Palliative Medicine最新文献

{"title":"Enhancing the wellbeing of refugees living with advanced life-limiting illness in high-income resettlement countries: A systematic review.","authors":"Merrington H, Mahimbo A, DiGiacomo M, Roxas-Harris B, Agar Mr, Nathan S, Hayen A, Heywood Ae, Dawson A","doi":"10.1177/02692163251338583","DOIUrl":"https://doi.org/10.1177/02692163251338583","url":null,"abstract":"<p><strong>Background: </strong>Refugees experience barriers to health care after resettlement and may have distinct palliative care needs. There is no systematic guidance to support person-centred palliative care services that are responsive to refugees' needs and preferences.</p><p><strong>Aim: </strong>To synthesis evidence regarding factors enhancing the wellbeing of refugees with advanced life-limiting illness, and their families, to inform palliative care in high-income resettlement countries.</p><p><strong>Design: </strong>A systematic review of primary research studies. We applied a strength-based assets framework to the data extraction and synthesis and conducted a directed content analysis.</p><p><strong>Data sources: </strong>We searched nine electronic databases.</p><p><strong>Results: </strong>Ten of the 1006 studies identified were included in the review: two qualitative, one quantitative and seven case studies. We identified 17 assets that enhanced refugees' wellbeing: resilience, religion, spirituality, sense of identity, belonging, community connections, health and death literacy, acculturation, family and social support, social capital, community structures, access to funeral information, access to services, palliative care service approaches, and workforce capacity. Resilience was linked to identity and belonging, connections within cultural and religious networks, social capital and creating meaningful funeral rituals in resettlement. Palliative care workforce capacity, death literacy, acculturation, refugees' grief experiences and willingness to discuss and plan for death, influenced refugees' attitudes to palliative care, communication with staff about treatment, prognosis and spiritual care, and care outcomes.</p><p><strong>Conclusions: </strong>Further research, co-designed with diverse refugee groups, is needed to inform palliative care service approaches, develop interventions to strengthen key assets and explore the nuanced role of social capital in end-of-life care.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"2692163251338583"},"PeriodicalIF":3.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"End-of-life care experiences and long-term outcomes of bereaved neuro-oncology caregivers: A cross-sectional survey.","authors":"Shaista Meer, Peter Buckle, Rosanna Miller, Louise Murray, Lucy Ziegler, Karin Piil, Florien Boele","doi":"10.1177/02692163251344164","DOIUrl":"https://doi.org/10.1177/02692163251344164","url":null,"abstract":"<p><strong>Background: </strong>The last three months of life (end-of-life phase) are profoundly challenging for patients with brain tumours and their family caregivers. Post-bereavement outcomes are largely unknown.</p><p><strong>Aim: </strong>To better understand long-term outcomes of a brain tumour diagnosis on families, we aimed to describe caregiver experiences during the end-of-life phase and beyond.</p><p><strong>Design: </strong>In this sequential mixed-methods study designed together with bereaved caregivers, we used an online survey. This comprised end-of-life experiences, and post-bereavement outcomes (family functioning: Family APGAR; resilience: CD-RISC-10; mood: HADS; prolonged grief: PG-13-R; post-traumatic stress: TSQ).</p><p><strong>Setting/participants: </strong>Caregivers of patients with brain tumours who were bereaved ⩾6 months ago were invited through social media and charities.</p><p><strong>Results: </strong>105 bereaved neuro-oncology caregivers participated. The end-of-life phase was marked by high symptom burden and disruption to family life, compounded by often unsatisfactory information provision and support. Forty-three percent did not describe the patient's death as dignified. Most caregivers were not well-supported post-bereavement, and current functioning was impacted by notable rates of prolonged grief disorder (64%), post-traumatic stress disorder (42%), depression (35%), anxiety (61%), disruption to family life (53%) and low levels of resilience. Multivariable regressions found better resilience and family functioning to be protective factors for both post-traumatic stress disorder and prolonged grief disorder symptoms, with a dignified death additionally linked to caregivers' prolonged grief scores, explaining 23.8% and 51.0% of variance, respectively.</p><p><strong>Conclusions: </strong>Bereaved neuro-oncology caregivers have high rates of adverse mental health outcomes, highlighting a pressing need for improvements in palliative, end-of-life and post-bereavement services.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"2692163251344164"},"PeriodicalIF":3.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparity in health care in end-of-life among patients with lung cancer and pre-existing mental disorders: A nationwide cohort study.","authors":"Nina Marie Videbech, Jan Brink Valentin, Søren Valgreen Knudsen, Anne Høy Seeman Vestergaard, Mogens Vestergaard, Torben Riis Rasmussen, Line Stjernholm Tipsmark, Søren Paaske Johnsen, Mette Asbjørn Neergaard, Amalie Helme Simoni","doi":"10.1177/02692163251344133","DOIUrl":"https://doi.org/10.1177/02692163251344133","url":null,"abstract":"<p><strong>Background: </strong>Research focusing on health care in end-of-life among cancer patients with mental disorders is limited and presents inconsistent findings.</p><p><strong>Aim: </strong>To investigate disparities in health care in end-of-life among patients who died from lung cancer according to pre-existing mental disorders.</p><p><strong>Design: </strong>A Danish nationwide cohort study linking nationwide registries on health care in end-of-life including specialist palliative care (including hospice admissions), 'drug reimbursement for terminal illness', high-intensity-treatment during the last 30 days before death and death at hospital, analysed using Poisson regression, adjusted for sociodemographic and clinical factors.</p><p><strong>Setting/participants: </strong>All adult decedents who died of lung cancer in Denmark from 2011 through 2020, including individuals with mental diagnoses prior to their cancer diagnosis.</p><p><strong>Results: </strong>Among 36,323 patients dying from lung cancer, 12% had pre-existing mental disorders. Patients with mental disorders were less likely to receive specialist palliative care (adjusted risk ratio (RR) 0.90; 95% CI: 0.87; 0.94), hospice admissions (RR: 0.86; 95% CI: 0.80; 0.94), chemotherapy (RR: 0.66; 95% CI: 0.57; 0.76), radiotherapy (RR: 0.82; 95% CI: 0.74; 0.92), surgery (RR: 0.47; 95% CI: 0.22; 1.00), hospital admissions (RR: 0.96; 95% CI: 0.92; 0.99) and to die in a hospital (RR: 0.88; 95% CI: 0.85; 0.91), compared to patients without mental disorders. No disparities were observed in receiving drug reimbursement, admissions to intensive care units or emergency care.</p><p><strong>Conclusion: </strong>Pre-existing mental disorders were associated with a lower probability of specialist palliative care, but also some high-intensity-treatments in end-of-life. These patients may be deprived of optimal palliative care but also appeared less subjected to possible overtreatment in end-of-life compared to patients without mental disorders.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"2692163251344133"},"PeriodicalIF":3.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing inequity in the provision of children's palliative care in low- and middle- income countries: A focus on education and research.","authors":"Julia Downing, Tracey Brand, Alex Daniels, Joe El-Khoury, Nahla Gafer, Gayatri Palat, Olena Riga, Regina Szylit, Ximena Garcia-Quintero","doi":"10.1177/02692163251348091","DOIUrl":"https://doi.org/10.1177/02692163251348091","url":null,"abstract":"","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"2692163251348091"},"PeriodicalIF":3.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role self-ascription of professionals conducting advance care planning conversations: A thematic analysis.","authors":"Anca-Cristina Sterie, Mathieu Bernard, Ralf J Jox, Eve Rubli Truchard","doi":"10.1177/02692163251331168","DOIUrl":"10.1177/02692163251331168","url":null,"abstract":"<p><strong>Background: </strong>During advance care planning, individuals can benefit from the support of a healthcare professional to navigate the intricacies of decision-making. There are specific roles to be played at each level of the process. Evidence is lacking about how professionals understand their role when conducting advance care planning conversations.</p><p><strong>Aim: </strong>To explore how professionals perceive, define and describe their role when conducting advance care planning conversations.</p><p><strong>Design: </strong>We conducted this exploratory cross-sectional study in Switzerland from November 2019 to June 2020 by using semi-structured interviews, which were transcribed and thematically analysed with an inductive approach.</p><p><strong>Participants: </strong>Fourteen professionals having received a training on advance care planning in Switzerland.</p><p><strong>Results: </strong>We identified three themes: (1) role typology; (2) individual-centred and (3) professional-centred aspects related to role ascription. Roles that professionals undertake were aggregated in two overarching categories, 'facilitators' and 'counsellors', according to whether they prioritise individual's capacity to decide for themselves or their need to receive guidance towards a particular decision. In practice, roles fluctuate between these categories, according to the individuals (to what extent they are informed and eager to engage in autonomous decisions, their communication capacity and desires) or the professional (main profession and involvement in the person's care plan).</p><p><strong>Conclusions: </strong>Advance care planning requires professionals to be very adaptable and flexible in order to identify the role that they can play in each situation. Training needs to take into consideration this complexity and address it explicitly.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"700-708"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The experience of nurses when providing care across acts that may be perceived as death hastening: A qualitative evidence synthesis.","authors":"Victoria Ali, Nancy Preston, Laura Machin, Jackie Malone","doi":"10.1177/02692163251331162","DOIUrl":"10.1177/02692163251331162","url":null,"abstract":"<p><strong>Background: </strong>Nurses can be involved in interventions that they perceive as hastening death. These interventions may intentionally cause death, as in the case of assisted dying or result in death as an unintended consequence, such as when life-sustaining treatment is withdrawn. There is increasing evidence regarding nurses' experiences of providing care in these separate contexts. However, it remains less clear whether parallels exist in experiences across various acts that nurses might consider death hastening.</p><p><strong>Aim: </strong>To synthesise qualitative research findings on the lived experiences of nurses when involved with acts that may be perceived as death hastening.</p><p><strong>Design: </strong>A qualitative evidence synthesis utilising thematic synthesis.</p><p><strong>Data sources: </strong>An initial search of CINHAL, PsychInfo and Medline was undertaken in December 2022 and updated in August 2024. Papers were quality assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research.</p><p><strong>Results: </strong>Twenty-three papers were included in the review. An overarching theme linked to the emotional labour required to provide care was developed. Three sub-themes influence emotional labour: (1) experiencing personal and professional conflicts, (2) the provision of 'normal(ised)' care and (3) perceptions of palliative care as a proxy for hastening death.</p><p><strong>Conclusions: </strong>This synthesis demonstrates that nurses experience significant emotional labour across acts that may be perceived as death hastening. The level of emotional labour is influenced by nurses' uncertainty of the ethical and moral status of these interventions and navigating these uncertainties alongside colleagues, patients and those important to them during care delivery.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"644-664"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of subcutaneous plastic cannulas in patients with severe thrombocytopenia: Findings from a retrospective analysis.","authors":"Till Arnold, Claudia Bausewein","doi":"10.1177/02692163251331160","DOIUrl":"10.1177/02692163251331160","url":null,"abstract":"<p><strong>Background: </strong>Continuous subcutaneous infusion is a common and well-established method for administering medications in palliative care. However, limited evidence exists regarding the safety of subcutaneous plastic cannulas in patients with severe thrombocytopenia (platelet count ⩽20 G/L), a population at higher risk of bleeding complications. Understanding the safety profile in this context is essential for guiding clinical practice.</p><p><strong>Aim: </strong>To determine the complication rates associated with the use of subcutaneous polyurethane cannulas for continuous subcutaneous infusion in patients with severe thrombocytopenia in a German palliative care unit.</p><p><strong>Design: </strong>A retrospective observational study was conducted, analyzing all patients treated in a palliative care unit over 4 years. Data on the use of polyurethane cannulas, number of subcutaneous punctures, days of cannulas in situ, and associated complications were collected and reviewed.</p><p><strong>Setting/participants: </strong>The study was conducted in a single German palliative care unit. Of 1475 patients treated during the study period, 61 patients (4.1%) had severe thrombocytopenia (platelet count ⩽20 G/L). Of these, 17 patients received 37 subcutaneous punctures, accounting for a total of 150 days with polyurethane cannulas in situ.</p><p><strong>Results: </strong>No complications related to the use of polyurethane cannulas in patients with severe thrombocytopenia were observed in the studied population (<i>n</i> = 0, 0%).</p><p><strong>Conclusions: </strong>The findings suggest that the use of polyurethane cannulas is safe even in patients with severe thrombocytopenia. Further research could explore larger sample sizes and different settings to validate these findings.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"724-726"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mixed methods exploration of the health and caregiving experiences of fathers of children with a life-limiting condition.","authors":"Victoria Fisher, Karl Atkin, Lorna K Fraser","doi":"10.1177/02692163251327877","DOIUrl":"10.1177/02692163251327877","url":null,"abstract":"<p><strong>Background: </strong>Fathers of children with a life-limiting condition are underrepresented in the literature. We know little about their experiences of caregiving, the impact of this on their health and their support needs.</p><p><strong>Aim: </strong>To explore the health and caregiving experiences of fathers of children with a life-limiting condition, both quantitatively and qualitatively.</p><p><strong>Design: </strong>A convergent mixed methods design comprised of (1) a quantitative survey and (2) semi-structured qualitative interviews prioritising the qualitative data.</p><p><strong>Setting/participants: </strong>Thirty-two fathers of children with a life-limiting condition took part in the survey. They were recruited via social media, three UK children's hospices and one UK children's hospital. Twelve of these fathers went on to take part in a qualitative semi-structured interview.</p><p><strong>Results: </strong>Thematic analysis resulted in three themes: (1) Everyday precarity; (2) cumulative distress; past, present and future; (3) the scope and severity of the impact of caregiving on fathers; a lack of understanding from others. In the survey, fathers reported high levels of carer strain and distress, alongside high levels of family wellbeing and positive appraisals of caregiving.</p><p><strong>Conclusion: </strong>Fathers' extensive and overwhelming daily routines are inflexible and unstable, leading to multidimensional precarity and a sense of overwhelm. Current care provision does not address the unique and fluctuating support needs of fathers, which are linked to those of their child, and need to be understood in the context of both parenting and caregiving. A process capable of identifying and addressing fathers' support needs to be established.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"678-688"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cinnamon Nanoparticles Loaded on Chitosan- Gelatin Nanoparticles Enhanced Burn Wound Healing in Diabetic Foot Ulcers in Rats.","authors":"Amirreza Hajati Ziabari, Mostafa Asadi Heris, Seyed Mohammad Doodmani, Alireza Jahandideh, Kave Koorehpaz, Rahim Mohammadi","doi":"10.1177/15347346221101245","DOIUrl":"10.1177/15347346221101245","url":null,"abstract":"<p><p>The objective of this work was to investigate impact of Cinnamon nanoparticles loaded on chitosan- gelatin nanoparticles on burn wound healing in diabetic foot ulcers in rat. We included sixty male rats into four groups. There were 15 animals in each group as follow: DFU group: We treated the burn wounds with normal saline (0.1 mL). DFU/SSD group: In this group, the wounds were with silver sulfadiazine 1% ointment. DFU/CGNP: In this group, the burn wounds were treated with chitosan-gelatin nanoparticles based ointment (0.05 mg/mL). DFU/CNP-CGNP group: In this group, the wounds were treated with CN-CGNPs (0.05 mg/mL). Wound area reduction measurements, biochemistry, histomorphometrical studies, hydroxyproline levels and reverse transcription polymerase chain reaction for caspase 3, Bcl-2, and p53 showed significant difference between rats in DFU/CNP-CGNP group in comparison with other groups (<i>P</i> < .05). Accelerated repair of the wounds in DFU/CNP-CGNP group showed that local application of Cinnamon nanoparticles loaded on chitosan- gelatin nanoparticles could be taken into consideration in burn wound healing in diabetic foot ulcers.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":"3 1","pages":"466-477"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87179035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative paramedicine: An interrupted time series analysis of pre-hospital guideline efficacy.","authors":"Mostyn Gooley, Belinda Delardes, Sarah Hopkins, James Oswald, Cheryl Cameron, Emily Nehme","doi":"10.1177/02692163251331167","DOIUrl":"10.1177/02692163251331167","url":null,"abstract":"<p><strong>Background: </strong>Paramedics are increasingly involved in palliative care and often support community-based palliative care service delivery to facilitate integrated practice. However, the impact of specific palliative care guidelines on clinical practice remains unknown.</p><p><strong>Aim: </strong>To determine the impact of an ambulance service palliative care guideline on rates of supportive medication administration and non-transport.</p><p><strong>Design: </strong>A retrospective cohort study of electronic patient care records from January 2014 to June 2023. Baseline characteristics were compared pre- and post-guideline introduction. Interrupted time series analysis was performed to examine guideline efficacy.</p><p><strong>Setting/participants: </strong>Patients of all ages receiving palliative care who were attended by paramedics in Victoria, Australia.</p><p><strong>Results: </strong>A total of 31,579 patients were included. The median age was 75 years (IQR = 64-84 years), and 56.4% were men. Overall, 25.8% of patients were not transported to hospital. Following guideline introduction, there were no significant trend changes in administration of supportive medications. However, the non-transport rate increased significantly per month (0.2%, <i>p</i> = 0.007), amounting to a 9.9% (<i>p</i> = 0.020) total increase by the end of the study period compared to a scenario in which the guideline had not been introduced. Subgroup analysis of patients diagnosed with 'pain' or attended after-hours also showed significant increases in non-transport (monthly increase: pain 0.3%, <i>p</i> = 0.003; after-hours 0.3%, <i>p</i> < 0.001; total increase: pain 29.7%, <i>p</i> < 0.001, after-hours 22.6%, <i>p</i> = 0.001).</p><p><strong>Conclusions: </strong>Introduction of a palliative care guideline was associated with a decrease in ambulance transport to emergency departments, allowing more patients continuity of care in the community.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"689-699"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}