Midwifery最新文献

{"title":"Epidural or water immersion? A prospective cohort study of maternal and neonatal outcomes in a tertiary hospital","authors":"Soledad CARREGUI-VILAR ,&nbsp;Eva M. MOYA-ARTUÑEDO ,&nbsp;Ricardo CHALMETA ,&nbsp;Lucia ROCCA-IHENACHO ,&nbsp;Eladio J. COLLADO-BOIRA","doi":"10.1016/j.midw.2025.104392","DOIUrl":"10.1016/j.midw.2025.104392","url":null,"abstract":"<div><h3>Background</h3><div>Providing evidence-based information on maternal and neonatal outcomes of epidural analgesia (EA) and water immersion (WI) is crucial for informed decision-making.</div></div><div><h3>Objective</h3><div>To compare process outcomes, obstetric interventions, and maternal and neonatal outcomes in medium low-risk women based on their choice of analgesia: EA or WI.</div></div><div><h3>Methods</h3><div>This prospective observational cohort study analysed 643 women from June 2020 to February 2023. Sociodemographic data, birth process characteristics, and outcomes were collected to compare 284 women who used EA and 319 who used WI (with 82.4% waterbirths). Additionally, 40 cases of women who switched from WI to EA were descriptively analysed. Propensity Score (PS) was applied to reduce selection bias in the comparative analysis.</div></div><div><h3>Findings</h3><div>WI was associated with a <strong>higher probability of spontaneous vaginal birth</strong> (18.7%, E:0.187; SE:0.025; <em>p</em> &lt; 0.001 95% CI 0.138,0.235), <strong>shorter first stage</strong> (-259.532 min; SE:13.592; <em>p</em> &lt; 0.00195%, 95% CI -286.171, -232.892), <strong>shorter second stage of labour</strong> (-17.829 min; SE:4.665; <em>p</em> &lt; 0.001 95% CI -26.973,-8.686) In terms of neonatal outcomes WI (with 82.4% of waterbirths) was associated with <strong>less neonatal ventilatory support</strong> (<strong>1.6%</strong> <strong>vs 9.5% <em>p</em></strong> <strong>&lt;</strong> <strong>0.001,RR 0.028 95% CI 0.11–0.56</strong>), <strong>less birth distress</strong> (<strong>0.9%</strong> <strong>vs 7.7% <em>p</em></strong> <strong>&lt;</strong> <strong>0.001,RR 0.22 95% CI 0.06–0.52</strong>), <strong>lower probability of neonatal admission rates</strong> (<strong>E:-0.102; SE 0.033, <em>p</em></strong> <strong>=</strong> <strong>0.002, 95%</strong> CI -0.166, -0.088), and <strong>higher probability of exclusive breastfeeding at discharge especially for multiparous women</strong> (<strong>E:0.114; SE 0.045 <em>p</em></strong> <strong>=</strong> <strong>0.01 95% CI 0.027, 0.202</strong>).</div></div><div><h3>Conclusion and Implication for practice</h3><div>Water immersion for low-risk women emerges as a valid, evidence-based approach to supporting physiological childbirth and reducing unnecessary interventions. This study highlights the need to reinforce its availability in maternity care and to ensure women's informed decision-making.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"146 ","pages":"Article 104392"},"PeriodicalIF":2.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735236","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":"Exploring the pressure to “bounce back” to pre-pregnancy weight after birth","authors":"Jordyn M. Cox ,&nbsp;Annick Poirier ,&nbsp;Brooke J. Hebert ,&nbsp;Taniya S. Nagpal","doi":"10.1016/j.midw.2025.104384","DOIUrl":"10.1016/j.midw.2025.104384","url":null,"abstract":"<div><div>Weight stigma is defined as negative attitudes and beliefs towards individuals based on their weight, which can manifest as stereotypes, rejection, and prejudice. During the postpartum period, societal pressures to quickly lose weight are intensified and often glorify rapid weight loss. These pressures can have a negative impact on maternal mental health, contributing to postpartum depression, anxiety, and impaired mother-infant bonding. This study aimed to identify the sources of potential pressure to ‘bounce back’ to pre-pregnancy weight among women who have recently given birth. The study involved an online survey, comprised of closed- and open-ended questions, completed by 114 women who were on average 71.0 (12.3) weeks postpartum. Data were assessed descriptively, and a content analysis was performed for open-ended questions. Sources of postpartum weight loss pressure included: Self-motivation (30%), Body Image Dissatisfaction (25%), Society (40%), Family (18%), Media (28%), and Other Postpartum Women (14%). Most (70%) participants were concerned about their postpartum weight, with 43% considering it very important to return to their pre-pregnancy weight. Participants commonly used exercise and nutrition as strategies for weight loss. These findings highlight the multifaceted sources of pressure women may face to conform to societal norms surrounding quick weight loss after childbirth. This study underscores the need for interventions to dismantle postpartum thin body ideals or celebration of rapid weight loss, and instead, encourage safe and inclusive management of postpartum weight retention.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104384"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682778","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":"International News May 2025","authors":"Elizabeth Duff (International News Editor)","doi":"10.1016/j.midw.2025.104368","DOIUrl":"10.1016/j.midw.2025.104368","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104368"},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636384","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":"Developing antenatal education resources for CALD women: First steps, exploring what women from CALD backgrounds want and need","authors":"Delnia Palani ,&nbsp;Julie Tucker ,&nbsp;Annette Briley","doi":"10.1016/j.midw.2025.104367","DOIUrl":"10.1016/j.midw.2025.104367","url":null,"abstract":"<div><h3>Problem</h3><div>There are significant health risks for women from culturally and linguistically diverse backgrounds accessing perinatal care.</div></div><div><h3>Background</h3><div>Disparity exists for accessing perinatal care. In Australia, women from culturally and linguistically diverse (CALD) backgrounds have higher rates of obstetric complications compared to others. Reasons are often complex and multifactorial. Low health literacy is commonly reported amongst CALD communities as a contributor to reduced antenatal care participation and utilisation, compromising recognition of pregnancy complications, and understanding of educational resources. Typically, antenatal education follows generic formats. The usefulness and appropriateness may not be suitable or understood amongst CALD women.</div></div><div><h3>Aim</h3><div>This project aims to derive deeper understanding of the needs and barriers of CALD women accessing antenatal resources.</div></div><div><h3>Method</h3><div>Qualitative study utilising in-depth semi-structured interviews in two focus groups (<em>n</em> = 10) with CALD pregnant women. Antenatal education resources were reviewed. Thematic analysis was used to uncover themes and subthemes.</div></div><div><h3>Findings</h3><div>Three themes were identified 1) Health Literacy, 2) Navigating service and 3) Identity.</div></div><div><h3>Discussion</h3><div>Improved health literacy was cited the main finding, with participants stating accessing information should be simplified and meet the cultural needs throughout a woman's perinatal journey. Women wanted information in multiple formats and variations to accommodate cultural sensitivities on taboo topics.</div></div><div><h3>Conclusion</h3><div>Improvements in current prenatal information are required for CALD women accessing care. Changes in content and format reflecting cultural needs would aid understanding and potentially improve pregnancy outcomes for this group. Further research is required understanding of the diverse cultural needs of maternity care for CALD women.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104367"},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637586","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":"Acupoint stimulation combined with transcutaneous electrical nerve stimulation on labour pain: A stepped wedge cluster randomised controlled trial","authors":"Yiyun Gu ,&nbsp;Xiaojiao Wang ,&nbsp;Jiangnan Wu ,&nbsp;Chunxiang Zhu ,&nbsp;Hui Min ,&nbsp;Jialu Zhang ,&nbsp;Liping Mao ,&nbsp;Hangyun Sun ,&nbsp;Yaming Dai ,&nbsp;Chunyi Gu","doi":"10.1016/j.midw.2025.104380","DOIUrl":"10.1016/j.midw.2025.104380","url":null,"abstract":"<div><h3>Background</h3><div>Labour pain management remains a critical concern, as pharmacological methods often carry side effects and potential risks. Non-pharmacological approaches, such as acupoint stimulation and transcutaneous electrical nerve stimulation (TENS) are being explored as viable alternatives. However, evidence regarding their combined use and overall effect on maternal and fetal outcomes remains limited.</div></div><div><h3>Aim</h3><div>This study aimed to evaluate the effectiveness of acupoint stimulation combined with TENS on labour pain, delivery outcomes, and childbirth experience for women undergoing a trial of labour.</div></div><div><h3>Methods</h3><div>A parallel multi-arm, stepped wedge cluster randomized controlled trial was conducted with 600 women randomized into four groups: TENS, acupoint stimulation, TENS combined with acupoint stimulation, and a control group. The study assessed Visual Analog Scale (VAS) scores, Non-Pharmacological to Pharmacological Pain Management Interval (NPI), the rate of epidural analgesia, delivery outcomes, and childbirth experience.</div></div><div><h3>Results</h3><div>After intervention, women's VAS scores in the TENS, acupoint stimulation, and combined groups were significantly lower than the control group at multiple time points (at 30 , 90, 120, 150, 180, 210, 240, and 270 min, <em>P</em> &lt; 0.05). Non-pharmacological to pharmacological pain management intervals (NPIs) were significantly longer in all intervention groups compared to the control group (<em>P</em> &lt; 0.001), with median NPIs ranging from 178 to 183.5 min in the intervention groups versus 104 min in the control group. A positive correlation was observed between NPI and childbirth experience scores (<em>r</em> = 0.101, <em>P</em> &lt; 0.05). No significant differences were found in epidural analgesia rates, delivery outcomes, postpartum bleeding, Apgar scores, labour duration, or perineal tear rates (all <em>P</em> &gt; 0.05). Childbirth experience scores (CEQ) were significantly higher in the TENS and combined groups compared to the control group (<em>P</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Acupoint stimulation combined with TENS is an effective non-pharmacological approach for alleviating labour pain and enhancing the overall childbirth experience. This integrated method is recommended for incorporation into labour pain management protocols, providing women with a valuable alternative or adjunct to pharmacological interventions.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104380"},"PeriodicalIF":2.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682709","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 psychological impact of working as a midwife in Australia: Findings from a scoping review","authors":"Kirsten Small ,&nbsp;Chanelle Warton ,&nbsp;Jennifer Fenwick ,&nbsp;Kathleen Baird ,&nbsp;Zoe Bradfield ,&nbsp;Caroline Homer","doi":"10.1016/j.midw.2025.104377","DOIUrl":"10.1016/j.midw.2025.104377","url":null,"abstract":"<div><h3>Background</h3><div>Burnout, stress, trauma and other psychological health issues are major drivers of attrition, absenteeism, and reduced workplace engagement for midwives. Given the central roles midwives play in providing quality maternity care, it is important to monitor the mental and emotional health of midwives and to understand factors that are associated with a higher or lower incidence of problems. The aim of this review was to report on empirical literature pertaining to the psychological impact of midwifery work for midwives working in Australia.</div></div><div><h3>Methods</h3><div>The Joanna Briggs scoping review methodology was used. MEDLINE, Embase, Emcare, Maternity &amp; Infant Care Datacare, CINAHL and SCOPUS were searched to identify research pertaining to the psychological impact of midwifery work for Australian midwives.</div></div><div><h3>Results</h3><div>A total of 26 papers met inclusion criteria. Midwifery work in Australia carried a significant psychological burden, with high rates of burnout, emotional exhaustion, depression, anxiety, and stress. Most midwives had witnessed traumatic events. Working in continuity of midwifery carer models was associated with lower rates of mental health concerns, while younger midwives and those with fewer years in the workforce were negatively impacted.</div></div><div><h3>Discussion</h3><div>Midwives in Australia are impacted significantly by their work; especially by burnout, the impact of witnessing traumatic events, depression, stress and anxiety, and moral distress. Midwifery continuity of carer models were protective for psychological impacts.</div></div><div><h3>Conclusions</h3><div>Effective workplace interventions to better support the midwifery workforce, including access to continuity models, are required to sustain Australia's high quality maternity care system.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104377"},"PeriodicalIF":2.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670399","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":"The ambivalence of abortion: An explorative study on attitudes towards elective abortion and abortion limits among pregnant women in Denmark","authors":"Mia Jess ,&nbsp;Sif Emilie Carlsen ,&nbsp;Maria Gantzel ,&nbsp;Ellen C.L. Løkkegaard ,&nbsp;Tom Møller ,&nbsp;Jane M. Bendix ,&nbsp;Helle Timm","doi":"10.1016/j.midw.2025.104381","DOIUrl":"10.1016/j.midw.2025.104381","url":null,"abstract":"<div><h3>Objective</h3><div>Since the legalization of elective abortion in Denmark in 1973, the abortion limit has been at gestational week 12. The abortion limit has recently been debated, leading to its extension to gestational week 18 by 2025. However, research on abortion limits is lacking in Danish and international contexts. This initial study aimed to examine Danish non-abortion-seeking pregnant women's attitudes towards elective abortion and abortion limits in Denmark, in relation to their own pregnancy and perceptions of the fetus.</div></div><div><h3>Methods</h3><div>This exploratory study was based on qualitative semi-structured interviews with 13 non-abortion-seeking pregnant women. All the interviews were conducted using video links. The interviews were transcribed verbatim and analyzed using thematic analysis.</div></div><div><h3>Results</h3><div>All participants supported abortion as a women's right. However, the responses showed a lack of knowledge about abortion procedures as well as cultural silence linked to abortion. Abortion was viewed as the responsibility and burden of women. The participants were equivocal about the placement of the abortion limit due to their own pregnancy experiences, but gestational week 12 was seen as an important milestone in securing the pregnancy and the expected child.</div></div><div><h3>Conclusion</h3><div>This study highlights that issues of elective abortion and abortion limits are linked to ambivalence Abortion was voiced as a woman's right, but also as a woman's responsibility, and burden. The fact that an embryo or fetus, is removed during an abortion procedure made it difficult and ambivalent for the participating women to articulate specific attitudes towards raised abortion limits.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104381"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682710","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":"Effectiveness of an online Japanese version of the mindfulness-based childbirth and parenting programme on prenatal mental health: A single group clinical trial","authors":"Ayumi Tanke ,&nbsp;Hiromi Tobe ,&nbsp;Yuriko Usui ,&nbsp;Kaori Yonezawa ,&nbsp;Emi Tahara-Sasagawa ,&nbsp;Megumi Haruna","doi":"10.1016/j.midw.2025.104379","DOIUrl":"10.1016/j.midw.2025.104379","url":null,"abstract":"<div><h3>Problem</h3><div>Pregnant women frequently experience psychological issues such as depression, anxiety, and excessive fear of childbirth. Non-pharmacological approaches for improving the mental health of pregnant women are increasingly needed in public health.</div></div><div><h3>Background</h3><div>Mindfulness-based interventions are among the most promising approaches to improving mental health.</div></div><div><h3>Aim</h3><div>This study aimed to 1) develop a short online Japanese version of the mindfulness-based childbirth and parenting programme, and 2) investigate its effectiveness in improving mental health after intervention and birth.</div></div><div><h3>Methods</h3><div>A pre- and post-test study was conducted in Japan from February to October 2021 on a single group of 37 healthy pregnant women (16–34 gestational weeks). The four-week online mindfulness-based childbirth and parenting programme included psychoeducation based on mindfulness practices and the physiological processes of pregnancy and childbirth. Participants self-reported their evaluations of mindfulness, self-esteem, subjective happiness, sense of coherence, depression, stress, anxiety, and fear of childbirth before and after the programme (response rate: 97.4 %). The pre- and post-intervention responses were compared using a paired <em>t</em>-test.</div></div><div><h3>Results</h3><div>The results showed a significant reduction in perceived stress and fear of childbirth and an increase in mindfulness, self-esteem, and subjective happiness. No significant effects were observed in this low-risk population with regard to perinatal depression, anxiety, or sense of coherence.</div></div><div><h3>Conclusion</h3><div>The newly developed condensed version of the mindfulness-based childbirth and parenting programme significantly improved maternal mental health. Further studies are required to clarify its effectiveness in larger and more diverse samples of pregnant women.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104379"},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674237","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":"Comment on 'Outcome of induction of labour at 41 weeks with foley catheter in midwifery-led care' of Velthuijs et al.","authors":"Renate Simmelink, Anna Seijmonsbergen-Schermers, Ank de Jonge","doi":"10.1016/j.midw.2025.104369","DOIUrl":"https://doi.org/10.1016/j.midw.2025.104369","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":" ","pages":"104369"},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670395","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 PRIMROSE Project: What is ‘physiological birth’? A quantitative approach to the perceptions of the Australian population","authors":"Brooke I. Henshall ,&nbsp;Heather A. Grimes ,&nbsp;Jennifer Davis ,&nbsp;Christine E. East","doi":"10.1016/j.midw.2025.104375","DOIUrl":"10.1016/j.midw.2025.104375","url":null,"abstract":"<div><h3>Background</h3><div>The definition of 'physiological birth' by the World Health Organization in 1997 may need to be revisited to better align with current practices in labour and birth in the Australian context, and to better understand the perspectives of women and their care providers.</div><div>This study explored if obstetric doctors, midwives, doulas, women, and support people (with experience in labour and birth in the last 12 months) recognise physiological birth differently, which interventions they consider congruent with physiological birth, and terms that should be included in a consensus statement of ‘physiological birth’.</div></div><div><h3>Methods</h3><div>A self-administered, anonymous, 68-field questionnaire was developed and shared online via social media platforms (Facebook, X, and LinkedIn). The questionnaire included Visual Analogue Scales, multi-choice, Likert scale, and open-text items. Data were collected between August - November 2023.</div></div><div><h3>Results</h3><div>733 participants interacted with the survey. Medical intervention such as vaginal examination to assess labour progress, was considered congruent with physiological birth, whereas continuous cardiotocography and artificial rupture of membranes were considered to be ‘non-physiological’. Doulas associated physiological birth with being ‘intervention-free’ more strongly than any other group.</div><div>Obstetrics doctors viewed birth as inherently risky. Respondents indicated that the psychological experience of birth, and terms such as ‘spontaneous onset’, ‘no/minimal intervention’ and ‘spontaneous delivery/birth’ should be included in a consensus statement of ‘physiological birth’.</div></div><div><h3>Conclusion</h3><div>There are multiple understandings of the term ‘physiological birth’, implying that the term lacks clarity. There are disparities in how care providers and women view intervention in birth; suggesting a consensus statement of ‘physiological birth’ is appropriate for the Australian context.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104375"},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670397","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}