European Journal of Midwifery最新文献

{"title":"Adaptation and validation of the Polish version of the Quality from Patient Perspective-Intrapartal (QPP-I) questionnaire to assess childbirth care.","authors":"Julia Nawrot, Dorota Matuszyk, Aneta Suder, Agnieszka Bień, Violetta Skrzypulec-Plinta, Agnieszka Gniadek","doi":"10.18332/ejm/201472","DOIUrl":"https://doi.org/10.18332/ejm/201472","url":null,"abstract":"<p><strong>Introduction: </strong>As midwifery shifts to a holistic, women-centered model, assessing care quality from the patient's perspective is crucial. The lack of standardized tools in Poland forces reliance on invalidated <i>ad hoc</i> measures. This study bridges the gap by translating and validating the QPP-I questionnaire.</p><p><strong>Methods: </strong>The Polish QPP-I was adapted and validated through a cross-cultural study. A pilot (25 women) and a multicenter study (153 women) were conducted 2-3 days postpartum, with a test-retest after 2-4 weeks. Convenience sampling was used, with data collected via online and paper questionnaires. The pilot ran in late 2019, and the main study (February 2020-March 2021) spanned five maternity wards. Internal consistency, test-retest reliability, and criterion relevance were analyzed.</p><p><strong>Results: </strong>The questionnaire was well-received by the target group, requiring minimal cultural adaptation. QPP-I PL demonstrated high internal consistency (α=0.935 for the 1st testing, α=0.95 for the test-retest) and good validity (mean Kendall W=0.65). Reliability was assessed using Cronbach's alpha. Most items showed good reliability (α >0.70). The Perceived Reality (PR) subscale had high reliability (α=0.90), while the Subjective Importance (SI) subscale reached α=0.93, confirming the appropriateness of all items. However, indicators related to participation in decision-making and midwifery attendance showed poor internal consistency. The mean alpha coefficient in the test-retest further supported good reliability (α=0.65).</p><p><strong>Conclusions: </strong>The Polish version of the QPP-I questionnaire demonstrates good validity and reliability for assessing the quality of perinatal care from the patient's perspective. The questionnaire reflects the Polish perinatal care context while maintaining the original tool's integrity.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"9 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional challenges in acknowledging and battling obstetric violence.","authors":"Alieke De Roon-Immerzeel, Maaike van Rijn, Marieke Smith, Suzanne M Thompson","doi":"10.18332/ejm/202344","DOIUrl":"https://doi.org/10.18332/ejm/202344","url":null,"abstract":"","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"9 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Being touched by death while giving birth to life: A meta-ethnography exploring women's experiences with postpartum hemorrhage.","authors":"Kristine E Allum, Synne Tilly, Bente Dahl","doi":"10.18332/ejm/200615","DOIUrl":"10.18332/ejm/200615","url":null,"abstract":"<p><strong>Introduction: </strong>Postpartum hemorrhage (PPH) is a serious complication following childbirth and the most common cause of maternal mortality globally. Women who survive PPH have an increased risk of enduring long-term physical and psychological consequences. This meta-ethnography aimed to investigate women's experiences of postpartum hemorrhage to develop new insights and understanding of women's needs for care and follow-up after a PPH.</p><p><strong>Methods: </strong>A meta-ethnography was carried out in accordance with Noblit and Hare's seven phases and the eMERGe reporting guidance. Comprehensive literature searches were conducted in MEDLINE, CINAHL, and Maternity and Infant Care, in January 2024. A PRISMA flowchart was used to illustrate the search process and quality assessment was performed according to CASP.</p><p><strong>Results: </strong>Eight studies were included based on specific inclusion criteria. The analysis and synthesis led to the overarching metaphor of 'Being touched by death while giving birth to life' encompassing three main themes. The first theme, 'When death roams by' described women's experiences with PPH as an encounter with death, leading to fear and severe pain. The second theme 'Living on with an emotional scar' indicated how PPH was an experience leaving deep impact in a person. The final theme, 'Healthcare providers as anchors amid the chaos', described that women valued healthcare professionals who demonstrated empathy and good communication skills.</p><p><strong>Conclusions: </strong>Our study emphasizes the importance of healthcare providers, particularly midwives, providing empathetic care to aid women in recovering from postpartum hemorrhage.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"9 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A meta-ethnography exploring parents' experiences of fetal death and the care they received between diagnosis and birth induction.","authors":"Cathrine H Pettersson, Tone H Sand, Bente Dahl","doi":"10.18332/ejm/200614","DOIUrl":"10.18332/ejm/200614","url":null,"abstract":"<p><strong>Introduction: </strong>Being notified that the fetus has died <i>in utero</i> is an extremely challenging situation for parents, involving emotional chaos, shock, and despair. Healthcare professionals also find it challenging to cope with these situations. The purpose of this study was to explore parents' experiences of fetal death and the care they received between diagnosis and birth induction.</p><p><strong>Methods: </strong>We conducted a meta-ethnography in accordance with Noblit and Hare's seven phases and the eMERGe reporting guidance. Literature searches were conducted in CINAHL, MEDLINE, PubMed and PsycInfo in October and November 2022 and updated in August 2024. A PRISMA flowchart was used to illustrate the search process and quality assessment was performed according to CASP.</p><p><strong>Results: </strong>Seven studies were included in the meta-ethnography. 'Realizing the unreal by taking control of the uncontrollable' emerged as an overarching metaphor through a reciprocal translation of the data. The metaphor illustrated four main themes: 1) Falling into the unknown, 2) Needing care during vulnerable times, 3) Communicating the meaningless, and 4) Navigating the terrain. Receiving the diagnosis resulted in feelings of chaos. However, healthcare providers possessing empathetic communication skills helped them to cope with the situation and prepare for birth.</p><p><strong>Conclusions: </strong>Optimal care performance, where communication is central, is a useful strategy for healthcare professionals in their encounters with parents who experience fetal death. Training is vital in order to provide good care and support for parents throughout the process.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"9 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the effects of peanut ball during labor: An updated systematic review and meta-analysis.","authors":"Somayeh Makvandi, Leila Karimi, Mona Larki, Amirhossein Sahebkar","doi":"10.18332/ejm/201345","DOIUrl":"https://doi.org/10.18332/ejm/201345","url":null,"abstract":"<p><strong>Introduction: </strong>Peanut balls, a specific type of positioning aid used during labor, have gained attention for their potential to enhance maternal comfort and facilitate fetal positioning. This meta-analysis aims to evaluate the effect of peanut balls on the duration of the first stage of labor, the rate of cesarean section, and maternal satisfaction.</p><p><strong>Methods: </strong>A comprehensive literature search was carried out employing electronic databases such as PubMed, Web of Science, and the Cochrane Library. The search included articles published from inception to 11 October 2023 with no language restrictions. Randomized controlled trials or quasi-experimental studies were considered for inclusion if they met the following criteria: participants were pregnant women in labor; intervention involved using a peanut ball during labor; and primary outcome included duration of labor, and the rate of cesarean section and maternal satisfaction were secondary outcomes. The risk of bias in the included studies was assessed using the Risk of Bias 2 (RoB2) tool. Results were synthesized using Review Manager software (RevMan version 5.1), employing both fixed-effect and random-effects models as appropriate, and results were presented as risk ratios for dichotomous outcomes and mean differences and standardized mean differences for continuous outcomes. The quality of the evidence was assessed using GRADEpro GDT (Guideline Development Tool).</p><p><strong>Results: </strong>Eight studies including 1352 laboring women met the criteria to be included in the systematic review and meta-analysis. The results of the meta-analysis showed that the women with epidural analgesia who used the peanut ball, experienced a shortened duration of the first stage of labor by 52.98 min, which was statistically significant (p=0.003). Heterogeneity evidence was not found among the included studies (χ²=6.83, p=0.15, I2=41%). It was also shown that the risk ratio of cesarean section in women who used peanut balls during childbirth was significantly lower than the control group (RR=0.74; 95% CI: 0.60-0.91, p=0.0004) (χ²=5.72, p=0.45, I2=0%). Compared to the control group, the women in the peanut ball group were found to have a higher satisfaction level, which was statistically significant (p<0.0001).</p><p><strong>Conclusions: </strong>The peanut birth ball reduces the first stage of labor duration, and lowers cesarean rates in women with epidural analgesia. While effective and non-invasive, the findings are limited by the risk of bias in some included studies.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"9 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in parental stress in mothers and fathers of preterm infants: A prospective study in Poland.","authors":"Barbara Zych, Witold Błaż, Katarzyna Kanadys, Ewa Dmoch-Gajzlerska, Małgorzata Nagórska","doi":"10.18332/ejm/200552","DOIUrl":"10.18332/ejm/200552","url":null,"abstract":"<p><strong>Introduction: </strong>The birth of a premature baby and hospitalization are stressful events for parents. The study aimed to assess the differences in parental stress experienced by parents of preterm infants provided with Kangaroo Mother Care (KMC) during their stay in the hospital.</p><p><strong>Methods: </strong>The cross-sectional study was conducted among 337 randomly chosen parents of hospitalized babies born in Poland in 2016. As research tools, the Personal Information Form (PIF), Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU) and Coping Inventory for Stressful Situations (CISS) were used.</p><p><strong>Results: </strong>The significant association in every subscale of PSS:NICU (p<0.001 vs p=0.003 vs p<0.001) with the overall stress score (p<0.001) were confirmed. The start time of KMC implementation also turned out to be significantly lower in the group of mothers starting KMC at 1 week of the child's life for the overall stress score and subscales and I and III (p=0.024 vs p=0.024; total: p=0.005), while KMC did not affect the PSS:NICU results in the group of mothers and fathers. Parents' dominant stress management strategy was Task-Oriented Coping (p=0.123), but confronting the reality with Avoidance-Oriented Coping was the basis of their adaptation (p=0.591).</p><p><strong>Conclusions: </strong>The parental stress level was higher in mothers than in fathers. Mothers' dominant strategy of coping with stress was Seeking Social Contact, and in fathers Emotion-Oriented Coping.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"9 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of antenatal education on maternal self-efficacy, fear of childbirth, and birth outcomes: A systematic review and meta-analysis.","authors":"Amal Zaman, Hammad A Fadlalmola, Sara E Ibrahem, Fathia H Ismail, Huda H Abedelwahed, Amira M Ali, Nafesa H Abdelgadim, Amna M A Mustafa, Insaf H Ahmed, Nasreldeen M Ahmed, Amna A Eltyeb, Dalia A Gaafar, Soad M Alnassry, Afaf A Adam, Nagat S Yasin, Rasha A Ali, Aida A Fadlalla, Amira E Eltayeb, Amira M Saad","doi":"10.18332/ejm/200747","DOIUrl":"10.18332/ejm/200747","url":null,"abstract":"<p><strong>Introduction: </strong>Antenatal education programs aim to prepare expectant mothers for childbirth and early parenthood. This meta-analysis assessed the impact of these programs on maternal psychological outcomes and birth experiences, focusing on childbirth self-efficacy, fear of childbirth, and maternal and neonatal outcomes, including rates of vaginal delivery, cesarean section, Apgar scores, and birth weight.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Web of Science, SCOPUS, and Cochrane Library until July 2024. Randomized controlled trials (RCTs) comparing antenatal education to standard care were included. Data were synthesized using meta-analysis with standardized mean differences (SMD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes.</p><p><strong>Results: </strong>Forty studies were reviewed, with 31 eligible for meta-analysis. Among 1116 pregnant women, antenatal education significantly increased childbirth self-efficacy (SMD=2.00; 95% CI: 1.06-2.95, p<0.0001) and decreased fear of childbirth (SMD= -1.26; 95% CI: -1.79 - -0.74, p<0.00001). Maternal outcomes showed higher vaginal delivery rates (RR=1.10; 95% CI: 1.04-1.16, p=0.0004) and lower cesarean rates (RR=0.80; 95% CI: 0.70-0.92, p=0.001). No significant differences were found in episiotomy rates, Apgar scores, or birth weight.</p><p><strong>Conclusions: </strong>Antenatal education improves maternal psychological outcomes and promotes vaginal delivery. However, high heterogeneity and potential bias in the studies limit generalizability. More research is needed on long-term impacts and effectiveness in low-resource settings.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"9 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Bristol Breastfeeding Assessment Tool (BBAT): Α systematic review of the psychometric properties of the translated versions.","authors":"Pinelopi Varela, Christina Nanou, Maria Bouroutzoglou, Giannoula Kyrkou, Anna Deltsidou","doi":"10.18332/ejm/201343","DOIUrl":"10.18332/ejm/201343","url":null,"abstract":"<p><strong>Introduction: </strong>The Bristol Breastfeeding Assessment Tool (BBAT) has gained the interest of healthcare professionals involved in breastfeeding. The aim of this systematic review is to assess the psychometrics of the translated versions of the BBAT.</p><p><strong>Methods: </strong>The databases PubMed, Scopus, Science Direct, and DOAJ were used to conduct a search for articles published between 2015 and 2023. The PRISMA guidelines were followed for the conduct and reporting of the review, and the COSMIN checklist was utilized to evaluate the psychometrics of the studies that were retrieved.</p><p><strong>Results: </strong>Of the 117 records initially identified, four studies were included. The analysis of these studies revealed that the scale is available in at least four different languages. The methodological quality of the structural validity reported by three studies was satisfactory. Only two studies provided information on test-retest reliability, while the majority of the studies demonstrated very good quality in terms of internal consistency. All studies examined the construct validity of the BBAT, and the methodological quality produced different outcomes.</p><p><strong>Conclusions: </strong>The methodological quality of the psychometrics of the translated versions of the BBAT provided mixed results. The continuation of the validation of the scale in more languages is recommended.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"9 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing breastfeeding for hospitalized newborns: A narrative review of midwifery-led interventions.","authors":"Kira Madeleine Harting, Dominique Singer, Julia Heiter","doi":"10.18332/ejm/200341","DOIUrl":"10.18332/ejm/200341","url":null,"abstract":"<p><p>Breastmilk is the best source of nutrition for newborns. The World Health Organization recommends exclusive breastfeeding for the first six months of life as it has benefits to mother and child. However, breastfeeding can be challenging. Especially when the newborn is hospitalized, the physical separation of mother and child can make breastfeeding difficult. Hence pre- and post-natal midwife care supporting breastfeeding become more important. The aim of this narrative review is to identify measures taken by midwives in the labor ward, on the postpartum unit and at home that can influence breastfeeding success positively in hospitalized newborns. A literature review was conducted in PubMed and CINAHL and on the website of the European Institute for Breastfeeding and Lactation from April to September 2023. Studies from 2013 to 2023 written in German or English comparing two different measures/groups were considered. Twenty studies were included and five measures, taken by midwives, were identified. Skin-to-skin contact leads to higher (exclusive) breastmilk feeding rates, better sucking behavior and a shorter time to full enteral feeding. Regular breastmilk expression and supervised breastfeeding attempts result in higher breast milk feeding rates. Breastfeeding counselling enables the mothers to access lactation education. Uninterrupted visiting hours lead to higher exclusive breastmilk feeding rates. Midwives play a key role in promoting breastfeeding among hospitalized newborns involving initiating lactation, strengthening the mother-child bond and providing appropriate breastfeeding advice. There is a further need for research, as midwives are rarely involved in studies.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"9 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ukrainian refugee women's experience with maternity care in Norway: A qualitative study.","authors":"Mirjam Lukasse, Fatima Akhmedova, Hanna Oommen","doi":"10.18332/ejm/200613","DOIUrl":"10.18332/ejm/200613","url":null,"abstract":"<p><strong>Introduction: </strong>European countries have recently received many migrants from Ukraine. Women's life experiences and expectations shape their perception of maternity care and childbirth. Our study aimed to explore how newly arrived Ukrainian refugee women experience their maternity care in Norway.</p><p><strong>Methods: </strong>Social media were used to recruit eight women meeting the criteria of being newly arrived Ukrainian refugee women. Semi-structured interviews, three face-to-face and five video-calls, were performed between December 2023 and January 2024. We used Braun and Clarke for thematic analysis.</p><p><strong>Results: </strong>Three main themes were identified: healthcare in country of origin, high-quality care in the new country, and challenges as a refugee. Women reported that in their home country, the cost of maternity care had a significant impact on the quality of care they received with a tendency toward overmedicalization, as access to certain services often depended on payment. Participants described instances of feeling disrespected by healthcare staff in their home country, in contrast to their experiences in Norway. Women reported that in Norway they experienced a high level of professionalism among healthcare staff and a well-functioning healthcare system with good physical conditions. Challenges that the women struggled with were communication and barriers to accessing services.</p><p><strong>Conclusions: </strong>Being treated professionally and with respect played a central role in creating a positive experience and mitigated the negative experiences of problems with communication and navigation in an unfamiliar healthcare system. Future research could investigate the use of written information to aid migrants in understanding the maternity services and some of the vocabulary.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"9 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}