MidwiferyPub Date : 2025-01-14DOI: 10.1016/j.midw.2025.104294
Camilla Solgaard Hoffmann , Nadia Flensted Hoegholt , Peter Vuust , Morten Kringelbach , Kira Vibe Jespersen
{"title":"The effect of music on pregnancy-related insomnia: A systematic review and meta-analysis","authors":"Camilla Solgaard Hoffmann , Nadia Flensted Hoegholt , Peter Vuust , Morten Kringelbach , Kira Vibe Jespersen","doi":"10.1016/j.midw.2025.104294","DOIUrl":"10.1016/j.midw.2025.104294","url":null,"abstract":"<div><h3>Background</h3><div>Pregnancy is associated with physical, physiological and hormonal changes, that significantly influence sleep. Pregnancy-related insomnia is associated with a higher risk of complications during pregnancy and labor as well as postpartum depression. Music is widely used to promote sleep, as it is easily accessible, non-pharmacological and without side effects, but the effect of music-listening for pregnancy-related insomnia is unclear.</div></div><div><h3>Methods</h3><div>Eight electronic databases were searched for RCTs investigating the effect of music listening on pregnant women with insomnia. Two researchers independently screened the identified studies for eligibility and post-intervention data were extracted. We assed risk of bias using the Cochrane risk of bias assessment (RoB1). A random-effects meta-analysis was conducted to assess changes in subjective sleep quality following a music-based intervention compared to controls.</div></div><div><h3>Results</h3><div>Four RCTs (348 participants) were included in the systematic review and meta-analysis. Music interventions significantly reduced sleep problems (MD -1.38, 95 % CI -2.56 to -0.19; <em>p</em> = 0.02) compared to no treatment or treatment as usual. Since it is not possible to blind participants to the music interventions, all the studies were rated with high risk of bias in at least one domain.</div></div><div><h3>Conclusion</h3><div>This review suggests that listening to music at bedtime may improve sleep quality in pregnant women with symptoms of insomnia, but more studies are needed to fully establish the effect.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"142 ","pages":"Article 104294"},"PeriodicalIF":2.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MidwiferyPub Date : 2025-01-14DOI: 10.1016/j.midw.2025.104296
Georgia Middleton , Karen Matvienko-Sikar , Annette Briley , Dimity Dutch , Samantha Morgillo , Jacqueline Anderson , Natasha Schranz , Fiona Margrie , Rachel Kirby , Rebecca K Golley , Sarah C Hunter
{"title":"Supporting parents in the transition to parenthood through wellbeing interventions; An international scoping review","authors":"Georgia Middleton , Karen Matvienko-Sikar , Annette Briley , Dimity Dutch , Samantha Morgillo , Jacqueline Anderson , Natasha Schranz , Fiona Margrie , Rachel Kirby , Rebecca K Golley , Sarah C Hunter","doi":"10.1016/j.midw.2025.104296","DOIUrl":"10.1016/j.midw.2025.104296","url":null,"abstract":"<div><h3>Problem</h3><div>Many first-time parents experience poor wellbeing during the transition to parenthood.</div></div><div><h3>Background</h3><div>The transition to parenthood can be challenging, with consequences to wellbeing for many first-time parents. While parents are often well-supported to care for their children, there are minimal supports available to care for themselves. To support parents in caring for their children, they need to be supported in their own care.</div></div><div><h3>Research question</h3><div>What evidence-based universal interventions supporting parent wellbeing from conception to 12 months post birth exist?</div></div><div><h3>Methods</h3><div>A scoping search across four databases to identify studies measuring and reporting wellbeing outcomes of parents who participated in a prevention intervention aiming to improve wellbeing.</div></div><div><h3>Findings</h3><div>Seventy-four studies, reporting on 70 unique interventions, were included. Interventions were grouped into eight categories depending on their main mechanism of focus. Studies measured a range of wellbeing outcomes. Thirty-five studies provided evidence of effectiveness across all their reported outcomes. These interventions ranged across the different categories of focus, typically included mothers-only, were delivered post-birth, by a facilitator, in-person and individually.</div></div><div><h3>Discussion</h3><div>Wellbeing is complex and existing evidence demonstrates a range of intervention components that may effectively support parent wellbeing. Inconsistency in defining wellbeing and diversity in outcome measurements limits our ability to determine which components of these interventions are the most effective.</div></div><div><h3>Conclusion</h3><div>Findings from this review support a multifaceted approach to supporting parents’ wellbeing during this transition, with considered intervention focus and design to support a universal population across all facets of wellbeing.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"142 ","pages":"Article 104296"},"PeriodicalIF":2.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MidwiferyPub Date : 2025-01-14DOI: 10.1016/j.midw.2025.104295
Rena Bina , Drorit Levy , Samira Alfayumi-Zeadna , Ana Raquel Marcelino Mesquita , Raquel Costa , Sara Domínguez-Salas , Claire A. Wilson , Ana Osorio , Eleni Vousoura , Ana Uka , Camellia Hancheva , Yolanda Contreras-García , Pelin Dikmen-Yildiz , Andri Christoforou , Emma Motrico
{"title":"Changes to social and healthcare providers support in the perinatal period: Impact on coping strategies, depression and anxiety","authors":"Rena Bina , Drorit Levy , Samira Alfayumi-Zeadna , Ana Raquel Marcelino Mesquita , Raquel Costa , Sara Domínguez-Salas , Claire A. Wilson , Ana Osorio , Eleni Vousoura , Ana Uka , Camellia Hancheva , Yolanda Contreras-García , Pelin Dikmen-Yildiz , Andri Christoforou , Emma Motrico","doi":"10.1016/j.midw.2025.104295","DOIUrl":"10.1016/j.midw.2025.104295","url":null,"abstract":"<div><h3>Background</h3><div>During the perinatal period, risk of depression and anxiety (D&A) increases. As in other crisis events, the COVID-19 pandemic, imposed social distancing measures, diminished social support and changes in perinatal healthcare provision which heightened this risk. This study aimed to examine how changes in social and healthcare provider support during the pandemic affected coping strategies and depression and anxiety symptoms (D&As) among perinatal women.</div></div><div><h3>Methods</h3><div>A cross-sectional international study included 7,368 pregnant and postpartum women up to six months postpartum from 12 countries (Albania, Brazil, Bulgaria, Chile, Cyprus, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom). Between June and October 2020, women answered an online survey regarding D&As (measured by the Edinburgh Postnatal Depression Scale and Generalized Anxiety Disorder-7), level of social and healthcare providers’ support, changes to these types of support and coping strategies.</div></div><div><h3>Results</h3><div>Main findings show that 24.6% of women had symptoms of depression and 20.2% of anxiety. Higher levels of D&A were associated with lower social and provider support, negative changes to social support and use of negative internal coping strategies. Positive coping strategies mediated the relationship between increased social and provider support and decreased D&As, while negative coping strategies mediated the relationship between negative changes to social support and increased D&As.</div></div><div><h3>Conclusion</h3><div>Social and provider support can promote coping strategies and reduce emotional distress. Healthcare providers should screen perinatal women for D&A, discuss ways to improve their coping strategies and social support as a preventive measure, and offer initial emotional well-being support.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"142 ","pages":"Article 104295"},"PeriodicalIF":2.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059464","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}
MidwiferyPub Date : 2025-01-09DOI: 10.1016/j.midw.2025.104284
Semanur Koyuncu , Aygül Kıssal
{"title":"Experiences of first-time fathers in the transition to parenting: A qualitative study","authors":"Semanur Koyuncu , Aygül Kıssal","doi":"10.1016/j.midw.2025.104284","DOIUrl":"10.1016/j.midw.2025.104284","url":null,"abstract":"<div><h3>Problem</h3><div>Despite cultural or individual differences, fathers have difficulty finding a role in the parenting process, they feel inadequate in baby care and they think they are excluded by health personnel.</div></div><div><h3>Background</h3><div>Little is known about how first-time fathers perceive their experiences, needs, and fatherhood roles during their transition to parenthood.</div></div><div><h3>Objective</h3><div>This study was conducted to understand the experiences, needs and fatherhood roles of first-time fathers in the transition to parenthood.</div></div><div><h3>Method</h3><div>This qualitative study including 12 fathers who had 3–12-month-old babies and lived with their spouses in a district in the north of Türkiye was conducted using individual in-depth interviews. Data were analysed using the content analysis.</div></div><div><h3>Findings</h3><div>The following four categories emerged in the content analysis of in-depth individual interviews: ‘new fathers’ perception of the fatherhood role’, ‘difficulties they experience due to becoming a new father’, ‘father-infant attachment and its effects on the new father” and “new fathers’ needs and suggestions. The participating fathers discovered their roles as income providers during pregnancy and as caregivers during labour and the postpartum period, and were willing to participate in the process. Father-infant attachment began during pregnancy and took shape in the postpartum period.</div></div><div><h3>Conclusion</h3><div>Although the fathers lacked knowledge and support for involvement, they were aware of their roles as providers and caregivers in parenting. Father-infant bonding appears to be both a cause and a consequence of the development of fathering roles.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"142 ","pages":"Article 104284"},"PeriodicalIF":2.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979192","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}
MidwiferyPub Date : 2025-01-09DOI: 10.1016/j.midw.2025.104285
Jessica Preziosi , Susanna Portaleone , Erika Colagiovanni , Giulia Tedesco , Francesca Rizzi , Maria Luisa Rega , Michelangela Danza , Antonio Lanzone , Gloria Anderson
{"title":"Predictors of cultural competence among healthcare professional in maternity department: A systematic review","authors":"Jessica Preziosi , Susanna Portaleone , Erika Colagiovanni , Giulia Tedesco , Francesca Rizzi , Maria Luisa Rega , Michelangela Danza , Antonio Lanzone , Gloria Anderson","doi":"10.1016/j.midw.2025.104285","DOIUrl":"10.1016/j.midw.2025.104285","url":null,"abstract":"<div><h3>Background</h3><div>In recent years, the number of foreign women seeking perinatal care from health services has increased. These women come from diverse cultural and social backgrounds, highlighting the importance of properly training healthcare professionals to respond effectively to their needs. <em>Cultural Competence</em> refers to the set of skills, knowledge, and awareness that providers must possess to deliver care to patients from different cultures.</div></div><div><h3>Aim</h3><div>This study aims to investigate the determinants of Cultural Competence in healthcare professionals who assist women during childbirth.</div></div><div><h3>Method</h3><div>A systematic literature review was conducted using MEDLINE/PubMed, Web of Science, CINAHL, Scopus, and ProQuest. Quantitative studies were included if they investigated at least one psychosocial characteristic in midwives or staff assisting pregnant women.</div></div><div><h3>Findings</h3><div>Out of 4,193 articles, 8 were selected that measured the level of Cultural Competence using validated scales. These studies related the data to the sociodemographic characteristics of the chosen population. Variables significantly associated with Cultural Competence that recurred in at least two studies were selected: age, gender, years of experience, role, and previous Cultural Competence training. These determinants were categorized as (a) individual variables and (b) Jobs-related variables.</div></div><div><h3>Discussion</h3><div>Age diversity boosts Cultural Competence (CC) in healthcare teams, enhancing care for diverse women. Our study confirms prior cultural training and experience with different cultures predict CC. Health services should promote CC, but understanding in high-income countries remains limited.</div></div><div><h3>Conclusions</h3><div>By strategically promoting age diversity, facilitating cultural training, and encouraging experiences with diverse populations, healthcare institutions can significantly improve the Cultural Competence of their staff.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"142 ","pages":"Article 104285"},"PeriodicalIF":2.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008240","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}
MidwiferyPub Date : 2025-01-08DOI: 10.1016/j.midw.2025.104287
Malin Hansson , Monica Eriksson
{"title":"Work related indicators of midwives’ job satisfaction and the modifying effect of sense of coherence. A national cross-sectional study in Sweden","authors":"Malin Hansson , Monica Eriksson","doi":"10.1016/j.midw.2025.104287","DOIUrl":"10.1016/j.midw.2025.104287","url":null,"abstract":"<div><h3>Background</h3><div>The global shortage of midwives highlights the importance of understanding the factors that contribute to job satisfaction to improve retention in the profession.</div></div><div><h3>Aim</h3><div>To identify the indicating work related factors of job satisfaction in Swedish midwives and analyse the potential modifying effect of Sense of Coherence (SOC).</div></div><div><h3>Methods</h3><div>A national sample of midwives <em>n</em> = 1663 were included in the five hierarchical regression models with the outcome job satisfaction. The dimension, <sup>1</sup>demands at work, <sup>2</sup>work organisation and job content, <sup>3</sup>inter personal relations and leadership, <sup>4</sup>social capital and <sup>5</sup>health and well-being were entered together with work experience as indicators in the first step. In the second step, SOC was entered in each of the five models.</div></div><div><h3>Findings</h3><div>The strongest indicator of job satisfaction was the work organisation and job content dimension, with 58 % explained variance. SOC had the strongest modifying effect in relation to the dimension demands at work with an additional 13 % R<sup>2</sup> change.</div></div><div><h3>Conclusions</h3><div>In order to improve midwives' job satisfaction, the work organisation and job content needs a comprehensive reorganisation. Increasing midwives’ influence at work, providing possibilities for development and prerequisites for high quality care and strengthen the resources meaningfulness and variation in work. SOC as a personal resource can buffer against job-related demands and stress, supporting a sustainable working life. The results highlight the critical importance of both structural job factors and personal resilience in fostering a satisfied and effective workforce as they can be a key factor to enable retention of midwives in the profession.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"142 ","pages":"Article 104287"},"PeriodicalIF":2.6,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Work and health-related determinants of midwives' intention to leave: Nationwide cross-sectional and prospective cohort studies in sweden","authors":"Gunnel Hensing , Anna Dencker , Ing-Marie Carlsson , Malin Hansson","doi":"10.1016/j.midw.2025.104283","DOIUrl":"10.1016/j.midw.2025.104283","url":null,"abstract":"<div><h3>Background</h3><div>Midwives are essential for achieving the Sustainable Development Goal on sexual and reproductive health. However, midwifery shortage challenge healthcare organisations globally. The aim was to analyse cross-sectional and prospective associations between independent variables: ‘possibilities of development’; ‘quality of work’; ‘role conflict’; ‘recognition’; ‘self-rated health’ and ‘burnout’ and dependent variables: ‘intention to leave current position’ and ‘intention to quit midwifery’.</div></div><div><h3>Methods</h3><div>In 2020 a nation-wide web-survey was distributed to midwives in Sweden (<em>n</em> = 5076) listed as members in unions that organise midwives. This was repeated in 2023 (<em>n</em> = 4398 midwives). Cross-sectional (<em>n</em> = 3696) and prospective (<em>n</em> = 531/406) uni- and multivariable logistic regressions were performed.</div></div><div><h3>Results</h3><div>We found a lower probability of intention to leave current position in respondents who reported possibilities for development, quality of work and recognition while those reporting role conflicts and burnout had a higher probability of intention to leave current position. In the first prospective analysis (<em>n</em> = 531) we found that reporting good quality of work and recognition at baseline were associated with a lower probability of reporting intention to leave current position at follow-up while burnout at baseline was associated with a higher probability of reporting intention to leave current position at follow-up. In the second prospective analysis (<em>n</em> = 406) we excluded respondents who reported intention to leave current position at baseline and found that only quality of work at baseline predicted a low probability of intention to leave at follow-up. For the second dependent variable, intention to quit midwifery, we found that possibilities for development and recognition was associated with a lower probability to quit while burnout was associated with a higher probability. In the first prospective analysis, we found that recognition at baseline was associated with a lower probability to quit while burnout at baseline was associated with a higher probability. When excluding those who reported intention to quit midwifery at baseline, we found that recognition and self-rated health was associated with a lower probability to report intention to quit at follow-up.</div></div><div><h3>Conclusion</h3><div>Quality of work, recognition and health appeared to be important for retention among midwives. Recognition stands out as a humble but relevant wish from a professional group of great importance for health care.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"142 ","pages":"Article 104283"},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MidwiferyPub Date : 2025-01-06DOI: 10.1016/j.midw.2024.104279
Joanne Rack , Vanora Hundley , Edwin van Teijlingen , Ann Luce
{"title":"The pregnant pause: Engaging and involving public contributors in maternal health research","authors":"Joanne Rack , Vanora Hundley , Edwin van Teijlingen , Ann Luce","doi":"10.1016/j.midw.2024.104279","DOIUrl":"10.1016/j.midw.2024.104279","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"142 ","pages":"Article 104279"},"PeriodicalIF":2.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MidwiferyPub Date : 2025-01-03DOI: 10.1016/j.midw.2025.104282
A.E. Burton, H. Cassidy, J. Taylor, A. Owen
{"title":"Experiences of tongue tie when breastfeeding twins: A qualitative study","authors":"A.E. Burton, H. Cassidy, J. Taylor, A. Owen","doi":"10.1016/j.midw.2025.104282","DOIUrl":"10.1016/j.midw.2025.104282","url":null,"abstract":"<div><h3>Problem</h3><div>Tongue tie is an added complication when breastfeeding, but little is known about the role tongue tie might play when breastfeeding twins.</div></div><div><h3>Background</h3><div>Twins are much less likely to be breastfed than singleton babies due to added complications regarding pregnancy, birth and ongoing care. Tongue tie can cause breastfeeding barriers including poor latch, inefficient milk transfer and nipple pain.</div></div><div><h3>Aim</h3><div>The aim of this study was to conduct an in-depth exploration of the experiences of mothers who have breastfeed twins with suspected or diagnosed tongue tie.</div></div><div><h3>Methods</h3><div>Interview and qualitative survey data exploring the experience of breastfeeding twins and multiples were analysed with a focus on the experiences of participants reporting on suspected or diagnosed tongue tie. Data were analysed using reflexive thematic analysis.</div></div><div><h3>Findings</h3><div>Three themes were developed. These were: 1) feeling disempowered by tongue tie denial; which illustrated the experience of dismissal by healthcare professionals, 2) the avoidable impact of diagnostic delay; highlighting the practical, physical and psychological impact of tongue tie, and 3) improvements following intervention; illustrating the immediate improvements experienced following frenotomy.</div></div><div><h3>Discussion</h3><div>Mothers who suspect tongue tie find themselves disempowered by denial of their experiences and needing to fight for intervention. Long delays lead to distress for both mother and child while intervention often leads to instant improvement.</div></div><div><h3>Conclusion</h3><div>Improved healthcare professional training and healthcare policy changes are needed to improve tongue tie support and intervention for parents of twins and reduce the threat to mother and child health and wellbeing.</div></div><div><h3>Statement of Significance</h3><div><strong>Problem or Issue:</strong> Breastfeeding rates for twins are much lower than for singleton babies. For some infants tongue tie may be an additional barrier to breastfeeding success.</div><div><strong>What is Already Known:</strong> Research with parents of singleton babies has shown that tongue tie can cause distress, frustration and physical pain for mothers who report dismissal by healthcare professionals and a need to fight for support.</div><div><strong>What this Paper Adds:</strong> The voices of parents of infants with tongue tie who have successfully breastfed twins are presented. Like parents of singleton infants, they experienced diagnostic delays and psychological and physical impacts of tongue tie. Intervention was often sought privately when NHS support was lacking. Regardless of source, tongue tie intervention often led to immediate improvement highlighting how the added stresses and challenges created by tongue tie for twin parents could be prevented with appropriate support and intervention ","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"142 ","pages":"Article 104282"},"PeriodicalIF":2.6,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}