Perspectives on Sexual and Reproductive Health最新文献

{"title":"\"It was classed as a nonemergency\": Women's experiences of kidney disease and preconception decision-making, family planning, and parenting in the United Kingdom during COVID-19.","authors":"Leah Mc Laughlin, Jane Noyes, Barbara Neukirchinger, Denitza Williams, Rhiannon Phillips, Sian Griffin","doi":"10.1111/psrh.12256","DOIUrl":"10.1111/psrh.12256","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the experiences of women with kidney disease, residing in the United Kingdom (UK), living through the first 18 months of the COVID-19 pandemic with specific focus on preconception decision-making, family planning, and parenting.</p><p><strong>Methods: </strong>We conducted a mixed-methods study, comprising an online survey and follow-up interviews, with UK-resident women aged 18-50.</p><p><strong>Results: </strong>We received 431 surveys and conducted 30 interviews. Half (n = 221, 51%) of the survey respondents considered that COVID-19 influenced the quality of communication with healthcare professionals and 68% (n = 295) felt that the pandemic disrupted their support networks. Interview participants indicated that delayed and canceled appointments caused anxiety, grief, and loss of pregnancy options. Women's perception of themselves as (good) mothers as well as their capacity to have and raise a child, meet partners, and sustain healthy relationships was negatively affected by the \"clinically extremely vulnerable\" label. Women's trust in their healthcare was dismantled by miscommunication and variation in lockdown rules that caused confusion and increased worry. Women reported that COVID-19 contributed to postnatal depression, excessive concern over infant mortality, preoccupation over others following rules, and catastrophising.</p><p><strong>Conclusion: </strong>Some women in the UK with chronic kidney disease lost or missed their opportunity to have children during the pandemic. Future pandemic planners need to look more holistically and longer term at what is and is not classed as an emergency, both in how services are reconfigured and how people with chronic conditions are identified, communicated with, and treated.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132894","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":"Neighborhood-level racialized socioeconomic deprivation and contraceptive use in the United States, 2011-2019.","authors":"Alice F Cartwright, Maeve Wallace, Jessica Su, Siân Curtis, Gustavo Angeles, Ilene S Speizer","doi":"10.1111/psrh.12269","DOIUrl":"10.1111/psrh.12269","url":null,"abstract":"<p><strong>Introduction: </strong>The social and structural environments where people live are understudied in contraceptive research. We assessed if neighborhood measures of racialized socioeconomic deprivation are associated with contraceptive use in the United States.</p><p><strong>Methods: </strong>We used restricted geographic data from four waves of the National Survey of Family Growth (2011-2019) limited to non-pregnant women ages 15-44 who had sex in the last 12 months. We characterized respondent neighborhoods (census tracts) with the Index of Concentration at the Extremes (ICE), a measure of spatial social polarization, into areas of concentrated privilege (predominantly white residents living on high incomes) and deprivation (predominantly people of color living on low incomes). We used multivariable binary and multinomial logistic regression with year fixed effects to estimate adjusted associations between ICE tertile and contraceptive use and method type. We also assessed for an interactive effect of ICE and health insurance type.</p><p><strong>Results: </strong>Of the 14,396 respondents, 88.4% in neighborhoods of concentrated deprivation used any contraception, compared to 92.7% in the most privileged neighborhoods. In adjusted models, the predicted probability of using any contraception in neighborhoods of concentrated deprivation was 2.8 percentage points lower than in neighborhoods of concentrated privilege, 5.0 percentage points higher for barrier/coital dependent methods, and 4.3 percentage points lower for short-acting methods. Those with Medicaid were less likely to use any contraception than those with private insurance irrespective of neighborhood classification.</p><p><strong>Conclusions: </strong>This study highlights the salience of structural factors for contraceptive use and the need for continued examination of structural oppressions to inform health policy.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11260244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297029","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":"Increasing access to LARC removal in pediatrics to support adolescent reproductive justice in the United States.","authors":"Joline S Hartheimer, Bianca A Allison, Martha F Perry","doi":"10.1111/psrh.12270","DOIUrl":"10.1111/psrh.12270","url":null,"abstract":"<p><strong>Background: </strong>In the United States (U.S.), adolescents and young adults are increasingly using contraception, including long-acting reversible contraception (LARC) [e.g., subdermal implants (e.g., Nexplanon®) and intrauterine devices (IUDs)]; however, access to LARC device removal may be difficult for adolescents and young adults. Reproductive justice is the right to bodily autonomy, have children, not have children, and safely parent the children we have.</p><p><strong>Methods: </strong>In this commentary, we discuss that while the specialties of family medicine and obstetrics and gynecology have incorporated the principles of reproductive justice into their contraceptive care, further work is needed to ingrain this philosophy into pediatrics training. Since LARC devices are historically only removable by health care providers, pediatricians may act as gatekeepers to removing LARC, obstructing the reproductive justice of adolescents and young adults.</p><p><strong>Results: </strong>We describe that adolescents and young adults in the U.S. face unique barriers to LARC removal including limited access to the health care system, potential breaches in confidentiality, and provider bias. These barriers may lead adolescents and young adults to remove their own LARC device when experiencing unwanted side effects or desiring pregnancy. While IUD self-removal is a safe and accessible option, safety and efficacy data on subdermal implant self-removal is currently limited.</p><p><strong>Conclusion: </strong>In order to promote reproductive justice in adolescents and young adults, we recommend that (1) pediatricians should address potential barriers to LARC removal prior to insertion, (2) pediatricians must offer unbiased LARC removal, (3) pediatricians who place LARC must be knowledgeable about complicated LARC removal, and (4) pediatricians should discuss LARC self-removal options with adolescents and young adults.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263083","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":"Assessing perspectives on an intervention connecting adolescents in outpatient psychiatry care to contraceptive counseling in the United States.","authors":"Abigail L Underwood, Kathryn A Hyzak, Ashley Ebersole, Alicia C Bunger, Elise D Berlan","doi":"10.1111/psrh.12261","DOIUrl":"10.1111/psrh.12261","url":null,"abstract":"<p><strong>Background: </strong>Adolescents with psychiatric disorders have high rates of unintended pregnancy and experience barriers to accessing sexual and reproductive health (SRH) care. Outpatient psychiatry visits are potential opportunities to connect adolescents to SRH care. This study informs the development of the Link2BC intervention which links adolescents in outpatient psychiatry care to SRH care.</p><p><strong>Methods: </strong>We conducted group interviews with adolescents (3 groups, 7 total participants) and caregivers (3 groups, 9 total participants) and individual interviews with 8 psychiatry providers who received or provided outpatient psychiatric treatment in clinics in a pediatric hospital in a city in the Midwestern United States. We asked questions about the acceptability of Link2BC, potential implementation needs, and implementation determinants. Using consensus-building techniques, two coders analyzed transcriptions using a codebook informed by the Consolidated Framework for Implementation Research 2.0.</p><p><strong>Results: </strong>Participants agreed on the need for interventions that expand access to SRH care. Adolescents emphasized that services should be confidential and accessible and were open to their psychiatrists introducing SRH topics during appointments. Providers expressed preference for training and clear workflows. Participants agreed that psychiatry providers could serve as liaisons between adolescents and their caregivers to facilitate conversations about contraception. Participants had concerns about time constraints during visits but mentioned few other barriers to the intervention.</p><p><strong>Conclusion: </strong>This study demonstrates the acceptability of connecting adolescents in outpatient psychiatry care to contraceptive counseling and informs the refinement and implementation of Link2BC. Integrating contraception counseling in outpatient psychiatry settings is an innovative approach to prevent unintended pregnancy among adolescents by increasing access to SRH care services.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307395","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":"High variability in self-pay pricing for vasectomy and vasectomy reversal in the United States.","authors":"Aaron Brant, Patrick Lewicki, Alec Zhu, Stephen Rhodes, Camilo Arenas-Gallo, Jonathan E Shoag, Peter N Schlegel, Joshua Halpern","doi":"10.1111/psrh.12266","DOIUrl":"10.1111/psrh.12266","url":null,"abstract":"<p><strong>Context: </strong>In the United States (US) men who undergo vasectomy and/or vasectomy reversal (vasovasotomy) are likely to pay out-of-pocket for these procedures. We characterized the publicly disclosed pricing of both procedures with a focus on variability in self-pay prices.</p><p><strong>Methods: </strong>We queried all US hospitals for publicly disclosed prices of vasectomy and vasovasotomy. We assessed interhospital variability in self-pay pricing and compared hospitals charging high (≥75th percentile) and low (≤25th percentile) self-pay prices for either procedure. We also examined trends in pricing after the 2022 US Supreme Court decision that allowed individual states to ban abortion.</p><p><strong>Results: </strong>Of 6692 hospitals, 1375 (20.5%) and 281 (4.2%) disclosed self-pay prices for vasectomy and vasovasotomy, respectively. There was a 17-fold difference between the 10th and 90th percentile self-pay prices for vasectomy ($421-$7147) and a 39-fold difference for vasovasotomy ($446-$17,249). Compared with hospitals charging low (≤25th percentile) self-pay prices for vasectomy or vasovasotomy, hospitals charging high (≥75th percentile) prices were larger (median 150 vs. 59 beds, p < 0.001) and more likely to be for-profit (31.2% vs. 7.8%, p < 0.001), academic-affiliated (52.7% vs. 23.1%, p < 0.001), and located in an urban zip code (70.1% vs. 41.3%, p < 0.001). From October 2022 to April 2023, the median self-pay price of vasectomy increased by 10% (from $1667 to $1832) while the median self-pay price of vasovasotomy decreased by 16% (from $3309 to $2786).</p><p><strong>Conclusion: </strong>We found large variability in self-pay pricing for vasectomy and vasectomy reversal, which may serve as a barrier to the accessibility of male reproductive care.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088879","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":"Brief of Amici Curiae economists in support of respondents in Dobbs v. Jackson Women's Health Organization.","authors":"Caitlin Myers, Anjali Srinivasan","doi":"10.1111/psrh.12268","DOIUrl":"https://doi.org/10.1111/psrh.12268","url":null,"abstract":"<p><p>A pillar of Mississippi's argument in Dobbs v. Jackson Women's Health was that there is no evidence of \"societal reliance\" on abortion, meaning no reason to believe that access to abortion impacts the ability of women to participate in the economic and social life of the nation. Led by economist Caitlin Myers and attorney Anjali Srinivasan, more than 150 economists filed an amicus brief seeking to assist the Court in understanding that this assertion is erroneous. The economists describe developments in causal inference methodologies over the last three decades, and the ways in which these tools have been used to isolate the measure of the effects of abortion legalization in the 1970s and of abortion policies and access over the ensuing decades. The economists argue that there is a substantial body of well-developed and credible research that shows that abortion access has had and continues to have a significant effect on birth rates as well as broad downstream social and economic effects, including on women's educational attainment and job opportunities. What follows is a reprint of this brief.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923182","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":"Research in brief: How prevalent is rough sex? Results from a national online sample of adults in Germany","authors":"Nicola Döring, M. Rohangis Mohseni, Laura Pietras, Arne Dekker, Peer Briken","doi":"10.1111/psrh.12267","DOIUrl":"https://doi.org/10.1111/psrh.12267","url":null,"abstract":"BackgroundRough sex refers to consensual sexual activities that incorporate playful aggression, such as hair pulling, spanking, or choking. It is relevant in the context of sexual health as it can enhance sexual arousal, pleasure, and intimacy among consenting partners. However, it can also be associated with consent violations, discomfort, and injuries ranging from mild to severe or even fatal. The prevalence of rough sex in Germany is widely unknown. Our study aims to establish, for the first time, the overall age‐related and gender‐related prevalence rates of active and passive rough sex involvement among adults in Germany.MethodsA national online sample of 1101 adults from Germany, aged 18–69 years (50% men, 49% women, 1% gender‐diverse individuals) gave informed consent and reported on their lifetime engagement in rough sex in active and passive roles. We recruited participants through a professional panel provider for a multi‐themed sexual health survey. Data analysis was conducted using R, with 95% confidence intervals of prevalence rates computed to answer the research questions.ResultsLifetime prevalence of rough sex involvement was 29%. Adults below the age of 40 reported higher rates of involvement (up to 43%) than people over 40 (up to 26%). Men reported predominantly active role involvement and women reported primarily passive role involvement.DiscussionResults show that rough sex is common. Sexual health professionals, educators, and researchers should be prepared to guide current and aspiring practitioners of rough sex, helping them understand potential benefits, risks, and age‐ and gender‐related differences.","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140826651","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":"Experiences with and unmet needs for medication abortion support: A qualitative study with US abortion support providers.","authors":"Jane W. Seymour, S. Ruggiero, Lynsie R. Ranker, T. Thompson","doi":"10.1111/psrh.12263","DOIUrl":"https://doi.org/10.1111/psrh.12263","url":null,"abstract":"INTRODUCTION\u0000Quality abortion care must be person-centered. Although academic literature has focused on full-spectrum and abortion doulas supporting instrumentation abortion (also referred to as procedural abortion) clients, clients undergoing medication abortion remain understudied and may have unique needs. We aimed to understand United States (US) abortion support providers' perceptions of medication abortion clients' support needs by exploring which needs they address, which needs remain unmet, and how remote support provision might help address client needs.\u0000\u0000\u0000METHODOLOGY\u0000Between April and October 2018, we conducted 60- to 90-min semi-structured, in-depth interviews by telephone with medication abortion support providers. The interviews focused on their experiences providing support to medication abortion clients in the US. We used a deductive thematic analysis approach.\u0000\u0000\u0000RESULTS\u0000We interviewed 16 abortion support providers affiliated with nine US-based organizations. Six participants provided in-person support to medication abortion clients, five provided remote support, and five provided both remote and in-person support. Both in-person and remote providers described offering support that addressed clients' informational, emotional, physical, spiritual, and logistical needs. Through participant narratives, we identified interwoven benefits and challenges to remote support care provision. Participants highlighted that most medication abortion clients did not have a support provider.\u0000\u0000\u0000DISCUSSION\u0000Participants revealed that abortion support providers, including remote support providers, can be a critical component of high-quality abortion care provision. More work is needed to ensure all abortion clients have access to support services as the abortion landscape in the US continues to evolve.","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140652900","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":"Can someone be both pro-life and pro-choice? Results from a national survey of US adults.","authors":"Kathryn J LaRoche, K. Jozkowski, Brandon L. Crawford, Frederica Jackson","doi":"10.1111/psrh.12262","DOIUrl":"https://doi.org/10.1111/psrh.12262","url":null,"abstract":"\"Pro-life\" and \"pro-choice\" are closely associated with discussions about abortion; we refer to the extent that people identify with these terms as \"abortion identity.\" Most polling measures present pro-life and pro-choice as mutually exclusive options, but there is a dearth of information about people who might simultaneously endorse both (or neither) labels.\u0000\u0000\u0000METHOD\u0000We administered a survey to adults in the United States (n = 580) that included two different formats for participants to select their abortion identity: a categorical item with response options ranging from strongly pro-choice to strongly pro-life (and \"both\" and \"neither\") and two separate items (sliders) that asked people the extent to which they identify with each term. We asked participants endorsing both pro-life and pro-choice to some extent on the slider items to explain their responses in an open-ended item. We used logistic regression to examine the relationship between participants' socio-demographic characteristics and the likelihood of dual identification slider scores; we analyzed open-ended data for content and themes.\u0000\u0000\u0000RESULTS\u0000On the sliders, more than 64% of participants identified as both pro-life and pro-choice to some extent. Variability existed between people's abortion identity on the close-ended items and their response to the open-ended questions. Among those with mixed abortion identities, participants described abortion as a serious and undesirable option but reflected positively on notions of personal choice and bodily autonomy.\u0000\u0000\u0000CONCLUSIONS\u0000Our findings demonstrate complexity in measuring people's endorsement of abortion identity labels. We recommend developing more nuanced and consistent measures to assess abortion attitudes.","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140658390","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":"Medication abortion for adolescents in the United States: Strengthening the role of pediatric primary care providers.","authors":"A. Starosta, Julen Harris, Aileen Gariepy, Shefali Pathy, Julia Cron","doi":"10.1111/psrh.12264","DOIUrl":"https://doi.org/10.1111/psrh.12264","url":null,"abstract":"BACKGROUND\u0000Recent legal changes have led to mounting abortion restrictions in the United States (US), disproportionately impacting adolescents, who already face multifaceted barriers to abortion care. Informed by the framework of reproductive justice, adolescents who become pregnant deserve comprehensive, unbiased, and non-judgmental pregnancy options counseling, inclusive of all choices for pregnancy continuation and termination. Pediatric primary care providers are at the front lines of caring for adolescent patients' reproductive health needs and frequently diagnose pregnancy, provide pregnancy options counseling, and assist patients in accessing abortion care. They are uniquely poised to provide this care given their trusted, ongoing relationships with adolescent patients and their families, and their values of deep respect for adolescents' individuality and autonomy.\u0000\u0000\u0000METHODS\u0000In this commentary, we aim to describe the medical and legal landscape of adolescent abortion access in the US and provide recommendations to support pediatric primary care providers' involvement in abortion care. We focus on medication abortion, as the provision of medication abortion has the potential to encompass a broad group of clinicians, including pediatric primary care providers.\u0000\u0000\u0000RESULTS\u0000We discuss the importance of providing options counseling to adolescents within the reproductive justice framework, improving abortion education for pediatric providers, and expanding access to abortion care by supporting providers at an institutional level if they opt to provide medication abortions.\u0000\u0000\u0000CONCLUSION\u0000In light of the current legal landscape, the role of pediatric primary care providers in ensuring adolescent access to abortion care is ever more critical. Although many pediatric and adolescent providers already provide this important care, we, a team of obstetricians/gynecologists and adolescent medicine physicians, echo prior calls for improved training and institutional support for pediatric providers to counsel about and provide abortion-related care. We hope that highlighting the role of pediatric providers in this sphere will help center the needs of adolescent patients and help them fulfill their family planning goals.","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140654197","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}