Journal of women's health最新文献

{"title":"Congressional Efforts at Stemming the Maternal Mortality Tide: Not Quite Enough.","authors":"Eli Y Adashi, Daniel P O'Mahony, Glenn I Cohen","doi":"10.1089/jwh.2025.0130","DOIUrl":"https://doi.org/10.1089/jwh.2025.0130","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges to Physician-Scientist Training Amid Restrictive Reproductive Health Policies.","authors":"Ammar D Siddiqi, Jasmine A Tuazon, Clayton D Rawson, Brad A Ryva, Elias M Wisdom, Rohini N Guin, Jessica L Ding","doi":"10.1089/jwh.2025.0117","DOIUrl":"https://doi.org/10.1089/jwh.2025.0117","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Mammographic Breast Density and Breast Arterial Calcification as an Incremental Predictor of Coronary Artery Disease.","authors":"Emma Aldous, Vinay Goel, William Cameron, Chee Yeong, Nushrat Sultana, Rachael Hii, Huong Tu, Anthony Salib, Edwin Xu, Sarang Paleri, Sheran Vasanthakumar, Rhea Nandurkar, Andrew Lin, Nitesh Nerlekar","doi":"10.1089/jwh.2024.0966","DOIUrl":"https://doi.org/10.1089/jwh.2024.0966","url":null,"abstract":"<p><p><b><i>Background:</i></b> Contemporary risk calculators underestimate coronary artery disease (CAD) risk in women. Breast arterial calcification (BAC) associates with CAD. Low breast density (BD) (greater breast adipose tissue) associates with cardiometabolic disease. Both are readily identifiable on screening mammography. We sought to evaluate the association between the combined features of BD, BAC, and CAD. <b><i>Methods:</i></b> We retrospectively studied women with clinically indicated mammography and contemporaneous coronary computed tomography angiography. CAD risk was estimated by CAD Consortium Scoring (CCS;>15% high risk). BD was visually assessed by four-level Breast Imaging-Reporting and Data System (BI-RADS) (low:BI-RADS A-B, high:BI-RADS C-D). BAC was visually assessed as present/absent. CAD was categorized as presence/absence of coronary artery plaque. Results are presented with odds ratio (OR) and [95% confidence intervals], and area under the curve (AUC). <b><i>Results:</i></b> In 153 patients (age 62 ± 10), low BD (67%) and BAC presence (24%) were both associated with CAD, respectively: OR: 3.21 [1.58-6.60], <i>p</i> = 0.001, and OR: 4.36 [1.58-12.00], <i>p</i> = 0.004. CAD proportion in low BD (68.9%) and BAC (42.9%) was lower than with combined low BD+BAC positive (89.7%). Compared with (high BD+BAC negative), the presence of (low BD+BAC positive) associated with CAD independent of modifiable (OR: 9.12 [2.44-45.83], <i>p</i> = 0.002) and nonmodifiable (OR: 4.87 [1.22-25.02], <i>p</i> = 0.035) risk factors. CCS >15% was seen in 33%. Significant incremental value was seen with the addition of BD/BAC status to CCS (AUC 0.64 versus 0.73, <i>p</i> = 0.004). <b><i>Conclusions:</i></b> Mammographic BAC and low BD, both alone and combined, associate with CAD, and improve risk prediction beyond standard coronary risk estimation. Standardized reporting of these features may provide benefit and should be tested in prospective screening studies.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women of Color and Intersectionality Initiative: A Workgroup Report on the Continued Need to Support and Retain Women of Color.","authors":"Toi Blakley Harris, Raquel Hernández Givens, AnaMaría López, Sara Tariq, NaShieka Knight, Jamila M Hackworth, Erika T Brown, LaConda G Fanning, Ana Núñez, Kenya McNeal-Trice","doi":"10.1089/jwh.2024.1096","DOIUrl":"https://doi.org/10.1089/jwh.2024.1096","url":null,"abstract":"<p><p><b><i>Background:</i></b> Unprecedented stressors have significantly impacted our nation. These occurrences compounded the prepandemic structural factors that disproportionately affect historically, economically, and socially marginalized communities of color and women as highlighted by the National Academies of Sciences, Engineering, and Medicine. In response, health care organizations and regulatory bodies have shifted from the quadruple aim to the quintuple aim to conceptualize health care improvement by adding to the prioritizing of the health workforce's well-being and advancing health equity (Nundy, Cooper, & Mate, 2022). The literature presents limited and conflicting information regarding workforce well-being based on demographic background. A 2021 report by the National Academies of Sciences, Engineering, and Medicine described the potential for race, ethnicity, gender identity, sexual orientation, age, and disability status to alter or amplify the career impacts of COVID-19 (National Academies of Sciences, Engineering, and Medicine, 2021). <b><i>Methods:</i></b> In 2020, the Association of American Medical Colleges (AAMC) convened a Women of Color and Intersectionality Initiative (\"Initiative\") to understand better and address factors contributing to the well-being challenges encountered in health systems by women of color (WOC). <b><i>Results:</i></b> Based on a rigorous review of existing data and national trends, the group concluded that WOC continue to exist and work at the margins and that the threat of \"not belonging\" is a key factor impacting their well-being. The authors, who are members of this AAMC WOC Intersectionality Initiative, identified key strategies in the domains of intersectionality and equity, work-life boundaries, gendered divisions of labor, and mental health and well-being for implementation and evaluation in future studies. <b><i>Conclusion:</i></b> Over the last 4 years, the health and scientific workforces have encountered staffing shortages, increased attrition rates, and an overall decline of wellness. Authors and thought leaders in this space have postulated the need to refine tools and methodologies to capture intersectional differences to inform strategy. This article presents recommendations from the Initiative that include solutions that prioritize intersectionality, which can be adopted by academic health systems to support the well-being of WOC.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and Treatment of Gestational Diabetes Mellitus: A National Survey of Physician Practices.","authors":"Sarah E Miller, Meryl M Sperling, Jonathan A Mayo, Stephanie A Leonard, Deirdre J Lyell, Tiffany Herrero, Yair J Blumenfeld","doi":"10.1089/jwh.2024.0918","DOIUrl":"https://doi.org/10.1089/jwh.2024.0918","url":null,"abstract":"<p><p><b><i>Aims:</i></b> We aimed to identify changes in United States practice patterns in gestational diabetes mellitus (GDM) diagnosis and treatment following publication of the 2008 Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study that supported transition toward a 2-hour oral glucose tolerance test. <b><i>Methods:</i></b> A total of 1,030 U.S. obstetric providers were surveyed in 2021 about GDM screening, diagnosis, and treatment, as well as perceptions surrounding preparation for the 1-hour, 50-g glucose loading test (GLT). Data were compared with data from a similar 2003 survey. The study was reviewed by the Institutional Review Board at Stanford University and was determined to be exempt. <b><i>Results:</i></b> Of 1,030 providers surveyed, 304 (30%) responded. Most respondents continued using the two-step screening method (95.0% versus 95.2% in 2003, <i>p</i> = 0.18). Fewer providers used insulin as a first-line medication (64.1% in 2021 versus 82.3% in 2003, <i>p</i> < 0.001). However, providers practicing for 0-10 years often used insulin as first-line compared with providers practicing for over 10 years (79% versus 55%, <i>p</i> < 0.001). Of 2021 respondents, 39.3% believed that fasting before the 1-hour GLT lowers the glucose result, 34.3% believed it increases the result, and 26.4% believed it would have no effect. <b><i>Conclusions:</i></b> Despite data from the HAPO trial, the majority of providers surveyed still use the two-step method for GDM screening. There is wide variability in perceptions and counseling regarding preparation for the 1-hour GLT.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biological, Clinical, and Sociobehavioral Factors Associated with Disproportionate Burden of Bacterial Vaginosis in the United States: A Comprehensive Literature Review.","authors":"Eren Watkins, Jay Lin, Melissa Lingohr-Smith, Candice Yong, Krishna Tangirala, Kevin Collins","doi":"10.1089/jwh.2024.0583","DOIUrl":"https://doi.org/10.1089/jwh.2024.0583","url":null,"abstract":"<p><p><b><i>Background:</i></b> Bacterial vaginosis (BV), a common gynecological infection characterized by reduced lactic acid-producing bacteria and increased anerobic bacteria in the vaginal microbiome, is associated with adverse health outcomes. <b><i>Methods:</i></b> A PubMed search for English-language articles about BV in the USA and factors contributing to disparities in BV risk, with an emphasis on the role of the vaginal microbiome, published from August 2012 to August 2022, identified 760 articles. <b><i>Results:</i></b> Among the 52 articles meeting the prespecified criteria, BV prevalence varied among different populations and disproportionately impacted Black women (49-51%), Hispanic ethnicity (32-43%), and women of reproductive age (30%). Differences in microbial ecology and host genetics were important factors underlying these disparities. Colonization of BV-associated bacteria was more common in women of color than in non-Hispanic White women. Other factors linked with disproportionate burden included multiple/same-sex partners, obesity, immunosuppression, and C-section birth. <b><i>Conclusions:</i></b> BV prevalence was multifactorial, with some populations having higher prevalence rates and distinctive microbiome profiles that may predispose them to the condition. BV treatment and recurrence prevention were challenging due to the complex interplay of biological, clinical, and sociobehavioral factors. Understanding these disparate risk factors is critical to reducing BV burden.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Sex and Lung Cancer Screening Adherence to Follow-Up in a Cohort of Veterans.","authors":"Ethan L Bernstein, Brett C Bade, Eric C DeRycke, Kathryn Lerz, Rached Zeghlache, Michal Rose, Jeffrey Kravetz, Melissa M Farmer, Lori Bastian, Kathleen M Akgün, Hilary C Cain","doi":"10.1089/jwh.2024.0780","DOIUrl":"https://doi.org/10.1089/jwh.2024.0780","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The 2021 update to the United States Preventive Services Task Force guidelines for lung cancer screening (LCS) aims to reduce disparities derived from sex, race/ethnicity, and socioeconomic status. Few studies have addressed adherence to LCS among female Veterans. <b><i>Methods:</i></b> To evaluate differences in adherence to LCS by sex, we conducted a retrospective cohort study within the VA Connecticut LCS Program between June 2013 and March 2020. Our primary outcome was nonadherence, defined as lack of completion of a chest CT scan within the guideline recommended interval plus a 90-day grace period. Eligible patients were enrolled in the screening program and had a baseline Lung-RADS score of 1, 2, or 3. Patients with Lung-Reporting and Data System (RADS) 4 were excluded due to variability in follow-up recommendations. We adjusted for age, race, smoking history, mental/medical comorbidities, and primary care (PC) visits (1-year after first/index CT). Logistic regression modeling was used to determine associations between sex and nonadherence overall and stratified by Lung-RADS 1-2 and Lung-RADS 3. <b><i>Results:</i></b> Among 4,711 Veterans, the overall rate of nonadherence was 34%. Female Veterans were 66% more likely nonadherent to follow-up (odds ratio [OR] = 1.66, confidence interval [CI] = 1.19-2.30) compared with male Veterans. Substance use disorder was associated with greater nonadherence (OR = 1.22, CI = 1.01-1.47). Lower nonadherence was observed among patients with COPD (OR = 0.77, CI = 0.66-0.9) and PC engagement (OR for nonadherence with 5 or more PC visits = 0.78, CI = 0.67-0.91). The associations between sex and nonadherence were similar in models stratified by Lung-RADS groups 1-2, although did not reach significance for the Lung-RADS 3 group. <b><i>Discussion:</i></b> In this cohort, female Veterans were more likely nonadherent. More work is needed to understand the distinct barriers to LCS follow-up among female Veterans. Health care system engagement significantly reduced nonadherence, which may partially explain higher rates of nonadherence among female Veterans who had fewer medical comorbidities.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Family Violence and Reproductive Autonomy Among Arab American Women.","authors":"Angubeen G Khan, Jennifer Cruz, Mona Makki, Madiha Tariq, Yasamin Kusunoki","doi":"10.1089/jwh.2024.0630","DOIUrl":"https://doi.org/10.1089/jwh.2024.0630","url":null,"abstract":"<p><p><b><i>Background:</i></b> Women who experience violence from an intimate partner are at risk of experiencing lower levels of reproductive autonomy. Among Arab American women, cases of intimate partner violence may also involve other family members, including in-laws or natal family, a phenomenon also known as family violence. This study examined the role of family violence on reproductive autonomy among Arab American women. <b><i>Methods:</i></b> Data were collected from a convenience sample (<i>N</i> = 99) of self-identified Arab American women between 18 and 65 years in Dearborn, Michigan, through a cross-sectional survey of self-reported experiences with family violence and reproductive autonomy. Analyses included univariate statistics on sociodemographic characteristics and prevalence of family violence, a psychometric analysis of a multidimensional scale of reproductive autonomy, and adjusted linear regressions to assess how sociodemographic characteristics and family violence were associated with reproductive autonomy. <b><i>Results:</i></b> Nearly 60% of the sample had ever experienced family violence. Among women who had ever had sex (<i>N</i> = 74), higher educational attainment was positively associated with communication and freedom from coercion, and receipt of public assistance was negatively associated with communication. Several types of family violence were negatively associated with the communication and freedom from coercion subscales from the reproductive autonomy measure. <b><i>Conclusion:</i></b> This study demonstrated that sociodemographic factors and family violence are both associated with reproductive autonomy among Arab American women. More research is needed to address family violence and reproductive autonomy in this community and examine how these experiences shape the reproductive health of Arab American women.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between U.S. Women's Toileting Behaviors and Lower Urinary Tract Symptoms: A Cross-Sectional Analysis of RISE for HEALTH Study Data.","authors":"Amanda Berry, Sonya S Brady, Kathryn L Burgio, Shayna D Cunningham, Sheila Gahagan, Aimee S James, Lisa Kane Low, D Yvette LaCoursiere, Terri H Lipman, Gerald McGwin, Margaret G Mueller, Mary H Palmer, Dulce P Rodriguez-Ponciano, Ariana L Smith, Siobhan Sutcliffe, Beverly R Williams, Jean F Wyman, Diane K Newman","doi":"10.1089/jwh.2024.0743","DOIUrl":"https://doi.org/10.1089/jwh.2024.0743","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Toileting behaviors are recognized as potential contributors to lower urinary tract symptoms (LUTS) in women. This study examines the association between toileting behaviors and LUTS among community-dwelling women and whether age modifies these associations. <b><i>Methods:</i></b> Cross-sectional analyses were conducted using baseline data from a population-based cohort study, RISE FOR HEALTH (RISE). Women completed validated questionnaires assessing toileting behaviors (Toileting Behaviors-Women's Elimination Behaviors scale) and LUTS (10-item Lower Urinary Tract Dysfunction Research Network-Symptom Index [LURN SI-10]). Toileting behaviors included place preference for voiding, premature voiding, delayed voiding, straining to void, and toileting position. LUTS items included urine storage, emptying, and postmicturition symptoms. Associations were analyzed by proportional odds logistic regression. Analyses were stratified by seven age groupings. <b><i>Results:</i></b> Data from 2,327 women (mean age 51.1 years, standard deviation = 18.2) were analyzed. Delayed voiding was most strongly associated with the LURN SI-10 composite score (odds ratio [OR] 1.89; 95% confidence interval [CI]: 1.72, 2.09) and urgency incontinence (OR 1.87; 95% CI: 1.66, 2.10). Premature voiding showed the strongest association with urgency (OR 1.82; 95% CI: 1.68, 2.04). Straining was strongly associated with emptying symptoms, including delay before urine starts (OR 2.28; 95% CI: 2.05, 2.54) and slow stream (OR 2.28; 95% CI: 2.05, 2.53). Age modified associations between delayed voiding and LUTS, with strongest associations among 18- to 25 year-old women. <b><i>Conclusions:</i></b> Premature voiding, delayed voiding, and straining showed the strongest associations with LUTS in this cross-sectional analysis. Longitudinal studies are needed to clarify the directionality of these associations. Educating young women on healthy toileting habits may mitigate potential effects of unhealthy toileting behaviors on bladder health.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Acting Reversible Contraception Use after Non-Receipt of Postpartum Permanent Contraception: A Retrospective Analysis.","authors":"Jill M Hagey, Ambika V Viswanathan, Brooke W Bullington, Kristen A Berg, Emily S Miller, Margaret Boozer, Tania B Serna, Jennifer L Bailit, Kavita S Arora","doi":"10.1089/jwh.2024.0395","DOIUrl":"10.1089/jwh.2024.0395","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To evaluate long-acting reversible contraception (LARC) use versus permanent contraception (PC) use at hospital discharge through 1 year postpartum after an unfulfilled immediate postpartum PC request. <b><i>Study Design:</i></b> We present a secondary analysis of a retrospective cohort study of patients across four study sites between 2018 and 2019 with PC as their documented inpatient postpartum contraceptive plan. We abstracted demographic and clinical characteristics, contraceptive plans and time to contraceptive fulfillment, reasons for non-fulfillment, and pregnancy incidence up to 1 year postpartum from medical records. <b><i>Results:</i></b> Of 3,013 patients initially desiring PC, 1,759 patients (58.4%) received PC and 136 patients (4.5%) received LARC on discharge; with an additional 217 patients receiving PC and an additional 176 patients receiving LARC in the 1 year postpartum. Participants who received inpatient LARC were more likely to be younger, to be unmarried, to have Medicaid insurance, and to have delivered vaginally compared with participants who received inpatient PC. Of the 304 patients who received LARC rather than PC during the year postpartum, 49 (16.1%) expressed an interest in LARC prenatally. Reasons for non-fulfillment of PC were varied at different time points postpartum, with 50.3% stating they did not receive PC by 1 year postpartum because they had changed their mind. <b><i>Conclusions:</i></b> Ten percent of patients with an unmet postpartum PC request use LARC methods instead at 1 year postpartum. Patients who do use LARC are unlikely to bridge to receipt of PC. Institutions should prioritize fulfillment of desired postpartum PC prior to hospital discharge.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"307-313"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}