Palliative Medicine最新文献

{"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":"10.1177/02692163251348091","url":null,"abstract":"","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"730-733"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","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":"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":"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":"803-813"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","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":"Identifying aspects of physiotherapy and occupational therapy provision in community palliative rehabilitation that could improve outcomes: A realist review.","authors":"Jane Manson, Paul Taylor, Susan Mawson, Joanne Bayly, Carol Keen, Jacqui Gath, Tracy Green, Frances Anderson, Rob Smith, Alicia O'Cathain","doi":"10.1177/02692163251331166","DOIUrl":"10.1177/02692163251331166","url":null,"abstract":"<p><strong>Background: </strong>The provision of physiotherapy and occupational therapy in palliative care is often poorly understood. There is currently no guidance on how to deliver these services in the community, potentially leading to unwarranted variation in practice and unmet patient need.</p><p><strong>Aim: </strong>To identify aspects of physiotherapy and occupational therapy provision in community palliative rehabilitation that could improve outcomes.</p><p><strong>Design: </strong>A realist review of the literature following RAMESES standards, with stakeholder input throughout.</p><p><strong>Data sources: </strong>Iterative literature searches were conducted from September 2023 to April 2024. All relevant data sources relating to delivery of physiotherapy and occupational therapy in community palliative care were included.</p><p><strong>Results: </strong>Forty-two international publications were included, published between 2000 and 2023. Five key aspects were identified: (1) Early referral into community palliative rehabilitation. (2) Layered model, basing level of service on complexity of needs. Within this, clinicians without professional qualifications deliver simple interventions after assessment by a qualified physiotherapist or occupational therapist while specialist clinicians review more complex presentations. Services are cohesive by being integrated with primary care, other community services and specialist medical and palliative care and there is representation of physiotherapists and occupational therapists within leadership teams. (3) Holistic assessments form the backbone of the service with personalised interventions tailored to patients' needs and goals. (4) Accessible and flexible services are offered to meet patients' needs throughout their palliative journey. (5) Information and education for patients and carers are available throughout.</p><p><strong>Conclusions: </strong>Integrating these five key aspects of physiotherapy and occupational therapy provision into community palliative rehabilitation could help ensure palliative patients receive the therapy they need.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"734-749"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024116","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":"iLIVE volunteer study: Volunteer and healthcare professional perceptions of newly developed hospital end-of-life-care volunteer services, in five countries.","authors":"Tamsin McGlinchey, Stephen Mason, Grethe Skorpen Iversen, Dagny Faksvåg Haugen, Inmaculada Ruiz Torreras, Pilar Barnestein Fonseca, Miša Bakan, Berivan Yildiz, Ruthmarijke Smeding, Anne Goossensen, Agnes van der Heide, John Ellershaw","doi":"10.1177/02692163251328197","DOIUrl":"10.1177/02692163251328197","url":null,"abstract":"<p><strong>Background: </strong>Volunteer services that provide direct support to patients receiving palliative and end-of-life care in hospitals are new and developing, but little is known about the use and experience of such services from key stakeholders.</p><p><strong>Aim: </strong>Explore the perceptions of volunteers, and healthcare professionals, towards newly established hospital end-of-life-care volunteer services, in five countries.</p><p><strong>Design: </strong>A phenomenological approach was adopted, using focus group interviews. Data were analysed using an adapted framework analysis.</p><p><strong>Setting/participants: </strong>Acute hospital in-patient units, in five European countries. Participants were recruited if they were: Volunteers from the end-of-life-care volunteer service, or Healthcare professionals working within the wards that the volunteer service is operational.</p><p><strong>Results: </strong>20 Volunteers and 20 healthcare professionals were recruited. Most participants were female (70%, <i>n</i> = 14/65%, <i>n</i> = 13). The healthcare professionals included a majority nurses (60%). Three overall themes were generated: (1) Volunteers provided 'unique, distinct, 'community' support' bringing familiarity to an unfamiliar, medically focussed environment. (2) Volunteers were able to 'establish a connection centred on 'being there' within the acute hospital environment' despite the fast paced and highly changeable environment. (3) Through 'relational interactions adapted to the individual person' volunteers attended to patients' existential and emotional needs.</p><p><strong>Conclusion: </strong>These services confer benefits that are transferrable across cultures and countries, 'fusing' formal care with the informal visiting of family or friends, attending to patients' existential needs. Recommendations include exploring ways to embed the end-of-life care volunteer service into this unique environment, alongside continuing research to explore cultural differences across different countries.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"792-802"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174318","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":"Evaluating outcomes of advance care planning interventions for adults living with advanced illness and people close to them: A systematic meta-review.","authors":"Jodie Crooks, Noura Rizk, Charlotte Simpson-Greene, Gina Hopwood, Owen Smith, Kathy Seddon, Briony Hudson","doi":"10.1177/02692163251344428","DOIUrl":"10.1177/02692163251344428","url":null,"abstract":"<p><strong>Background: </strong>Advance care planning enables individuals to define goals and preferences for future medical care. Despite advances in research and the production of tools and methods for advance care planning, uncertainty remains regarding whether and which interventions support intended outcomes for patients. This lack of clarity is occurring despite high financial investment into advance care planning research through grant funding, relative to other palliative care areas.</p><p><strong>Aim: </strong>To utilise published reviews to explore the efficacy of current advance care planning interventions, including how they are evaluated, and whether they achieve their intended outcomes for adults living with an advanced illness.</p><p><strong>Design: </strong>Meta-review of reviews.</p><p><strong>Data sources: </strong>Five electronic databases (PubMed, CINAHL, EMBASE, Medline and PsychINFO) were searched for reviews published between 2015 and 2025. Quality of reviews was assessed by the AMSTAR-2 tool.</p><p><strong>Results: </strong>Thirty-nine reviews were included. Fifteen reviews evidenced significantly decreased hospital utilisation in line with patient's preferences following advance care planning. Fourteen reviews evidenced significant increases in patients receiving care consistent with their goals, and 12 evidenced significant increases in patients documenting their preferences. Evidence on the impact of advance care planning on decisional conflict was mixed.</p><p><strong>Conclusions: </strong>This review highlights where advance care planning interventions significantly impact outcomes defining successful advance care planning. The existence of a range of interventions can accommodate preferences of patients or families regarding how to receive and engage with their options. This heterogeneity is, however, a challenge for synthesising research data to understand the impact of interventions and inform practice.</p>","PeriodicalId":19849,"journal":{"name":"Palliative Medicine","volume":" ","pages":"2692163251344428"},"PeriodicalIF":3.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333651","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":"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":"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":3.9,"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":"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}