Midwifery最新文献

{"title":"Corrigendum to \"How valuable is an implementation Toolkit for midwives? An exploratory study\" [Midwifery 141 (2025) 104241].","authors":"Annemarie De Leo, Linda Sweet, Peter Palamara, Dianne Bloxsome, Sara Bayes","doi":"10.1016/j.midw.2024.104263","DOIUrl":"https://doi.org/10.1016/j.midw.2024.104263","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":" ","pages":"104263"},"PeriodicalIF":2.6,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829348","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":"Resumption of sexual activity after childbirth and its related factors in Spanish women, a cross-sectional study.","authors":"Isabel Artieta-Pinedo, Carmen Paz-Pascual, Arturo Garcia-Alvarez, Paola Bully, Ema-Q Group, Maite Espinosa","doi":"10.1016/j.midw.2024.104259","DOIUrl":"https://doi.org/10.1016/j.midw.2024.104259","url":null,"abstract":"<p><p>The resumption of sexual activity (RSA) after childbirth is problematic for many women; however, it is rarely addressed as a whole in consultation with a midwife.</p><p><strong>Objective: </strong>to describe the sexual function of women in the postpartum period and its relationship with their personal characteristics. To make a proposal adapted to their needs in conjunction with a midwife.</p><p><strong>Method: </strong>a descriptive cross-sectional study carried out within the Basque Health Service. 281 postpartum women were recruited by a midwife in hospital, in primary care or through peer information, and answered a digital questionnaire about RSA with ten questions about desire, arousal, lubrication, orgasm, satisfaction, pain and knowledge and attitude about contraception. The predictor variables were type of delivery, perineal injury, breastfeeding, self-image and partner affection. Age, parity and educational level were taken into consideration. A descriptive analysis of each variable was carried out and multiple linear regression models were built for each domain.</p><p><strong>Results: </strong>25.73 % of the total had resumed sexual relations, and 49.5 % of those who responded 6 weeks after giving birth had not yet done so. Satisfaction scored 3.52 (maximum 5). Genital injuries (β=-0.23, 95 %CI:-1.54, -0.07, p = 0.003), breastfeeding (β=-0.34, 95 %CI: -4.8, -1.18, p = 0.002), emotional support (β = 0.33, 95 %CI: 1.1, 4.69, p = 0.002) and self-image (β =-0.23, 95 % CI: -1.2,-0.07, p = 0.003) influenced at least three domains of sexual function.</p><p><strong>Discussion: </strong>Postpartum care should include an expert response about physical state and an interview with the couple that addresses changes, self-image and emotional support.</p>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"141 ","pages":"104259"},"PeriodicalIF":2.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823820","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's experiences and needs in the use of digital technologies for the management of gestational diabetes: An integrative systematic review.","authors":"Qimeng Zhao, Alison Cooke, Gading Aurizki, Dawn Dowding","doi":"10.1016/j.midw.2024.104262","DOIUrl":"https://doi.org/10.1016/j.midw.2024.104262","url":null,"abstract":"<p><strong>Introduction: </strong>Gestational diabetes mellitus (GDM) represents a widespread complication occurring during pregnancy, posing potential risks to both expectant mothers and their babies. Evidence shows that digital technologies provide comparable levels of care to conventional methods for GDM self-management, which help to improve maternal and neonatal outcomes. This systematic review aimed to explore women's experiences in using digital technologies, inform future technology design for gestational diabetes and potentially help improve usability.</p><p><strong>Methods: </strong>An integrative systematic review including quantitative, qualitative and mixed-method studies. The search was conducted in five databases including CINAHL, Web of Science, Medline, Embase, and PsycInfo. Studies were eligible when including the experience of using digital technologies for GDM self-management from the women's perspective. The screening processes were conducted by two independent reviewers and reached an overall moderate agreement on inter-rater reliability. Quality appraisal was conducted using the Mixed Method Appraisal Tool version 2018.</p><p><strong>Results: </strong>Thirty peer-reviewed articles were included, with a predominant or partial focus on five types of digital technologies including mobile applications, virtual care services, webpages, digital devices, and online communities. Women's experiences and needs of using GDM digital technologies were synthesised into five overarching themes: (1) sufficient and straightforward GDM-relevant educational information; (2) advanced personalisation and broader commitments in coaching components; (3) easy data recording and advanced data visualisation in data management; (4) improved healthcare professionals' engagement; (5) development of online community interfaces.</p><p><strong>Conclusion: </strong>This integrative systematic review gives information on the types of available features across technologies and specific preferences for features by women with GDM. According to the inferred gaps, efforts should be made to facilitate women's self-monitoring using data and feedback, provide personalised information corresponding to women's condition, meet different behaviour change needs using customised coaching features, and enable wider access to information and support.</p>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"141 ","pages":"104262"},"PeriodicalIF":2.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813830","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":"Validation of the Edinburgh Postnatal Depression Scale and its 3-item anxiety subscale, and the Generalised Anxiety Disorder-7 item for screening of postpartum depression and anxiety in women in Malta.","authors":"Rachel Buhagiar, Kristina Bettenzana, Kerry-Ann Grant","doi":"10.1016/j.midw.2024.104256","DOIUrl":"https://doi.org/10.1016/j.midw.2024.104256","url":null,"abstract":"<p><strong>Background & aim: </strong>Perinatal mental health disorders are common complications of pregnancy and the postpartum period. The value of screening for their early detection is well-recognized, but to-date, research-validated mental health measures for postpartum women in Malta are lacking. In this prospective cross-sectional study, we assessed the validity of the Edinburgh Postnatal Depression Scale (EPDS), an EPDS subscale (EPDS-3A), and the Generalised Anxiety Disorder-7 item (GAD-7) as screening measures for postpartum depression and anxiety. The optimal cut points were calculated.</p><p><strong>Methods: </strong>243 randomly selected women from birth to 12 months postnatally self-completed the EPDS and the GAD-7. For women scoring ≥10 in at least one of the questionnaires, the Mini International Neuropsychiatric Interview (MINI) was applied to confirm or refute a diagnosis of depression and/or anxiety disorder based on DSM-5 criteria. Total EPDS, EPDS-3A and GAD-7 scores were analysed against MINI outcomes using receiver operator curve (ROC), and area under curves (AUCs) were determined. Sensitivity, specificity, positive and negative predictive values, likelihood ratios and Youden's indices were calculated across a range of cut-off values.</p><p><strong>Findings: </strong>Both the EPDS and GAD-7 had significant AUCs (>0.8) and Youden's indices (>0.6), contrary to the EPDS-3A. When screening for postnatal depression with the EPDS, the optimal cut-off is 11/12 (sensitivity 75 %; specificity 87.6 %). For postnatal anxiety, the recommended GAD-7 cut-off is 8/9 (sensitivity 79.2 %; specificity 85.3 %).</p><p><strong>Conclusion: </strong>Both the EPDS and GAD-7 are valid screening measures for postpartum depression and anxiety, respectively. These findings can inform the implementation of postpartum screening programs to improve maternal healthcare in Malta.</p>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"141 ","pages":"104256"},"PeriodicalIF":2.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818604","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":"Area-level deprivation as a risk factor for stillbirth in upper-middle and high-income countries: A scoping review.","authors":"Jessica V Keane, Laura A Robinson, Richard A Greene, Paul Corcoran, Sara Leitao","doi":"10.1016/j.midw.2024.104251","DOIUrl":"https://doi.org/10.1016/j.midw.2024.104251","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic deprivation has been associated with health inequalities and poor perinatal outcomes. Deprivation is described as a multidimensional concept, with composite indicators (e.g. area-based) developed internationally to study population health.</p><p><strong>Aim: </strong>This scoping review aims to examine published literature on the relationship between area-level deprivation and stillbirth in upper-middle to high-income countries.</p><p><strong>Methods: </strong>The Joanna Briggs Institute methodology for scoping reviews was utilised. The research question based on the Population (studies that examined stillbirth) Concept (area-level deprivation and its impact on stillbirth) Context (upper-middle- to high-income countries) framework. Six scientific databases were searched. Results were screened and reference lists searched to identify relevant literature. Data extraction on study characteristics and evidence of association provided was completed and a narrative summary reported the main findings.</p><p><strong>Results: </strong>A total of 29 studies were included, from 9 countries (majority UK-based: n = 20) published between 1998 and 2023. A variety of composite deprivation indices were utilised, the UK's Index of Multiple Deprivation (IMD) was the most common (n = 8), followed by the Townsend and Jarman indices (n = 6 and n = 3, respectively). Income, employment, education and access to services were the most common factors included as measures of deprivation in the indices. Twenty-two of the 29 studies (75.9%) showed positive correlations between stillbirth and areas identified more socioeconomically deprived.</p><p><strong>Conclusion: </strong>This review suggests that area-level deprivation seems an influencing factor on stillbirth in upper-middle to high-income countries. Focused initiatives to reduce stillbirth among those at higher deprivation related risk may be useful in improving maternal and perinatal outcomes.</p>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"141 ","pages":"104251"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791527","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":"Reliability and validity of the Spanish version of the Breastfeeding Motivation Scale (BMS). An approach to maternal mental health through psychological factors.","authors":"Cecilia Peñacoba-Puente, Octavio Luque-Reca, Lucía Agudo-Díaz, Miri Kestler-Peleg","doi":"10.1016/j.midw.2024.104260","DOIUrl":"https://doi.org/10.1016/j.midw.2024.104260","url":null,"abstract":"<p><strong>Background: </strong>The decision to breastfeed can be complex due to the significant benefits of breastfeeding and the various barriers that mothers have to face. In this context, it is important to have adequate instruments that provide insight into a mother's motives for breastfeeding.</p><p><strong>Aim: </strong>Given the absence of instruments in this language, this study focuses on translating and validating the Breastfeeding Motivation Scale (BMS) in Spanish mothers.</p><p><strong>Method: </strong>After cultural adaptation and an item clarity assessment with a pilot sample (n = 28), exploratory factor analysis was conducted with a preliminary sample (n = 118). The main study involved 193 Spanish primiparous mothers, aged 24-48 (M = 34.5; SD = 4.2), recruited within two months postpartum, where confirmatory factor analysis, internal consistency, group comparisons, and validity measures were explored.</p><p><strong>Results: </strong>The findings (χ²=358.925, df=183, p<0.001, CFI=0.971, TLI=0.967, SRMR=0.079, and RMSEA=0.071 [90% CI: 0.060-0.081]) supported the existence of four motivational factors for breastfeeding: i) external and identified, ii) intrinsic, iii) integrated, and iv) introjected motivation. The four factors of the scale showed excellent internal consistency (ω_o ranging from 0.77 to 0.92), as well as good convergent and discriminant validity regarding theoretically-related variables (breastfeeding self-efficacy, positive attitude towards breastfeeding, and postpartum depression). Additionally, the scale showed incremental validity with respect to breastfeeding self-efficacy, but not regarding postpartum depression.</p><p><strong>Discussion: </strong>The BMS evidenced good psychometric properties in Spanish primiparous mothers. The findings are discussed in the context of Ryan and Deci's self-determination theory, also reviewing the study's limitations and implications.</p>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"141 ","pages":"104260"},"PeriodicalIF":2.6,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791750","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":"Measuring autonomy and respect: A qualitative, cross-cultural adaptation of the Mothers Autonomy in decision making scale and mothers on respect index instruments in Danish.","authors":"Ida Dayyani, Ingrid Jepsen, Saraswathi Vedam, Rikke Damkjær Maimburg","doi":"10.1016/j.midw.2024.104253","DOIUrl":"https://doi.org/10.1016/j.midw.2024.104253","url":null,"abstract":"<p><strong>Objective: </strong>Decision-making is important in user-involved maternity care and patient experience instruments Mothers Autonomy in Decision Making scale (MADM) and Mothers on Respect index (MORi) are used internationally to measure the user involvement quality and users' experiences of autonomy and respect. This study aimed to translate and qualitatively adapt the original MADM and MORi instruments to the Danish language and culture.</p><p><strong>Methods: </strong>A forward and backward translation using a standard guideline. Subsequently, qualitative interviews to refine the translation and cultural adaptation by pilot testing the scales.</p><p><strong>Results: </strong>The translation process showed cultural differences linked to linguistic variations between Danish and English. Cognitive interviews with 14 diverse pregnant women revealed challenges in women's understanding of decision-making in maternity care. Changes in wording and assisting descriptive texts were made. Further, the order of the MADM items was changed to improve the understanding of decision-making.</p><p><strong>Discussion: </strong>Primarily, the discussion concerns how decision-making can be understood in the context of maternity care and why women's understanding of decision-making in Danish maternity care in the MADM scale items was challenged.</p><p><strong>Conclusion: </strong>The qualitative pilot test using cognitive interviews after translation of the instruments was a valuable method for cultural adaptation providing important knowledge on women's understanding and perceptions of item contents. The cognitive interviews provided a comprehensive understanding of decision-making and contributed to a thoroughly worked Danish version of the MADM and MORi instruments.</p>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"141 ","pages":"104253"},"PeriodicalIF":2.6,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807022","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":"Enhancing maternal wellbeing: A qualitative exploration of women's experiences of tailored education and holistic support while experiencing Hyperemesis Gravidarum.","authors":"Taryn J Elder, Gina Iacurto, Linda Deys","doi":"10.1016/j.midw.2024.104258","DOIUrl":"https://doi.org/10.1016/j.midw.2024.104258","url":null,"abstract":"<p><strong>Problem: </strong>Hyperemesis Gravidarum (HG), poses significant physical, psychological, emotional, and financial challenges for affected women and their families. Despite its prevalence and impact, tailored education and holistic support interventions are lacking.</p><p><strong>Background: </strong>Nausea and vomiting in pregnancy affect 69 % of pregnancies, HG impacts around 1.1 %, though it is likely underreported. It is a leading cause of early pregnancy hospitalisation. Prior research highlights the benefits of professional support, including individualised health education and telephone calls. However, understanding the experiences of women with HG receiving personalised care remains a gap.</p><p><strong>Methods: </strong>A qualitative, explorative study employing reflexive thematic analysis was used to understand the experience of women with HG who were enrolled and recruited from a newly established treatment program. In-depth semi structured interviews (n = 9) were conducted with participants throughout 2022 and 2023 at the conclusion of their HG experience.</p><p><strong>Findings: </strong>Four main themes were identified - The impact of HG; Lack of understanding and recognition of HG; Impact of HG Program; and Need for improved resources and education.</p><p><strong>Discussion: </strong>Women's experience with HG highlights the significant physiological and psychosocial impact and the need for increased clinician knowledge and support. Having dedicated HG clinicians can positively impact symptom reduction, mental health, and health-system navigation.</p><p><strong>Conclusion: </strong>HG profoundly affects women. Tailored education and holistic support by dedicated clinicians is crucial. There is a need for improved recognition, support, and access to care, advocating for expanded services and increased clinician knowledge and response skills.</p>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"141 ","pages":"104258"},"PeriodicalIF":2.6,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785656","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":"Being pregnant and obese: A qualitative study of the experiences of pregnancy and birth of women who are obese.","authors":"Angela Kerrigan, Helen Cheyne, Edward Duncan, Carol Kingdon","doi":"10.1016/j.midw.2024.104257","DOIUrl":"https://doi.org/10.1016/j.midw.2024.104257","url":null,"abstract":"<p><strong>Objectives: </strong>This study explored the views and experiences of maternity care of postnatal women identified as being obese.</p><p><strong>Design: </strong>A qualitative methodology was adopted using individual semi-structured interviews. Data was analysed using a framework approach.</p><p><strong>Setting: </strong>Two National Health Service Hospitals- a large tertiary unit in England, and a district general hospital in Scotland.</p><p><strong>Participants: </strong>8 women with a body mass index of greater than 35 who had recently had a baby.</p><p><strong>Findings: </strong>The overall interpretation 'Being pregnant and obese; Obese women's experiences of pregnancy and birth' was underpinned by three key emergent themes: embodiment of obesity; being pregnant and overweight, and resource intensive maternity care. These findings are encapsulated in a conceptual framework that was formed to demonstrate the trajectory from the embodiment of obesity to becoming pregnant as an obese woman, experiencing the maternity regime that is currently in place for the care of obese women and then finally returning to being an obese woman.</p><p><strong>Key conclusions: </strong>Women who are obese have an intrinsic fear of pregnancy and birth, have a desire for normal birth and 'obese pregnancy' presents a window of opportunity for both short and long-term lifestyle change.</p><p><strong>Implications for practice: </strong>Currently one-fifth of women in the UK are obese. There is increasing evidence of the detrimental effects obesity has on intrapartum outcomes and a lack of research on how to minimise the associated risks of obesity through non-medicalised interventions and how to support women who are obese to maximise their experience of birth. Addressing the intrapartum management through non-medicalised interventions is of paramount importance to maximise the experience of birth and reduce the associated morbidities.</p>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"141 ","pages":"104257"},"PeriodicalIF":2.6,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785598","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":"Effectiveness of sacral massage during labor in pregnant women: A systematic review and meta-analysis.","authors":"Somayeh Makvandi, Zahra Hadizadeh-Talasaz, Seyedeh Fatemeh Nosrati Hadi Abad, Elham Manouchehri, Mona Larki","doi":"10.1016/j.midw.2024.104252","DOIUrl":"https://doi.org/10.1016/j.midw.2024.104252","url":null,"abstract":"<p><strong>Background and aim: </strong>Performing sacral massage during the childbirth process can provide numerous benefits due to its potential to alleviate stress and exhaustion. This systematic review and meta-analysis aimed to assess the effectiveness of sacral massage in pregnant women during labor.</p><p><strong>Method: </strong>A comprehensive search was conducted in main databases from inception to 18th May 2024. The quality of included randomized control trials (RCTs) and quasi-experimental studies was assessed using the Jadad Scale and the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS), respectively. All analyses were performed using the RevMan version 5.3. The GRADEpro GDT tool was utilized to determine the level of certainty of the evidence.</p><p><strong>Findings: </strong>Nine articles were included in the systematic review and eight studies were included in the meta-analysis. The findings showed that in the sacral massage group, the labor pain intensity was significantly decreased (SMD= -2.40, 95 % CI -3. 5 to -1.29, p<0.0001, I² = 97 %). The findings also showed that sacral massage does not significantly alter the length of the first labor stage (MD=-0.04, 95 % CI -0.27 to 0.20, p = 0.77, I² = 0 %) and the total duration of labor (MD= -0.56, 95 % CI -1.66, 0.55,p = 0.32, I² = 90 %). The certainty of evidence for labor pain was moderate and for duration of the first stage and total duration of labor were very low.</p><p><strong>Conclusion: </strong>This study demonstrated that sacral massage was an effective, non-pharmacologic method that significantly alleviating pain in women during childbirth. As a result, this intervention can be implemented in clinical settings during labor.</p>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"141 ","pages":"104252"},"PeriodicalIF":2.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823818","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}