Midwifery最新文献

{"title":"Dietary management in the first stage of labor: A scoping review","authors":"Peimin Xie ,&nbsp;Linglin Pan ,&nbsp;Hong Li ,&nbsp;Xiaojing Hu ,&nbsp;Yiting Xu ,&nbsp;Lina Yang ,&nbsp;Rong Huang","doi":"10.1016/j.midw.2025.104343","DOIUrl":"10.1016/j.midw.2025.104343","url":null,"abstract":"<div><h3>Aims</h3><div>The aims herein are to describe the principal components of dietary management during the first stage of labor and to assess the outcome of childbirth.</div></div><div><h3>Design</h3><div>A scoping review.</div></div><div><h3>Methods</h3><div>We conducted a systematic search of eight databases from database establishment until June 30, 2024. Papers accessed through manual searching were also listed. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for Scoping Reviews in our research. Two independent reviewers screened the papers, extracted the data, and synthesized the findings using a table.</div></div><div><h3>Results</h3><div>After systematic searching, 10 articles on diet management during the first stage of labor were included in this scoping review. We identified six primary components by analyzing the implementation of this diet management model. By extracting data, we concluded that this dietary management can exert a positive effect on birth outcomes by shortening the labor process and reducing postpartum hemorrhage. It is evident that our dietary management model is feasible and can improve birth outcomes. Further research, however, is required to strengthen the evidence that dietary management during the first stage of labor will improve birth outcomes.</div></div><div><h3>Impact</h3><div>This scoping review provided evidence for the positive role of dietary management during the first stage of labor on birth outcomes. We posit that our analysis will contribute to the implementation of dietary management during the first stage of labor.</div></div><div><h3>No patient or public contribution</h3><div>No further public or patient contribution was made in view of the review-based nature of this investigation.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104343"},"PeriodicalIF":2.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577587","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":"Evaluating a midwife-led consultation for women after a traumatic birth experience: Preliminary results","authors":"Valérie Avignon ,&nbsp;Valentine Annen ,&nbsp;David Baud ,&nbsp;Julie Bourdin ,&nbsp;Antje Horsch","doi":"10.1016/j.midw.2025.104358","DOIUrl":"10.1016/j.midw.2025.104358","url":null,"abstract":"<div><h3>Background</h3><div>Approximately 9 to 50 % of women report a traumatic birth experience and 12 % develop childbirth-related posttraumatic stress disorder symptoms (CB-PTSS). A recent study using a postpartum midwifery-led counselling session showed promising results in reducing CB-PTSS, but more evidence is needed.</div></div><div><h3>Objectives</h3><div>The main objective of the study was to evaluate the impact of a midwifery-led counselling session 6 weeks post-partum or later, on depression and CB-PTSS.</div></div><div><h3>Study Design</h3><div>The pre-post-intervention study, including 159 women, took place in a Swiss 18 university hospital. It was designed as a healthcare service quality project and therefore was therefore not registered a priori in a clinical trial registry. Ethical approval from the institutional board was obtained (n° 2020–06). A midwifery-led counselling session, six weeks or more after birth, allowed women to discuss their childbirth experience and to receive additional information about childbirth. Women completed the Edinburgh Postnatal Depression Scale (EPDS) and the PTSD Checklist for DSM-5 (PCL-5) two weeks before and three months after the consultation.</div></div><div><h3>Results</h3><div>Results showed a significant decrease in depression and CB-PTSS, and in cases with probable childbirth-related posttraumatic stress disorder diagnosis (CB-PTSD): 24.7 % (36/146) before counselling versus 6.3 % (5/80) three months after (<em>p</em> &lt; 0.01). The session was rated as extremely/very satisfactory by 91 % of women and extremely/very useful by &gt;87 % of women. No associations were found between depression and CB-PTSD scores and obstetrical or neonatal data.</div></div><div><h3>Conclusion</h3><div>A midwifery-led single-session offered to women 6 weeks or more after birth seemed to be associated with a decrease of depression and CB-PTSS. However, the attrition rate (49 %) made definitive conclusions difficult. More research is needed with a larger sample, a randomized design, and a wait-list control group to consider the effect of time on depression or CB-PTSS.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104358"},"PeriodicalIF":2.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529460","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":"What are the experiences of women and midwives of non-severe perineal trauma assessment? A meta-synthesis","authors":"Giada Giusmin,&nbsp;Ginny Mounce,&nbsp;Sue Schutz","doi":"10.1016/j.midw.2025.104360","DOIUrl":"10.1016/j.midw.2025.104360","url":null,"abstract":"<div><h3>Background</h3><div>In the UK, most women giving birth vaginally experience perineal trauma, predominantly non-severe, yet there is no validated assessment tool to evaluate wound healing postnatally. Current NICE guidelines provide only generic advice on how to complete this assessment, exposing the potential for a variety of non-standardised practices. Criticism of UK postnatal care is widespread, and inadequate perineal trauma assessment might contribute to this.</div></div><div><h3>Question</h3><div>What are the experiences of women and midwives of non-severe perineal trauma assessment?</div></div><div><h3>Methods</h3><div>Systematic literature review with meta-synthesis using three online databases. Data was synthesised using constant comparative analysis.</div></div><div><h3>Databases</h3><div>CINAHL, PubMed, and Web of Science.</div></div><div><h3>Findings</h3><div>Nine studies exploring the experiences of women (8/9) and midwives (1/9) on non-severe perineal trauma were included. Three themes emerged: ‘<em>How society and healthcare professionals are silencing women's experiences</em>’, ‘<em>The inadequate provision of perineal care</em>’, and ‘<em>A glimmer of hope, examples of positive experiences</em>’.</div></div><div><h3>Discussion</h3><div>Women report being underprepared about the extent of their perineal trauma, the potential impact on their lives and the services available if concerns. Some women are not offered perineal assessment and feel their concerns are trivialised by clinicians. These issues are not unique to the UK, as similar challenges exist globally. Improving postnatal care requires better communication, a therapeutic woman-midwife relationship, and societal change to reduce stigma around perineal trauma, which impacts women's psycho-physical health.</div></div><div><h3>Conclusion</h3><div>Improving postnatal perineal trauma care is crucial, with research needed on assessment practices and tools. Therapeutic relationships and women-centred clinical pathways can enhance experiences.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104360"},"PeriodicalIF":2.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529461","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":"Disgust sensitivity in the first trimester predicts anxiety levels in advanced pregnancy","authors":"Lea Takács ,&nbsp;Jana Ullmann ,&nbsp;Daniela Dlouhá ,&nbsp;Catherine Monk ,&nbsp;Kamila Nouzová ,&nbsp;Hana Hrbáčková ,&nbsp;Šárka Kaňková","doi":"10.1016/j.midw.2025.104357","DOIUrl":"10.1016/j.midw.2025.104357","url":null,"abstract":"<div><h3>Problem</h3><div>Disgust contributes to anxiety-based psychopathology, and in turn, anxiety increases disgust proneness.</div></div><div><h3>Background</h3><div>Disgust and anxiety undergo significant changes in pregnancy, but no previous study has examined their longitudinal associations in this time period.</div></div><div><h3>Aim</h3><div>This prospective longitudinal study aimed to identify longitudinal associations between disgust sensitivity and state anxiety across the three trimesters of pregnancy, while exploring the directionality of the effect between those two variables.</div></div><div><h3>Methods</h3><div>At each trimester of pregnancy, the pregnant women (<em>n</em> = 261) completed the Disgust Scale-Revised (DS-R), the Pathogen disgust domain of the Three Domains of Disgust Scale (TDDS), and the State-Trait Anxiety Inventory. A path analysis (structural equation model) was used to assess cross-lagged effects between disgust sensitivity and state anxiety across the three pregnancy trimesters.</div></div><div><h3>Findings</h3><div>We found significant cross-lagged associations between disgust and anxiety such that higher disgust (overall DS-R score, Core disgust subscale of DS-R and Pathogen disgust domain of TDDS) in the first trimester predicted greater anxiety in the third. No significant cross-lagged associations were found between Animal-reminder or Contamination disgust subscales of DS-R and state anxiety. State anxiety did not predict disgust sensitivity at any time point.</div></div><div><h3>Discussion</h3><div>Our results indicate a unidirectional association between disgust sensitivity and state anxiety in pregnant women such that disgust sensitivity in early pregnancy predicts state anxiety in late pregnancy, but anxiety does not predict disgust sensitivity at any time point.</div></div><div><h3>Conclusion</h3><div>Assessing disgust in early pregnancy could help to identify women at risk of higher anxiety levels in advanced pregnancy.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104357"},"PeriodicalIF":2.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593215","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":"‘Just a Midwife’: A qualitative study on perceived barriers and facilitators facing Filipino midwifery students in reaching ICM standards","authors":"Georgia Leigh Macad ,&nbsp;Lucia Rocca-Ihenacho","doi":"10.1016/j.midw.2025.104355","DOIUrl":"10.1016/j.midw.2025.104355","url":null,"abstract":"<div><h3>Background</h3><div>The Philippines is struggling to lower its maternal mortality rate and while midwives are nationally recognized as autonomous maternal health care providers, research suggests they may not receive adequate training or support to fulfill their functions.</div></div><div><h3>Aim</h3><div>To gain deeper understanding of the lived experiences of student midwives in the Philippines with the intent to make recommendations that may assist midwifery programs to meet international standards for midwifery education.</div></div><div><h3>Method</h3><div>A qualitative research project with a realist constructivist approach, using semistructured interviews to explore perceived barriers and facilitators of a group of Filipino student midwives in achieving International Confederation of Midwives’ standards during training.</div></div><div><h3>Findings</h3><div>Thematic analysis led to the creation of one central concept, supported by six overarching themes and 18 subthemes, describing a disempowering culture for student midwives due to medical paternalism and the low status of midwifery in the Philippines.</div></div><div><h3>Discussion and recommendations</h3><div>Student midwives in the Philippines may routinely face disempowering experiences which limit them in achieving clinical competency prior to graduation. Recommendations for improving midwifery programs include empowering students and improving methods of clinical instruction.</div></div><div><h3>Conclusion</h3><div>Student midwives remained resilient in their desire to serve their communities, even in the face of adversity encountered during training. While midwifery training may not currently reach International Confederation of Midwives standards, increased investment, and support of midwives in the Philippines may lead to improved training opportunities in the future.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104355"},"PeriodicalIF":2.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551248","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":"Barriers and facilitators to implementation of home phototherapy for neonatal hyperbilirubinaemia: Perspectives from healthcare professionals and parents","authors":"Jessie Spaan ,&nbsp;Berthe A.M. van der Geest ,&nbsp;Jasper V. Been ,&nbsp;Christian V. Hulzebos ,&nbsp;Erwin Ista","doi":"10.1016/j.midw.2025.104356","DOIUrl":"10.1016/j.midw.2025.104356","url":null,"abstract":"<div><h3>Background</h3><div>Phototherapy for hyperbilirubinaemia in neonates is one of the most frequent causes of hospitalisation in the first week of life, accounting for up to 35 % of hospital (re)admissions. Studies suggest that phototherapy can be applied safely and effectively at home. However, in-hospital phototherapy is still the standard care in most settings.</div></div><div><h3>Aim</h3><div>We aimed to explore determinants of implementing home phototherapy from the perspectives of healthcare professionals and parents to inform its wider implementation.</div></div><div><h3>Methods</h3><div>We conducted focus group interviews with healthcare professionals involved in home phototherapy for neonatal hyperbilirubinaemia. In addition, individual interviews were performed with parents of neonates treated with home phototherapy. We used the Consolidated Framework for Implementation Research (CFIR) for identifying determinants to guide data collection and analysis.</div></div><div><h3>Findings</h3><div>Five focus group interviews with 21 healthcare professionals and 10 semi-structured interviews with parents (10 mothers, eight fathers) were conducted. Barriers concerned the lack of reimbursement options and the challenge to reach all the different healthcare professionals for education. Main facilitators concerned multiple relative advantages of home phototherapy experienced by healthcare professionals and parents such as keeping the family together, the low complexity of home phototherapy, the motivation of parents to perform home phototherapy, the attitude and self-efficacy among healthcare professionals, and the involvement of all key stakeholders from the beginning of the implementation process.</div></div><div><h3>Conclusion</h3><div>This study identified key barriers and facilitators regarding implementation of home phototherapy for neonatal hyperbilirubinaemia. Based on these findings, tailored implementation strategies can be developed.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104356"},"PeriodicalIF":2.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551322","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":"Psychometric assessment of the breastfeeding self-efficacy scale—short form: An alternative german translation","authors":"Martin Kramuschke ,&nbsp;Katja Linde ,&nbsp;Franziska Lehnig ,&nbsp;Michaela Nagl ,&nbsp;Cindy-Lee Dennis ,&nbsp;Anette Kersting","doi":"10.1016/j.midw.2025.104348","DOIUrl":"10.1016/j.midw.2025.104348","url":null,"abstract":"<div><h3>Background</h3><div>The identification of low breastfeeding self-efficacy allows for tailored interventions to increase the rate of exclusive breastfeeding among women in accordance with WHO recommendations. While breastfeeding self-efficacy can be measured using the widely accepted Breastfeeding Self-Efficacy Scale—Short Form (BSES-SF), the construct and predictive validity of a translated German version have not been sufficiently demonstrated. The present study aimed to assess the psychometric properties of an alternative German translation of the BSES-SF.</div></div><div><h3>Methods</h3><div>The BSES-SF was administered to mothers at three months (<em>N</em> = 143) and six months (<em>N</em> = 115) postpartum. In addition, exclusive breastfeeding duration and related constructs were assessed.</div></div><div><h3>Results</h3><div>Excellent internal consistency (<em>Cronbach's α</em> = 0.91) was shown. A good model fit was achieved in the confirmatory factor analysis only when error covariances were considered (CFI = 0.95, SRMR = 0.057, RMSEA = 0.074), raising concerns about a unidimensional structure in the translated version. Construct and divergent validity were supported by significant correlations with self-esteem and social support, and negative correlations with depression, stress, and general anxiety. Importantly, predictive validity was confirmed. Furthermore, breastfeeding self-efficacy at three months postpartum was significantly correlated with exclusive breastfeeding duration at six months (<em>r</em> = 0.312).</div></div><div><h3>Conclusion</h3><div>This study ensures the construct validity of the German BSES-SF and confirms its predictive validity for the first time. The German translation enables midwives and healthcare professionals in German-speaking countries to identify mothers in need of breastfeeding support up to three months postpartum. Targeted interventions can be tailored based on the overall BSES-SF score or specific item responses, contributing to improved breastfeeding outcomes.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104348"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511527","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":"International News April 2025","authors":"Elizabeth Duff (International NewsEditor)","doi":"10.1016/j.midw.2025.104338","DOIUrl":"10.1016/j.midw.2025.104338","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"143 ","pages":"Article 104338"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453743","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":"What do safety and risk mean to women who choose to birth at home? A systematic review","authors":"Candice Chauncy ,&nbsp;Kate Dawson ,&nbsp;Sara Bayes","doi":"10.1016/j.midw.2025.104340","DOIUrl":"10.1016/j.midw.2025.104340","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite clear evidence to support the safety and efficacy of homebirth, the concept challenges the almost universal belief that hospital is the safest place to give birth. Homebirth remains largely unsupported around the world due to prevailing beliefs and constructs surrounding risk and safety. Despite barriers to access, women continue to choose home as a place to birth.</div></div><div><h3>Methods</h3><div>A systematic review of qualitative research was conducted to explore and understand women's views on what constitutes risk and safety in labour and birth for those who choose to birth at home. All studies were evaluated for quality and relevance. Reflexive thematic analysis was used to identify themes.</div></div><div><h3>Results</h3><div>Analysis of the 29 papers included in this review identified three main themes: <em>risk of hospital birth, risk of homebirth,</em> and <em>safety of homebirth</em>, and convey that women who choose to birth at home view their social, emotional, psychological and spiritual safety as highly important, with homebirth protecting and respecting these factors. For the women in the studies we reviewed, physical safety was enhanced through having the expertise of a midwife present at their birth. Participants considered the cultural paradigm within hospital services to focus on care for the physical body and not the whole person, which had the potential to cause psychological and physical harm.</div></div><div><h3>Discussion</h3><div>This review demonstrated that women who choose to birth at home assess risk and safety differently to the way health care institutions assess these parameters. These findings will be of interest to maternity services and educators of maternity care practitioners.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104340"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519449","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":"Exploring early labour care in the context of an institutional reorganisation towards a more women-centred approach: An ethnographic field study","authors":"Nanna Bjerg Pagh ,&nbsp;Katja Schrøder ,&nbsp;Mie G de Wolff","doi":"10.1016/j.midw.2025.104347","DOIUrl":"10.1016/j.midw.2025.104347","url":null,"abstract":"<div><h3>Background</h3><div>Internationally, midwifery is working to improve early labour care by shifting away from delayed admission (i.e., waiting for measurable signs of impending active labour) towards an emphasis on the needs of individual women and their partners. Individualised in-hospital early labour care is a new field that is largely unexplored.</div></div><div><h3>Aim</h3><div>To explore how midwives provide care for women in early labour within a clinical practice that is transitioning towards a more woman-centred approach.</div></div><div><h3>Methods</h3><div>The researchers conducted an ethnographic field study using participant observation and informal interviews at a new section for women in early labour alongside the labour ward. The section featured latent-phase rooms for women and their partners who felt uncomfortable staying at or returning home.</div></div><div><h3>Findings</h3><div>Data analysis identified three main themes: “Navigating Uncharted Terrain” unfolds how embedded care practices challenged detecting women's needs and delivering woman-centred care. “Addressing Insufficient Language for Undefined Needs and Relational Care” highlights the challenges in attending to women's needs due to a lack of specific language for certain care types. Finally, “Caring Within an Institution” emphasises the influence of institutional conditions on achieving woman-centred early labour care.</div></div><div><h3>Conclusion</h3><div>Despite working in a hospital setting that promotes individualised early labour care, the midwives in our study had limited early labour care experience and needed additional support from the institution in developing new care practices. A woman-centred early labour care program valuing the significance of relational care is necessary to successfully build and implement woman-centred early labour care competencies and practices.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104347"},"PeriodicalIF":2.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611641","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}