Gesundheitswesen最新文献

{"title":"Perspektiven, Handlungsstrategien und Lösungsansätze für eine klimaresiliente und treibhausgasarme Gesundheitsversorgung.","authors":"Fabian Baum, Katharina van Baal, Jobst Augustin, Heike van de Sand, Klara Lorenz-Dant, Christina Lindemann, Dorothea Baltruks, Christa Büker, Johannes Deutschbein, Karin Geffert, Holger Gothe, Alina Herrmann, Claudia Hornberg, Claudia Konnopka, Anna Kuehne, Esther Luhmann, Maria-Inti Metzendorf, Ingo Meyer, Andreas Meyer-Lindenberg, Jochen Schmitt, Miriam Steinmann, Petra Thürmann, Jennyfer Wolf, Patrick Ziech, Annika Ziegler, Martin Härter, Ivonne Panchyrz","doi":"10.1055/a-2872-4388","DOIUrl":"10.1055/a-2872-4388","url":null,"abstract":"<p><strong>Abstract: </strong>The impact of climate change on human health, healthcare, and health systems constitute one of the most pressing challenges of our time. In response, this position paper outlines perspectives, strategic approaches, and potential solutions aimed at fostering a climate-resilient and low-carbon healthcare sector. It was developed in collaboration with representatives from scientific societies, working groups, professional associations, and institutions with a dedicated expertise on the topic and was the subject of extensive interdisciplinary dialogue. This position paper reflects the outcome of a broad consensus-building process involving stakeholders from diverse academic and professional backgrounds. While it does not claim to be exhaustive, it represents the current state of discussions. The paper addresses six central topics: (1) Transformative research, (2) Research funding and research networking, (3) Data access and linkage, (4) Education and information opportunities, (5) Prevention, mitigation, and adaptation, as well as (6) Sustainability and climate neutrality in the health and research sector. The position paper advocates for intensified collaboration, courage and willingness to make decisions on the part of the scientific community, policymakers, and civil society to develop a future-proof and resilient healthcare system capable of withstanding the multifaceted challenges posed by climate change. This position paper is intended as a foundation for ongoing discourse and the development of concrete policy and practice-oriented strategies to enhance climate resilience and sustainability in health systems over the long term.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Who benefits from dental health care research in Germany? - A scoping review of routine and secondary data analysis of dental billing data in Germany].","authors":"Dustin Fornefeld, Oliver Fricke, Andreas G Schulte, Enno Swart, Patrick Brzoska, Peter Schmidt","doi":"10.1055/a-2876-6533","DOIUrl":"10.1055/a-2876-6533","url":null,"abstract":"<p><strong>Background: </strong>Oral diseases are among the most common health problems worldwide, and they are heavily influenced by social inequalities. Routine and secondary dental data can provide valuable insights into care provision and help identify gaps in care and risk factors. This work aims to analyze the current state of routine and secondary data use in the field, highlight research gaps, and develop implications.</p><p><strong>Method: </strong>This scoping review was conducted according to the method developed by Arksey and O'Malley, which was partially refined by Levac, Colquhoun, and O'Brien. Several databases were searched, including PubMed/MEDLINE, SCOPUS, and PubPsych. A total of 5,823 articles were identified, and 38 publications met the inclusion criteria. Three experienced reviewers evaluated the studies using criterion-guided codebooks.</p><p><strong>Results: </strong>Most publications (n=29; 76.3%) are international and were published within the last ten years (n=33; 86.8%). Most publications (n=34; 89.5%) focused on a single data source. Only four publications linked different data sets (data linkage). Most publications (n=15; 39.5%) dealt with cost-benefit analyses and economic aspects. Thirteen publications used routine and secondary data to describe utilization behavior and specific risk factors of vulnerable groups, with four focusing on children and adolescents.</p><p><strong>Discussion: </strong>Routine and secondary data analyses in dentistry offer great potential for identifying gaps in care, pinpointing specific needs, and determining risk factors. There appears to be a three-way division in the content-related objectives of routine and secondary data analysis in dentistry: 1) clinical questions, 2) economic efficiency, and 3) description or identification of vulnerable groups. The latter focuses on people with comorbid somatic diseases, older adults, people with disabilities, and children and adolescents in international discourse. To improve dental care, routine and secondary dental data in Germany must be made more accessible and usable.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guiding Principles for Co-Creation and Collective Learning in Living Labs: Insights from Designing Physical Activity Interventions.","authors":"Kathrina Dankl, Markus Garschall, Diotima Bertel","doi":"10.1055/a-2885-5093","DOIUrl":"10.1055/a-2885-5093","url":null,"abstract":"<p><strong>Abstract: </strong>The KliMate project used the co-creative living lab approach to develop a multimodal intervention that supports older adults in achieving international physical activity recommendations while considering personal and climate-related factors. Participants were involved in the co-design of an App and analogue exercise formats. Based on the project's iterative cycles, this study shows how co-creation and collective learning influenced each other. Guiding principles - such as regular exchange within the consortium, concrete proposals as a basis for co-creation, flexible co-creation methods, and the transformation of open questions into new learning challenges - underline the value of methodological openness in future living labs. The central finding and main contribution to the existing literature is the importance of concrete proposals as triggers for critique, rejection, and iterative development.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Workload Caused by Prescription Drug Shortages in General Practices in Germany: Results of a Cross-Sectional Study with Medical Assistants].","authors":"Susanne Kersten, Stephanie Klosterhalfen, Achim Mortsiefer, Christine Kersting","doi":"10.1055/a-2886-2966","DOIUrl":"https://doi.org/10.1055/a-2886-2966","url":null,"abstract":"<p><strong>Background: </strong>Since 2020, medication supply shortages have been a growing problem for patients, pharmacies and everyday working life in GP practices. This study investigates the resulting workload and the impact on the stress perception of medical assistants (MA) in German GP practices.</p><p><strong>Methods: </strong>In a participatory cross-sectional study, requests for unavailable prescription drugs were documented in 30 GP practices. Preparation, processing time, new consultation with a doctor and perceived stress.</p><p><strong>Methods: </strong>were recorded. The surveys took place for one week each in November 2023 and April 2024. In addition, a participatory process analysis was conducted, the contents of which had previously been developed together with MAs in a preparatory workshop. This formed the basis for a subsequent health economic model calculation.</p><p><strong>Results: </strong>Of the 61 participating MAs (all female, average age 42.7 years), 162 requests about drug supply shortages were documented. These mainly concerned antibiotics, diabetes, asthma and cardiovascular drugs. 49.3% of requests took more than five minutes to process, 65.8% required consultation with the responsible doctors and 4.3% of requests remained unresolved. Around half of the MAs (53.6%) perceived requests regarding unavailable medicines as more stressful compared with other requests in routine daily practice. 60% of the medical assistants felt sufficiently informed to process the requests. The process analysis revealed a theoretical minimum processing time of 9 minutes per request. With a shortage rate of 1.2%, this results in an additional time expenditure of 1 hour and 35 minutes per quarter and practice.</p><p><strong>Conclusion: </strong>More than half of the requests lead to a relevant workload, as they take more than five minutes to process, require consultation with doctors or represent an increased stress load. The results make it clear that medication supply shortages not only affect patients, but also result in a considerable additional workload for service providers, especially for medical assistants in GP practices.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Evaluation of a Model Project for the Medical Care of People without Health Insurance in Bremen].","authors":"Lena-Katharina Oeltjen, Laila Göbberd, Sibylle Gerstl, Marianne Schaaf, Ansgar Gerhardus","doi":"10.1055/a-2833-6480","DOIUrl":"https://doi.org/10.1055/a-2833-6480","url":null,"abstract":"<p><strong>Background: </strong>It is estimated that between 0.5 million and 1 million people live without health insurance in Germany. Medical care provided by municipalities, charitable organizations, or voluntary services is very limited in scope. To improve healthcare access for these people, the federal state of Bremen established a counseling and treatment center as part of a pilot project (MVP) in 2022. It offers low-threshold medical consultations and care on-site through a supporting association, counseling on potential (re)integration into health insurance entitlement (\"clearing\"), and the issuance of treatment vouchers for care within the regular healthcare system. The aims of the project evaluation were to analyze healthcare and cost data as well as the perspectives of stakeholders and users.</p><p><strong>Methods: </strong>Healthcare data were collected by the MVP and cost data additionally by the Gesundheit Nord Bremen hospital network. Interviews were conducted with five MVP staff members, eight billing healthcare providers, three users, and eight employees of organizations supporting these populations. Billing healthcare providers were also addressed in an online survey. Quantitative data were analyzed descriptively, qualitative data by content analysis.</p><p><strong>Results: </strong>Between July 1, 2022, and December 31, 2023, a total of 971 individuals from 76 countries utilized the MVP services. A total of 91.2% of users participated in at least one clearing consultation; for 142 (16%) of them, there was insurance coverage, and for another 168 (19%), insurance coverage was established. In total, 2,933 treatment vouchers were issued. Overall, €1,327,679 were spent, of which 52% was for inpatient and 10.5% for outpatient treatments. Interview and survey results showed high satisfaction with access to and quality of care. Particularly highlighted were improvements in specialist treatment and the reduction of financial barriers for those involved. Challenges identified included limited staffing capacity, uncertain financial security of the project, restricted geographical accessibility, and language barriers.</p><p><strong>Conclusions: </strong>The model project led to a significant improvement in healthcare provision for uninsured individuals. Limitations included restricted resources and high inpatient costs. However, it remains unclear how many people in need did not utilize the service. A temporal and geographical expansion of the model project is recommended.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Gender differences in the willingness to transition to interprofessional general practice teams].","authors":"Michaela Trompke, Katharina Zeiser, Lisa Schumacher, Dominik Weissenburger, Marco Roos","doi":"10.1055/a-2854-0128","DOIUrl":"10.1055/a-2854-0128","url":null,"abstract":"<p><strong>Introduction: </strong>Interprofessional team practices are seen as a solution to the current problems in general practice care. As a high proportion of general practitioners (GPs) in future will be female, it is important to analyse the expectations and needs of women in general practice. The study aims to investigate the extent to which the genders differ in terms of their willingness to transform into a team practice.</p><p><strong>Methods: </strong>Through qualitative focus groups and individual interviews, opportunities for and barriers to the implementation of team practice concepts among Bavarian GPs were identified and analysed using the framework method, with a focus on gender-specific differences. The findings were then expanded with the help of a quantitative online survey aimed at all GPs in Bavaria.</p><p><strong>Results: </strong>Bavarian GPs (n=37) participated in the qualitative interviews and n=336 in the quantitative survey. Regardless of gender, there was a high level of willingness to transform to interprofessional collaboration. Male GPs were more likely than female GPs to want to take over the overall management of a team practice. However, women considered joint team decisions and social circumstances within the team to be more important than men.</p><p><strong>Conclusion: </strong>The gender-specific presentation of opportunities for GPs and the barriers to their joining interprofessional teams can support realization projects for testing. For example, pilot projects with female doctors should focus on social circumstances and appreciation within the work team. An expansion of quality management and personnel management competencies should be considered for projects with male doctors.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical Crisis Intervention and Psychosocial Support in Somatic Clinics in Germany - Results of a Nation-Wide Cross-Sectional Study].","authors":"Hanna Batzoni, Markus Witzmann","doi":"10.1055/a-2872-3200","DOIUrl":"https://doi.org/10.1055/a-2872-3200","url":null,"abstract":"<p><strong>Background: </strong>In everyday care at somatic clinics, patients, their relatives and staff can be confronted with potentially traumatic crisis situations. Although there are established standards for psychosocial emergency care (PSNV) in pre-hospital and non-hospital settings, no comparable system exists within hospitals.</p><p><strong>Problem: </strong>Clinical crisis intervention (KKI) and psychosocial support (PSU) are currently in the early stages of professionalisation. Support services vary in terms of their focus, target group specificity and internal implementation. The different terminology poses an additional challenge.</p><p><strong>Objective: </strong>This study is the first to examine the structures of CCI and PSU in German hospitals providing somatic care across all specialist departments. Availability, struc-tural characteristics, satisfaction and implementation barriers were analysed, among other things.</p><p><strong>Methodology: </strong>A nationwide, multicentre, cross-sectional study of an exploratory nature was conducted using a standardised online survey (Lime Survey; June-July 2025).</p><p><strong>Results: </strong>Following systematic data cleansing, 94 evaluable datasets from 13 federal states remained (net response rate: 9.2%). 78.7% of hospitals offer support services. 70.3% of these provide services for all three target groups: patients, relatives and friends, and employees. The team composition is predominantly interdisciplinary. The estimated need for employee-specific services is lower than for patients (47.5% vs. 64.6%) and relatives and family members (47.5% vs. 66.7%). Barriers to implementation cited included financial resources, staff shortages, and a lack of refinancing options.</p><p><strong>Limitations: </strong>The response rate and regional distribution limit the generalisability of the findings. Access to the field was difficult due to a lack of systematisation and heterogeneous organisational structures. No formal validity or reliability testing was carried out; however, the questionnaire was optimised iteratively through pre-tests.</p><p><strong>Conclusion: </strong>The study shows considerable heterogeneity in existing CCI and PSU structures. Action is needed to establish binding definitions, quality standards and sustainable financing models.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[School accidents revisited - A comparison oft wo five-year periods].","authors":"Tim A Cebulla, Christian Heiß, Ralf Kraus","doi":"10.1055/a-2871-9822","DOIUrl":"https://doi.org/10.1055/a-2871-9822","url":null,"abstract":"<p><strong>Introduction: </strong>Children and adolescents spend up to 50% of their waking day attending school, during which they may have accidents and sustain injuries. Therefore, in 1971, the DGUV (German Statutory Accident Insurance) established the pupils insurance. The aim of the study was, for the first time, to analyse changes in the frequency and severity of accidents related to school attendance over a period of more than 20 years.</p><p><strong>Material and methods: </strong>Retrospectively, based on the medical records of a German University Hospital, all school accidents from a five-year period from 1/2019 to 12/2023 and their causes, extent of injury and treatment effort were recorded and processed using descriptive statistics. For comparison, nearly identical data from the same Hospital from period 7/1999 to 6/2004 were available.</p><p><strong>Results: </strong>A total of 3031 school accidents were identified (comparison period: 1399). The average age was 10.7 years (11.8). While sports were the most frequent cause of accidents in the first study period, in the second period it was breaks and leisure activities (p<0.001). The distribution of injuries across body regions was roughly the same. The proportion of treatments requiring anaesthesia decreased from 16.4% to 5.1% (p<0.001).</p><p><strong>Conclusion: </strong>Overall, the number of children and adolescents treated after a school accident increased significantly between the two periods. Minor injuries predominated. The causes can only be speculated upon so far. Numerically alone, however, the increase represents a considerable personnel and logistical challenge for the statutory accident insurance system. Our data can help to expand capacities in a targeted and needs-based manner. Furthermore, the focus of injury prevention in schools can potentially be adjusted.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptation to Climate Change and Climate Protection in Geriatric Care for Older People: Strategies, Infrastructure, and Good Practice Examples.","authors":"Thomas E Dorner, Andrea E Schmidt, Matei Capatu, Anita Sackl, Sophia Spagl, Ruperta Lichtenecker, Hans-Peter Hutter","doi":"10.1055/a-2886-3229","DOIUrl":"https://doi.org/10.1055/a-2886-3229","url":null,"abstract":"<p><strong>Abstract: </strong>Anthropogenic climate change presents significant health challenges for older people with care needs across all care settings, from private homes and supported living arrangements to institutional care facilities. Those particularly at risk include individuals with limited mobility, multimorbidity, or social isolation. Care and support systems therefore need to implement measures for both climate change mitigation and adaptation. Mitigation encompasses reducing energy and water consumption, minimising waste, decreasing reliance on fossil fuels, managing chemicals, and strengthening political and regulatory cooperation. Adaptation involves capacity building, technological innovation, financial management, education and research, monitoring and evaluation, as well as institutional and social support. The effectiveness of structural, organisational, and social measures, such as thermally resilient buildings, efficient ventilation and cooling systems, emergency power supply, secure water and waste infrastructure, hygiene standards, and community-based support services, is well documented. Good practice examples, including community-based support in home settings, structural and technical modernisation in care facilities, and strategic instruments in procurement and governance, demonstrate that climate-resilient strategies enhance care security, support the prevention of care dependency, improve the quality of life of older people, and simultaneously achieve ecological and economic objectives. Climate mitigation and adaptation are integral components of future-oriented, needs-based care, positioning care facilities and community structures as key levers for sustainable transformation.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"['Pediatric Migrant & Public Health Center Munich' (PMPH Munich): A new Model for Integrated and Comprehensive Tuberculosis Care for Children and Adolescents with a Refugee or Migrant Background].","authors":"Marta Alustiza, Kolahta Asres Ioab, Martin Wächtler, Elisabeth Scarlat, Franz Sollinger, Elisabeth Waldeck, Eva Annette Rehfuess, Ulrich von Both","doi":"10.1055/a-2886-5418","DOIUrl":"10.1055/a-2886-5418","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) represents a growing public health concern in Germany, particularly among children and adolescents with a migration or refugee background. Complex diagnostics and structural barriers to accessing healthcare necessitate migration-sensitive measures.</p><p><strong>Methods: </strong>A retrospective analysis examined data from 31,480 children and adolescents (0-17 years) with a migration or refugee background, collected in Munich between 2015 and 2024 as part of the mandatory TB screening.</p><p><strong>Results: </strong>The number of screenings fluctuated significantly, peaking in 2015 (41%) during the Syrian crisis and reaching a low in 2020 (3%) during the COVID-19 pandemic. A total of 190 active TB cases were diagnosed. To address existing healthcare gaps, the 'Pediatric Migrant & Public Health Center Munich (PMPH Munich)' was developed as a cross-sectoral, interdisciplinary care model that closely links clinical facilities and public health services.</p><p><strong>Conclusion: </strong>PMPH integrates clinical and public health expertise, offering child-friendly diagnostics, psychosocial support, and culturally sensitive care. The aim is to enable early TB detection and treatment in vulnerable populations. An evaluation of the model's effectiveness is currently underway to assess its impact and scalability.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}