Journal of Patient Safety最新文献

{"title":"The TRANS-SAFE Patient Safety Learning Laboratory: A Protocol for Systems Improvement for Psychosocial Safety in Transgender Care.","authors":"Tara N Cohen, Jennifer T Anger, Hanna Barton, Jill Blumenthal, Amanda Gosman, Falisha Kanji, Rai Khamisa, Jejo Koola, Priya Lewis, Maja Marinkovic, Bixby Marino-Kibbee, Maxwell Moore, Kyle Okamuro, Shanaya Sidhu, Victor Trasvina, Florin Vaida, Alan J Card","doi":"10.1097/PTS.0000000000001383","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001383","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to advance patient safety science by identifying and addressing the systemic causes of psychosocial harm among transgender and gender nonbinary (TGNB) individuals. The 4-year TRANS-SAFE patient safety learning laboratory (PSLL) will follow a 6-phase systems engineering approach to study ways to improve the safety of TGNB patients.</p><p><strong>Methods: </strong>This study involves conducting a systematic scoping review, interviews with patients, providers, and community members, and observations of TGNB patient and provider experiences to identify determinants of avoidable patient suffering. In addition, the PSLL will provide financial support for pre-doctorate and post-doctorate research scholars in the TGNB community. Human-centered solutions will be co-designed to mitigate psychosocial harm among TGNB individuals. Interventions will be developed through engagement with stakeholders in an iterative process of co-design and evaluation.</p><p><strong>Results: </strong>Interventions will be evaluated in real and simulated clinical environments for effectiveness, acceptability, usability, feasibility of implementation, and sustainability. A structural innovation of this PSLL is its focus on sustainment and dissemination, which will be facilitated through the development of a TRANS-SAFE certification process for health care organizations in partnership with the World Professional Association for Transgender Health (WPATH).</p><p><strong>Conclusions: </strong>This PSLL will address a fundamental gap in the science and practice of patient safety by assessing and addressing psychosocial patient harm in a high-risk population that has been too often neglected in the patient safety literature.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Harm in Fall Incidents in Hospital Settings With 200 or More Beds in Korea.","authors":"Youngmi Kang, Eunyoung Hong","doi":"10.1097/PTS.0000000000001385","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001385","url":null,"abstract":"<p><strong>Objective: </strong>Falls are a significant patient safety concern in hospital settings, often resulting in unintended harm. This study aimed to investigate the prevalence and risk factors for falls in Korean hospitals with 200 or more beds, analyzing 13,034 incidents reported to the Korean Patient Safety Reporting and Learning System from 2017 to 2021.</p><p><strong>Methods: </strong>The level of harm was classified into 3 categories: near-miss, adverse, and sentinel events. Hospital-related factors (hospital type, bed capacity, and location and time of fall incident) and patient-related factors (sex, age group, and admitting medical department) were included in the analysis. χ2 tests were used to evaluate differences in fall severity, and binary logistic regression identified factors associated with harmful incidents.</p><p><strong>Results: </strong>The study found that harmful falls were more likely to occur in nontertiary hospitals, particularly those with >500 beds, as well as in emergency departments. Furthermore, older female patients and those admitted to the internal medicine department are especially at risk.</p><p><strong>Conclusions: </strong>Based on the results of this study, especially in nontertiary hospitals with >500 beds, comprehensive strategies for preventing falls, including the promotion of patient safety culture, are needed to reduce fall occurrence and its associated disabilities.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing and Comparing Perceptions of Patient Safety Culture Among 4579 Health Care Staff in 13 General and Specialized Hospitals: A Cross-sectional Study.","authors":"Qian Lin, Dan Zhang, Calvin Kalun Or","doi":"10.1097/PTS.0000000000001377","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001377","url":null,"abstract":"<p><strong>Background: </strong>Although general and specialized hospitals have distinct roles and characteristics that can lead to differences in patient safety culture, there is a limited number of studies examining these differences.</p><p><strong>Objectives: </strong>To assess and compare health care staff's perceptions of patient safety culture between general and specialized hospitals.</p><p><strong>Methods: </strong>A cross-sectional questionnaire-based study of 4579 health care staff members, including physicians; nurses; other health care providers; and administrative staff, was conducted at 5 general and 8 specialized public hospitals in a major city in China. The Hospital Survey on Patient Safety Culture questionnaire was used to measure 12 dimensions of patient safety culture. The differences in perception of the 12 dimensions between general and specialized hospitals were analyzed using a χ2 test.</p><p><strong>Results: </strong>In general and specialized hospitals, positive ratings for \"communication openness, overall perceptions of patient safety, teamwork across departments, and handoffs and transitions\" ranged from 50% to 70%. Positive ratings for \"staffing\" and \"nonpunitive response to errors\" were <50%. Positive ratings for 8 of the dimensions analyzed were significantly lower in general hospitals than in specialized hospitals, with differences ranging from 2.23% to 4.4%. Within subgroups of health care staff, the dimensions with significant differences varied across professions. Specifically, among physicians, 9 out of 12 dimensions had lower positive ratings in general hospitals than in specialized hospitals, with differences ranging from 3.84% to 7.23%.</p><p><strong>Conclusions: </strong>General hospitals exhibited a more negative patient safety culture than specialized hospitals and thus require more proactive efforts to enhance their patient safety culture, especially among physicians. Both types of hospitals should urgently address issues related to \"staffing\" and \"nonpunitive response to errors.\"</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Health Care Resilience Through \"Reflexive Spaces\" in Home Care Services: A Multiple Embedded Case Study.","authors":"Camilla Seljemo, Olav Røise, Eline Ree, Siri Wiig","doi":"10.1097/PTS.0000000000001375","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001375","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to explore where and how managers facilitate arenas for collective reflections and knowledge sharing (\"reflexive spaces\") in homecare services during the COVID-19 pandemic. Moreover, we sought to understand how these \"reflexive spaces\" contributed to adaptations to challenges induced by the pandemic. Finally, we aimed to discuss how these spaces might incorporate resilience into health care.</p><p><strong>Methods: </strong>This multiple embedded case study includes interviews with health care staff (n=16) and managers at different system levels (n=21) from 4 Norwegian municipalities. The data were analyzed in accordance with reflexive thematic analysis.</p><p><strong>Findings: </strong>The analysis identified 2 overarching themes: (1) arenas for reflection, communication, and dialogue, and (2) establishing new solutions through collective reflection facilitated by managers. Managers who initiated dialogue and established arenas for reflection and communication were highlighted as important for discussing and sharing knowledge about challenges created by the pandemic. In these spaces, both managers and staff reflected, collaborated, and learned from each other and then designed a tactical and resilient response to the ongoing challenges.</p><p><strong>Conclusions: </strong>Managers had a key role as facilitators for \"reflexive spaces\" within and across levels of responsibilities. Moreover, managers had a mediating role in bridging knowledge and understanding across levels within the health care system. Using \"reflexive spaces\" as part of daily practice appeared as an important measure to balance demands and capacity and respond both to crises and to everyday challenges.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety Outcomes Following Implementation of a Systematic Cataract Surgery Protocol at a Tertiary Referral Eye Center.","authors":"Joshua Ong, Beth K Hansemann, Paul P Lee, Jennifer S Weizer","doi":"10.1097/PTS.0000000000001376","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001376","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the longitudinal safety outcomes of incorrect intraocular lens (IOL) implantation using a standardized cataract surgery operating standard operating procedure (SOP) devised at a tertiary referral eye center. This evaluation represents a critical but underrepresented topic in ophthalmic literature.</p><p><strong>Methods: </strong>This was a quality improvement, retrospective analysis, and description of the Healthcare Failure Mode Effect and Analysis (HFMEA) and resultant SOP implemented in 2018 following incorrect IOL events. Analysis of subsequent safety events following implementation of the SOP and modifications/reassessments performed was analyzed. The main outcome measures were processes identified in the HFMEA and incorrect IOL safety events occurring following implementation of the SOP.</p><p><strong>Results: </strong>The HFMEA identified 170 processes/subprocesses steps, 177 potential failure modes, and 75 potential failure mode causes. Twenty-nine system vulnerabilities were identified through analysis of the failure mode causes. From 2018 to 2023, 8 additional incorrect IOL safety events occurred, which led to subsequent revisions of the SOP.</p><p><strong>Conclusion: </strong>Continuous reassessment of standardized protocols for cataract surgery is critical to ensure patient safety.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Putting Patients at Risk: The Effect of Health Care Provider Burnout on Patient Care in the Operating Room. A Narrative Review.","authors":"Juan Antonio Hueto Madrid, Judith Hargreaves, Beata Buchelt","doi":"10.1097/PTS.0000000000001369","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001369","url":null,"abstract":"<p><strong>Objectives: </strong>This review aimed to explore the prevalence of burnout among health care professionals working in the operating room (OR) and its impact on patient safety and care quality.</p><p><strong>Methods: </strong>A focused narrative review was conducted, utilizing PubMed, CINAHL, Semantic Scholar, WorldCat, Cochrane Library, and clinical trials registries. Full-text primary literature published in English between 2018 and 2024 was included. Studies specifically addressing burnout in the OR and its effects on patient safety and care quality were selected. Data extraction included prevalence rates, stress factors, and impacts on patient outcomes.</p><p><strong>Results: </strong>Burnout was found to be highly prevalent among OR health care professionals, particularly affecting surgeons, anesthesiologists, and OR nurses. Reported prevalence rates ranged from 10% to 83%, with the highest levels occurring during the COVID-19 pandemic. Burnout was linked to critical aspects of health care quality and safety, primarily through communication breakdowns and operational inefficiencies. Impaired communication contributed to safety incidents, while disruptions in OR scheduling and increased turnover times further exacerbated workflow challenges. Although studies directly connecting burnout to patient safety events were limited, burnout was consistently associated with poor decision-making, weakened teamwork, and higher staff turnover-factors that collectively undermine patient outcomes.</p><p><strong>Conclusions: </strong>Burnout among OR health care professionals poses a significant threat to both staff well-being and patient safety, a challenge that was further intensified by the COVID-19 pandemic. Addressing burnout requires a multifaceted approach, including enhanced training, workload optimization, and robust support systems. Implementing comprehensive, context-specific interventions can improve staff resilience and patient safety.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of a Systems Theory-Based Accident Analysis Technique to Perioperative Safety Reports From the COVID-19 Pandemic.","authors":"Aubrey L Samost-Williams, Robert D Sinyard, Leo L Tabayoyong, Joseph R Fogarty, Rebecca D Minehart, Karen C Nanji","doi":"10.1097/PTS.0000000000001372","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001372","url":null,"abstract":"<p><strong>Objectives: </strong>Nonlinear retrospective analytic techniques can allow for in-depth understanding of accidents and their causes, yet they are infrequently used in health care. The purpose of this study was to provide an example, using Causal Analysis based on Systems Theory (CAST) together with an inductive thematic analysis to understand the contextual factors contributing to one hospital's perioperative safety events.</p><p><strong>Methods: </strong>We created a hierarchical control structure of the hospital's perioperative system with input from a multidisciplinary group. We then analyzed safety events that were self-reported during a COVID surge (April 2020) using CAST to understand their contributing factors. Next, we analyzed the contributing factors using inductive qualitative thematic coding to identify system-level safety risks. We mapped each system-level safety risk to a recommendation for future mitigation.</p><p><strong>Results: </strong>We screened 122 safety reports and found 19 safety events that met inclusion criteria. The analysis revealed 245 contributing factors represented by 22 subthemes corresponding to 3 major themes: (1) vulnerable processes, being problems with workflows or communication channels; (2) personnel challenges including challenges with staff redeployment as well as cognitive and behavioural challenges; and (3) poorly designed or unavailable equipment. Each subtheme corresponded to a prevention strategy, such as creation of a central protocol hub.</p><p><strong>Conclusions: </strong>Using a nonlinear accident analysis technique together with thematic analysis, we were able to identify system-wide contributing factors to safety events. These contributing factors led to recommendations for future pandemics or crises characterized by scarce resources, limited data, and a rapidly changing environment.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying and Mitigating Latent Safety Threats in Neonatal Resuscitation Rooms Across Nine Hospitals Through In Situ Simulation Training.","authors":"Jens-Christian Schwindt, Reinhold Stockenhuber, Sybille Haider, Bertram Schadler, Eva Schwindt","doi":"10.1097/PTS.0000000000001373","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001373","url":null,"abstract":"<p><strong>Introduction: </strong>To ensure effective care in rare events such as neonatal resuscitation, high levels of system safety and error management are essential. It is thus imperative to mitigate avoidable errors and latent safety threats (LSTs). This study examined the use of safety reports (SR) from 3-day interdisciplinary, high-fidelity neonatal in situ simulation trainings (SIMs) to classify LSTs and assess their recurrence or resolution across successive SIMs.</p><p><strong>Methods: </strong>We retrospectively screened the SR of 9 Austrian hospitals for LSTs and grouped the identified LSTs into 3 main categories: (1) equipment, environment, and ergonomics (EEE); (2) knowledge, skills and training (KST); and (3) systems, pathways, and resources (SPR). The LSTs from consecutive SR were compared for each hospital.</p><p><strong>Results: </strong>A large number of LSTs were identified: 271 in 9 initial reports (SR1) and 129 in the 9 follow-ups (SR2). Comparing SR2 with SR1, fewer LSTs were reported in all 3 categories in all 9 hospitals (ranging from -37% to -79%). We detected fewer than half of the number of LSTs in SR2 for EEE (-62%). LSTs in KST were almost halved in SR2 (-45%), and marginally changed in SPR (-10%). A third SR (SR3) obtained in 4 hospitals indicated a further reduction in overall LSTs (-21% to -60%).</p><p><strong>Conclusion: </strong>This study shows that SIMs effectively reduce LSTs in neonatal care, with SR highlighting significant improvements, particularly in equipment-related issues. SIMs prove to be a valuable tool for enhancing safety and driving continuous improvement in neonatal care settings.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Structured Morbidity and Mortality (M&M) Meetings on Clinician Engagement and Patient Safety Culture.","authors":"Emily Steel, Kylie Sellwood, Monika Janda","doi":"10.1097/PTS.0000000000001370","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001370","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the range of experiences and opinions of people participating in morbidity and mortality (M&M) meetings at a public health service, and the perceived effects of a structured approach to the meetings on clinician engagement and patient safety culture.</p><p><strong>Methods: </strong>Semistructured interviews and focus groups were conducted with 13 participants from a large public health service (14,000 staff) in Australia. A semistructured interview guide was used to explore the experiences and opinions of committee chairs and M&M meeting members. Thematic analysis was used to identify key themes from transcripts.</p><p><strong>Results: </strong>Five themes were identified: (1) purpose, (2) attendance, (3) formality, (4) case selection and review, and (5) leadership and culture. Within these 5 themes, clear differences emerged in experiences between chairs and members and between individual participants. Factors associated with variation in experiences and opinions of participants included the nature and extent of their individual, previous, and current involvement in M&Ms and with the state of development of their local M&M meeting's purpose, leadership, and governance.</p><p><strong>Conclusions: </strong>A high level of maturity is required for M&M meetings to meet the diverse and competing needs of clinicians and health services. Structural elements such as a meeting agenda and register of recommended actions may assist junior staff and/or staff who do not attend regularly. Reflective and respectful leaders can foster psychological safety for members. Organisations can support their staff with the administration and communications for M&M meetings and help to share the learnings across departments and hospitals through clinical governance systems.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Evaluation of a Multifaceted Intervention Program for Preventing Medication Administration Errors by Nurses.","authors":"Won Hee Sim","doi":"10.1097/PTS.0000000000001345","DOIUrl":"10.1097/PTS.0000000000001345","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop and evaluate a multifaceted intervention program based on the Systems Engineering Initiatives for Patient Safety (SEIPS) model to prevent medication administration errors (MAEs) by nurses in an adult general ward of a comprehensive hospital in Seoul, South Korea.</p><p><strong>Methods: </strong>The program was developed using the Analysis, Design, Development, Implementation, Evaluation (ADDIE) model with a 3-round Delphi survey conducted with 16 experts. Strategies were categorized under the SEIPS model and finalized into a program with 9 domains and 21 interventions. A pretest-posttest design with 73 nurses (36 experimental, 37 control) evaluated the program's effectiveness in a tertiary care hospital in Seoul, South Korea. Surveys on patient safety culture, medication safety practices, and error rates were analyzed before and after a 3-month intervention using double-difference and time-series methods.</p><p><strong>Results: </strong>The DID analysis demonstrated significant improvements in patient safety culture perception (0.42, P <0.001) and medication safety compliance (0.53, P <0.001), with large effect sizes ( d =1.07 and d =1.41, respectively). However, changes in self-reported medication error rates between groups were not statistically significant ( P =0.555), likely due to the short intervention period.</p><p><strong>Conclusion: </strong>The program improved patient safety awareness and medication safety compliance, validating its approach. This study highlights the importance of theoretically based interventions and suggests shifting from solely nurse education to addressing systemic issues for medication safety.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"226-239"},"PeriodicalIF":1.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}