human resources for health must be addressed for it to yield its intended outcome.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"83"},"PeriodicalIF":3.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding challenges of primary healthcare financial resource allocation in Iran.","authors":"Somayeh Mahdiyan, Mostafa Amini-Rarani, Reza Rezayatmand, Nasrin Shaarbafchizadeh","doi":"10.1186/s12961-025-01331-x","DOIUrl":"10.1186/s12961-025-01331-x","url":null,"abstract":"<p><strong>Background: </strong>Primary healthcare (PHC) is essential for health systems worldwide, and resource allocation is vital for sustainability. However, various challenges hinder the allocation process, negatively affecting health outcomes. Therefore, this study explored the current challenges related to financial resource allocation within the PHC system in Iran.</p><p><strong>Materials and methods: </strong>This study is a qualitative descriptive study conducted on the basis of the guide provided by Villamin et al. Data were collected through semi-structured interviews. Accordingly, 20 interviewees were selected via a purposive and snowball sampling approach. The interviewees were experts in budgeting, primary healthcare, and health policies. This study was conducted in 2024. Data were collected between May 2024 and October 2024. The interviews continued until the saturation point was reached. The interview data were analysed via an inductive thematic analysis approach. MAXQDA version 2020 and Microsoft Excel were used for data extraction.</p><p><strong>Results: </strong>The challenges associated with financial resource allocation were categorized into five main themes, eight subthemes, and 25 codes. Themes (subthemes) included the population base (demographic and geographical), health needs (epidemiological), governance (policymaking and political), implementation (process-related and management) and impact (financial).</p><p><strong>Conclusions: </strong>The findings provide a comprehensive set of challenges for allocating financial resources to PHC. Addressing these challenges is essential for health system managers, policymakers and political leaders. Additionally, awareness of PHC financial resource allocation challenges and how to address them clearly demands a multifaceted approach. Successful outcomes depend on collaboration amongst managers at the health system's macro, meso, and micro levels. Such cooperation will be instrumental in creating an effective allocation of financial resources that supports the ongoing development and sustainability of PHC initiatives.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"82"},"PeriodicalIF":3.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An exploratory study of context and factors shaping policies for integrated management of multimorbidity in Malawi.","authors":"Gift Treighcy Banda-Mtaula, Elias Rejoice Maynard Phiri, Miriam Taegtmeyer, Felix Limbani, Rhona Mijumbi, Multilink Consortium","doi":"10.1186/s12961-025-01358-0","DOIUrl":"10.1186/s12961-025-01358-0","url":null,"abstract":"<p><strong>Background: </strong>Malawi faces a high burden of chronic diseases. There is an increasing prevalence of multimorbidity, where individuals experience the coexistence of two or more chronic communicable and noncommunicable diseases. International organizations such as the WHO call for policy reforms that embrace integrated disease management. Our study explored the policy environment and decisions directly relevant to the delivery of integrated multimorbidity care in Malawi.</p><p><strong>Methods: </strong>This was a cross-sectional qualitative study. We used a single case-study methodology combining two sources of data: a document review of policies published between 2000 and 2023 (N = 11) and key informant interviews with policymakers (N = 13). We used the policy triangle framework to examine the context in which the policies aimed at improving management of multimorbidity were formulated, the actors involved, the policy process and the contents of the policies. Additionally, we identified barriers to the implementation of these policies.</p><p><strong>Results: </strong>Malawi advocates for integrated health promotion, screening, treatment and management of chronic conditions across key policies, with a bias towards noncommunicable disease (NCD) + NCD and NCD + human immunodeficiency virus (HIV) integration. Integrated disease management was seen as a tool to accelerate achieving global and local goals such as the Sustainable Development Goals and universal health coverage. However, the formulation and implementation of these policies have been challenged by several factors including unclear burden of multimorbidity, donor-driven priorities through vertical disease funding and inadequate number and training of healthcare workers to manage multimorbidity.</p><p><strong>Conclusions: </strong>We suggest that the timely provision of resources, creation of guidelines for multimorbidity management, building clinicians' capacity and harmonization of donor-government goals should accompany policy rollout for integrated multimorbidity management.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"84"},"PeriodicalIF":3.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health research protocols: a template for empirical bioethics and other investigations.","authors":"Henri-Corto Stoeklé, Christian Hervé","doi":"10.1186/s12961-025-01362-4","DOIUrl":"10.1186/s12961-025-01362-4","url":null,"abstract":"<p><p>We have formalized a protocol template suitable for all types of humanities and social sciences investigations in the domain of health, including empirical bioethics in particular. To achieve this, we revisited the protocol template proposed by O'Brien et al. in Academic Medicine in 2014, better known as the \"Standards for Reporting Qualitative Research (SRQR)\". We reorganized, fused and/or renamed several of the sections, and partly or entirely rewrote several of the corresponding instructions. This made it possible to overcome the limitation of the initial protocol to qualitative approaches, and to render the resulting template equally suitable for quantitative and mixed approaches, and/or other approaches. This new protocol template should be seen as a highly adaptable base.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"80"},"PeriodicalIF":3.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Raising complex public health challenges on local government agendas: a Norwegian case study.","authors":"Kristine Løkås Vigsnes, Charlotte Kiland, Harry Rutter, Eirik Abildsnes","doi":"10.1186/s12961-025-01347-3","DOIUrl":"10.1186/s12961-025-01347-3","url":null,"abstract":"<p><strong>Background: </strong>Public health challenges, ranging from noncommunicable disease prevention to pandemic preparedness, involve both policymaking and the handling of complexity at local, national or global level. The complexity of public health challenges arises from uncertain knowledge, hidden mechanisms, differing conceptual models and multiple stakeholders, making it difficult to identify and agree on problem definitions and potential solutions. This case study aims to provide insights into how complex public health challenges are addressed within local government agendas. We use theories of policy entrepreneurs and agenda setting to explore the processes behind the agenda setting of a public health programme for work inclusion.</p><p><strong>Methods: </strong>We conducted an in-depth case study in a local government context. Data from interviews with key informants and political documents were triangulated and analysed using deductive thematic content analysis, framed within Kingdon's agenda-setting theory and theories of policy entrepreneurs.</p><p><strong>Results: </strong>We identified problem framing, the involvement of multiple actors, and turbulent surroundings as influential factors for agenda setting of complex public health challenges in local government. We further identified the significance of the level of influence of policy entrepreneurs' positions, their coalitions and maintaining agenda control as core mechanisms for enabling agenda setting. We found that strategic manoeuvres of policy entrepreneurs were crucial to handle and manoeuvre complexity within the multiple streams described by Kingdon.</p><p><strong>Conclusions: </strong>This article contributes knowledge of how complex public health problems receive attention and how these issues are shaped and defined, placed on governmental agendas, and paired with solutions. The article contributes important insights for understanding policy responses to complex public health problems and how policy entrepreneurs strategically manoeuvre within the streams of policy development to create windows of opportunity and maintain agenda control. This is important knowledge to support agenda setting for public health challenges and to realize policies to improve public health.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"79"},"PeriodicalIF":3.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative evaluation of hospital workplace violence prevention and control policies in China: based on PMC index model.","authors":"Haoyu Chi, Hanye Tang, Chao Sun, Linjun Zhong, Jiaqi Guo, Yuanheng Li, Yazhou Wang, Mingxue Ma, Lifeng Wei, Jingzhi Wang, Jiajun Shi, Kun Wei, Jida Li, Wei Jiang, Peihang Sun, Mingli Jiao","doi":"10.1186/s12961-025-01350-8","DOIUrl":"10.1186/s12961-025-01350-8","url":null,"abstract":"<p><strong>Background: </strong>Hospital workplace violence (WPV) is a serious obstacle to the sustainable development of global health care, Therefore, it is necessary to adjust and optimize the current WPV prevention and control policies (WPVPCPs), and policy evaluation is the first prerequisite of this link. However, there is little literature on WPVPCPs. The aim of our study is to quantitatively evaluate the China's WPVPCPs, and provide empirical evidence for the formulation, adjustment and optimization of relevant policies.</p><p><strong>Methods: </strong>On the basis of the PMC index model, text mining technology was used to construct a WPVPCPs evaluation system. Overall, 37 WPVPCPs published in China were quantitatively evaluated, and representative policies were selected to draw PMC-Surface chart.</p><p><strong>Results: </strong>Among 37 WPVPCPs, 1 was excellent, 27 were good and 9 were acceptable. The average PMC index was 6.43.</p><p><strong>Conclusions: </strong>The overall quality of WPVPCPs is high, but there is still room for improvement. Specifically, the overall score of primary variables such as policy perspective and policy level is low, and the score of secondary variables of policy nature, policy object, policy tool and policy prescription is unbalanced. These aspects may be the entry point for effective improvement of WPV, so they should be taken seriously in the development and optimization of relevant policies in the future.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"77"},"PeriodicalIF":3.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It is time to acknowledge and act on the importance of power in integrated knowledge translation.","authors":"Anita Kothari, Bev J Holmes, Iain Lang, Chris McCutcheon, Leigha Comer, Ian D Graham","doi":"10.1186/s12961-025-01353-5","DOIUrl":"10.1186/s12961-025-01353-5","url":null,"abstract":"<p><p>Integrated knowledge translation (IKT) has emerged as an approach to research centered on collaboration between researchers and knowledge users, particularly in health research. There has been a growing focus on power within the IKT literature, especially the concern that overlooking power inequities within IKT partnerships may reproduce forms of knowledge production and dissemination that do not align with IKT's aspirations of shared decision making to produce useful and usable research findings. However, there remain significant gaps in our understanding of how to address and attend to power in IKT. The lack of conceptual precision around power complicates these efforts. In this commentary, we draw on existing literatures that have grappled with the notion of power to sensitize those who study and engage in IKT to the importance of power and to identify helpful ways of thinking about power in IKT. We propose that it is time to not only acknowledge the importance of power in IKT but also to develop empirically based strategies through which the many dimensions of power can be identified and navigated.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"78"},"PeriodicalIF":3.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring factors influencing health impact assessment policy identification in China: a comparative study of health and nonhealth sectors.","authors":"Yanyun Xu, Liyuan Song, Xiang Liu, Yingzi Liu, Siyu Zhou, Meng Zhang","doi":"10.1186/s12961-025-01312-0","DOIUrl":"10.1186/s12961-025-01312-0","url":null,"abstract":"<p><strong>Background: </strong>Existing research indicates that both subject trust and procedural justice exert an influence on government staff's level of identification with health impact assessment (HIA) policies, revealing notable differences in attitudes, comprehension levels and preferences for implementing HIA policies among staff from different sectors. There is an urgent requirement to develop an integrated research model that systematically investigates the extent of HIA policy identification and its underlying drivers, commencing with the perspectives of staff from health and nonhealth sectors alike.</p><p><strong>Methods: </strong>A questionnaire survey using a multistage stratified random sampling method was conducted among health sector staff (n = 247) and nonhealth sector staff (n = 408) in Zhejiang province in China. Univariate analysis was used to describe differences in HIA policy identification between the two groups. A multigroup analysis within a structural equation model tested the similarities and differences of influencing factors on HIA policy identification in different sectors.</p><p><strong>Results: </strong>Health sector staff (4.26 ± 0.59) demonstrated a significantly higher level of policy cognition regarding HIA than nonhealth sector staff (3.96 ± 0.63). Conversely, nonhealth sector staff (3.72 ± 0.73) exhibited significantly higher levels of policy evaluation than health sector staff (3.47 ± 0.88). Subject trust positively influenced the three dimensions of HIA policy identification for both groups. However, procedural justice only positively influenced the policy sentiment and evaluation of health sector staff, with no significant impact on nonhealth sector staff. Additionally, other factors, such as position, education, work experience and familiarity with HIA, impacted HIA policy identification across sectors.</p><p><strong>Conclusions: </strong>This study confirms that subject trust can enhance policy identification and cooperative behaviour. On the basis of this, the health sector should strive to understand the policy objectives of other sectors to seize opportunities for action, thereby enabling nonhealth sectors to participate in the actions of the health sector.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"76"},"PeriodicalIF":3.6,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An analysis of migrant health policies in Iran.","authors":"Kanishka Ghiasi, Ali Mohammad Mosadeghrad, Hossein Dargahi, Ebrahim Jaafaripooyan","doi":"10.1186/s12961-025-01336-6","DOIUrl":"10.1186/s12961-025-01336-6","url":null,"abstract":"<p><strong>Introduction: </strong>Migrant health has emerged as a critical global public health issue, necessitating effective policies to address the needs of this vulnerable population. Iran, hosting over 4.5 million migrants - many undocumented - faces significant challenges in ensuring equitable healthcare access. Despite existing policies, implementation gaps persist, exacerbating health disparities. This study analyzes Iran's migrant health policies, identifies challenges and proposes effective solutions.</p><p><strong>Methods: </strong>This qualitative study involved semi-structured interviews with 38 stakeholders, including policymakers, managers, healthcare providers, migrant health experts and migrants themselves, selected through purposeful and snowball sampling. Data were triangulated with a review of 15 policy documents. Guided by the Integrated Policy Analysis Framework, the study focused on four phases: preparation, formulation, implementation and evaluation. Data analysis followed Ritchie and Spencer's framework analysis method, ensuring systematic categorization and thematic interpretation.</p><p><strong>Results: </strong>The analysis generated 49 codes, grouped into 10 sub-themes and four main themes aligned with the policy analysis framework. Key findings revealed persistent challenges across all phases: (1) policy preparation was hindered by the absence of a formal governance structure, such as the lack of a specific committee within the Ministry of Health and Medical Education for migrant health policies, and insufficient stakeholder involvement; (2) policy formulation suffered from selective health priorities, significant data gaps and the exclusion of undocumented migrants from legal coverage; (3) policy implementation faced financial constraints, insurance disparities and systemic barriers, including e-prescription requirements tied to Iranian IDs; and (4) policy evaluation lacked formal mechanisms for monitoring and assessment, highlighting the need for standardized metrics and accountability frameworks.</p><p><strong>Conclusions: </strong>Addressing migrant health in Iran requires a multi-faceted approach that prioritizes stakeholder engagement, robust data collection and inclusive implementation strategies. Establishing dedicated committees, improving data accuracy and ensuring equitable access to health services are critical steps. By implementing these recommendations, Iran can enhance health outcomes for migrants, promote public health and foster social cohesion. This study provides a foundation for evidence-based policy reforms to address the unique health needs of migrant populations.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"75"},"PeriodicalIF":3.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Assessing the impact of an evidence- and consensus-based guideline for controlling SARS-CoV-2 transmission in German schools on decision-making processes: a multi-component qualitative analysis.","authors":"Katharina Wabnitz, Mike Rueb, Eva A Rehfuess, Brigitte Strahwald, Lisa M Pfadenhauer","doi":"10.1186/s12961-025-01346-4","DOIUrl":"10.1186/s12961-025-01346-4","url":null,"abstract":"","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"74"},"PeriodicalIF":3.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}