Journal of Patient Safety最新文献

{"title":"Unveiling the Impact of Operational Failures on Patients: A SEIPS-based Analysis From the Perspective of Hospital Nurses.","authors":"Sem Vanbelleghem, Melissa De Regge, Yves Van Nieuwenhove, Paul Gemmel","doi":"10.1097/PTS.0000000000001341","DOIUrl":"10.1097/PTS.0000000000001341","url":null,"abstract":"<p><strong>Objectives: </strong>Operational failures (OFs) in hospital environments pose significant challenges for nurses, affecting patient care, workflow efficiency, and clinical processes. Common OFs include supply chain disruptions, communication breakdowns, and equipment failures. Although OFs are pervasive and frequent, current research primarily focuses on process improvement and employee well-being, neglecting the patient-centric perspective in this discourse. The objective of this study is to explore the impact of OFs on patient well-being through semi-structured interviews conducted with hospital nursing staff.</p><p><strong>Methods: </strong>A qualitative and exploratory approach, in accordance with the SRQR guidelines, was employed to ensure methodological rigor and transparency by providing a comprehensive understanding of the phenomenon. This multicenter study was conducted in 23 wards across 5 general hospitals in Belgium. It included in-depth, semi-structured face-to-face interviews with 26 nurses, and 2 group discussions: one with nurse managers (n=6), and another with patients (n=14). Thematic analysis was guided by the Systems Engineering Initiative for Patient Safety (SEIPS) framework to examine how OFs emerge within work systems and affect patients.</p><p><strong>Results: </strong>The results indicate that minor OFs, including short delays in care or small communication lapses, can disrupt the continuity of care, leading to heightened patient stress and dissatisfaction. Conversely, major OFs, such as critical equipment breakdowns or medication errors, pose substantial and widespread risks, negatively impacting both patient experience and safety. Patients' reactions to such failures depend on the preventability of the error and the severity of its consequences, ranging from understanding to outright anger.</p><p><strong>Conclusions: </strong>The numerous day-to-day problems that nurses encounter due to poorly performing work systems can significantly compromise patient well-being and safety, ultimately affecting patient satisfaction and trust in health care.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"339-347"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722112","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":"How Were Patient Safety Incidents Responded to, Investigated, and Learned From Within the English National Health Service Before the Implementation of the Patient Safety Incident Response Framework? A Rapid Review.","authors":"Gemma Louch, Carl Macrae, Rebecca Talbot, Siobhan McHugh, Jane K O'Hara","doi":"10.1097/PTS.0000000000001349","DOIUrl":"10.1097/PTS.0000000000001349","url":null,"abstract":"<p><strong>Objective: </strong>To understand how National Health Service organizations routinely responded to, investigated, and learned from patient safety incidents in England before the implementation of the Patient Safety Incident Response Framework, and to identify associated success criteria and barriers.</p><p><strong>Methods: </strong>We followed rapid review methodology and searched 2 electronic databases. We aimed to identify and synthesize literature regarding patient safety incident response, investigation, and learning within the English National Health Service, before the implementation of the Patient Safety Incident Response Framework.</p><p><strong>Results: </strong>Nineteen articles were included. A narrative synthesis generated 4 concepts: (1) a multifaceted reporting culture, (2) investigation processes, (3) the landscape of support and involvement, and (4) opportunities to learn. Barriers to incident reporting included time, task characteristics, a culture of blame, and lack of feedback. Root cause analysis was cited as the most common investigation method. Studies outlined points of support and involvement for patients and families, the importance of supporting and involving patients and families, and acknowledged contributions from patients and families may be overlooked currently. For health care staff, the need for timely and personalized support soon after an incident was emphasized. Studies underlined the limitations of current approaches to learning and improvement.</p><p><strong>Conclusions: </strong>These findings lend support to the challenges associated with health care systems' infrastructures and strategies for responding to and learning from patient safety incidents. These challenges centre on 2 interrelated issues: the investigative challenges of rigorously conducting systems analysis and learning-oriented improvement; and the relational challenges of supporting genuine relationships of care, open and honest communication, and supportive engagement after patient safety incidents.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"e42-e55"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047891","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}

{"title":"SCALPEL: A Structured Handoff Protocol for Scrub Nurses in the Operating Room for Patient Safety.","authors":"Saeid Amini Rarani","doi":"10.1097/PTS.0000000000001331","DOIUrl":"10.1097/PTS.0000000000001331","url":null,"abstract":"","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"e73"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524806","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":"Value of Incident Reporting to Address Real-time Safety Opportunities During the COVID-19 Pandemic.","authors":"Pamela S Roberts, Nandita Raman, Brandi Rico, Edward Seferian","doi":"10.1097/PTS.0000000000001344","DOIUrl":"10.1097/PTS.0000000000001344","url":null,"abstract":"<p><strong>Objectives: </strong>A strong safety culture encourages staff to identify and report safety events and near misses through an incident reporting system. The objectives were to: (1) assess the effectiveness of real-time reporting of safety events for timely identification of trends and improvement opportunities in a rapidly changing environment and (2) determine temporal changes in safety event categories throughout the 4 COVID-19 pandemic waves in Southern California.</p><p><strong>Methods: </strong>This retrospective study involved all safety incidents reported in patients over age 18 related to the care of COVID-19 through the hospital's incident reporting system, CS-Safe from March 17, 2020 to February 25, 2022.</p><p><strong>Results: </strong>There were 5843 suspected and confirmed COVID-19 cases across the 4 waves. The reported events primarily were associated with patients between the ages of 65 and 84 years, with the majority (62.7%) male, white (65.4%), and non-Hispanic (73.5%). Most events reported were related to clinical care issues (41.6%). A difference in the rates of safety incidents was observed across the waves. The highest rate of medication management-related safety incidents was in wave 2 (0.25 incidents/1000 d) and the highest rate of incidents occurred in critical care in wave 3 (1.20 incidents/1000 d).</p><p><strong>Conclusions: </strong>The alignment of COVID-19-related safety incidents across the 4 waves with the occurrences during this time demonstrates the value of real-time reporting in identifying trends and opportunities for improvement in a rapidly changing environment. Hence, real-time assessment of events can be valuable in concurrently addressing demands during unprecedented situations.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"371-376"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796352","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":"Patient Safety Culture Research: A Bibliometric Analysis From 2001 to 2023.","authors":"Tianli Huang, Yan Wu","doi":"10.1097/PTS.0000000000001338","DOIUrl":"10.1097/PTS.0000000000001338","url":null,"abstract":"<p><strong>Objectives: </strong>To perform a bibliometric analysis of research on patient safety culture from 2001 to 2023.</p><p><strong>Methods: </strong>Retrieve the SSCI and SCIE data in the Web of Science Core Collection with the title \"Patient Safety Culture\" from January 1, 2001, to December 31, 2023. HistCite, Bibliometrix Package, VOSviewer, and Jshare were used to conduct bibliometric analyses. The analysis contents included publications, distribution of countries/regions, core journals, organizations, the evolution of keywords over the years, future trends of the field, author contributions, and citation analysis.</p><p><strong>Results: </strong>A total of 595 articles authored by 2383 individuals from 1048 different sources were collected. The United States emerged as the most prolific country (N=142), while Westat Corporation was the leading institution (N=11). The number of papers issued by developing and advanced economies is gradually balanced after 2022. The top researchers were Wagner C, Hammer A, and Hasegawa T. The analysis identified 1427 keywords, with the most frequently used being \"climate,\" \"health care,\" \"adverse events,\" \"nurses,\" and \"quality.\" It was noted that trending topics such as \"healthcare providers,\" \"work environment,\" and \"high-reliability\" have gained traction recently, while earlier years saw a focus on \"climate,\" \"care,\" \"healthcare,\" \"perceptions,\" and \"nurses.\"</p><p><strong>Conclusions: </strong>Patient safety culture research is gaining increasing attention in the coming years, especially in developing countries. Future research should prioritize the \"work environment\" and \"climate\" to enhance patient safety culture, particularly addressing the \"barriers\" to improving \"management\" and \"communication.\"</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"e62-e72"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701841","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":"Unveiling Disparities in Patient Rights Awareness and Practice: Insights From Artificial Neural Networks.","authors":"Loai M Saadah, Dalal B Alnatour, Mumen S Hadidi, Fadia F Samara, Sana S Shakhshir, Wafa'a M Alnsour, Maisa K Saket","doi":"10.1097/PTS.0000000000001326","DOIUrl":"10.1097/PTS.0000000000001326","url":null,"abstract":"<p><strong>Background: </strong>High-quality universal health care coverage for all patients is the common theme in patient rights. However, pertinent investigations on this topic within the context of Jordanian health care are absent. This systematic review, coupled with a pooled artificial intelligence analysis of the data in retrieved studies, paves the way for such research by pooling data sets sourced from across the Middle East and North Africa (MENA) region.</p><p><strong>Methods: </strong>National Library of Medicine (NLM), through its secondary database of primary literature (PubMed), was queried with the terms \"Patient\" and \"Rights\" in April 2024. Quantitative surveys from MENA containing individual item assessments mapped to 1 of the 7 domains of Jordan National Patient Rights Charter were pooled. Finally, factors extracted for all studies were then used to build an artificial neural network (ANN) to test the hypothesis that information asymmetry in both awareness and practice of patient rights exist even among health care providers.</p><p><strong>Results: </strong>A total of 8 studies with 131 survey items were identified in the MENA region. All items tested either knowledge (awareness) or practice (implementation) of respondents regards patient rights except for 25 items in one study which measured both. ANN converged to a best net of multilayer feedforward with 3 hidden nodes. Patient right domain, from Jordanian Patient Rights Charter, ranked first and respondent type second as most important among the variables. However, there was huge and statistically significant asymmetry between students 0.602 (0.499 to 0.853), patients 0.627 (0.518 to 0.636), and nurses 0.492 (0.340 to 0.786) on one side and clinicians 1.166 (1.025 to 1.258) on the other side in the ANN model (both paired t test and Wilcoxon signed rank test P <0.0001) for any pairwise comparisons.</p><p><strong>Conclusions: </strong>Jordan National Patient Charter can fit any patient right item one could think of in the infinite space of patient rights. Huge information asymmetry exists in both awareness and implementation between practicing professionals and society but also among the different health professions.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":"317-323"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416065","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":"Engineering Safe Care Journeys: Designing a Patient Safety Passport.","authors":"Nicole E Werner, Maureen Smith, Rachel A Rutkowski, Hanna J Barton, Kathryn Wust, Peter Hoonakker, Barbara J King, Manish N Shah, Brian W Patterson, Michael S Pulia, Paula Vw Dail, Pascale Carayon","doi":"10.1097/PTS.0000000000001397","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001397","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to use a participatory Human Factors Engineering (HFE) approach to identify key design guidelines and design requirements of a patient safety passport (PSP) to improve patient safety at care transition points along the patient journey.</p><p><strong>Methods: </strong>We conducted a work system analysis and participatory design process to integrate the needs of multiple perspectives using cognitive interviews, contextual inquiry, team-based analysis, and codesign sessions.</p><p><strong>Results: </strong>We conducted semistructured interviews (N=29) with clinicians. We also conducted 20 contextual inquiry observations of older adult patients in the emergency department (ED) followed by 20 interviews with the ED clinicians who cared for those patients. We mapped the care transition process that included transitioning to the ED, being seen in the ED, and transitioning from the ED to the next location. We identified 21 categories representing the interaction of work system barriers and facilitators to safe ED care transitions. We identified 5 design guidelines, which provide the overarching conceptual characteristics of a PSP, and 5 design requirements to guide PSP design.</p><p><strong>Conclusions: </strong>Our participatory HFE approach with a multidisciplinary design team identified key design guidelines and requirements for a PSP. Although this work was focused on the ED, a PSP is likely applicable to a range of care transition domains. Future work should seek to validate and refine PSP design requirements and guidelines across domains as part of a learning health system that can transform care transitions to be points of patient safety resilience.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754902","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":"Assessment of Patient Safety Culture Among Citizens: A Survey Study.","authors":"Micaela La Regina, Chiara Parretti, Daniela Bernardini, Nuccia Oneto, Giulia Torricelli, Lorenzo Federici, Riccardo Tartaglia","doi":"10.1097/PTS.0000000000001391","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001391","url":null,"abstract":"<p><strong>Objectives: </strong>Public engagement in quality and safety improvement is crucial in health care. To have an effective participation, it appears essential to align knowledge, language, and values among users and workers. Present study is aimed to assess patient safety culture and knowledge among a representative sample of Italian citizens, with/without chronic medical conditions.</p><p><strong>Methods: </strong>A semistructured, self-administered questionnaire was distributed through email to a nationally representative population database (DOXA, Milan, Italy). The email response rate was 21% out of 5678 emails sent. The sample consisted of 1200 individuals, of whom 400 had severe chronic conditions requiring regular hospital visits (referred to as \"patients\") and 800 did not have such conditions (referred to as \"citizens\").Descriptive and inferential statistical analyses were done, comparing subjects with/without chronic medical conditions across various demographic variables. Main investigation areas: fundamentals and best practice of patient safety, sources of information, attitudes towards telemedicine and clinical trials, participation to health care improvement and identification of relevant experiences.</p><p><strong>Results: </strong>Findings revealed limited knowledge of patient safety fundamentals, clinical trials and telemedicine, and better knowledge of patient safety practices. No significant differences emerged between patients and citizens regarding the understanding of medical error (60.8% patients versus 64.1% citizens) and adverse event (17.8% patients versus 15.9% citizens). The only significant difference concerning good practices relates to the interference of food with therapy (82.3% patients versus 72.5% citizens). The patient safety responsibility is attributed mainly to physicians (68% patients versus 66% citizens), then to management (48% patients versus 49% citizens) and nurses (41% patients versus 42% citizens).No statistically significant differences were found between citizens with/without chronic diseases; being over 44 years and/or having high-level education were associated with better culture. Structured citizen engagement is not widespread in the country.</p><p><strong>Conclusions: </strong>Effective strategies for cultivating health care quality and safety culture among citizens are needed, as well as enhancing and monitoring medical information, especially in view of telemedicine and artificial intelligence.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754901","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":"Using SEIPS 101 Tools to Model Surgical Count Processes.","authors":"Julia Meilan, Connor Lusk, Elizabeth K Galinsky, Megan McCray, Matthew T Nare, William Shelton, Bruce Crookes, Ken Catchpole","doi":"10.1097/PTS.0000000000001386","DOIUrl":"10.1097/PTS.0000000000001386","url":null,"abstract":"<p><strong>Objectives: </strong>Retained foreign objects (RFOs) are a frequent sentinel event that may cause significant harm to patients. The surgical count is the primary prevention measure for RFOs, yet there has been limited research into the system factors that interact in this process. The objective of this study is to create SEIPS 101 tools that help to better understand the contributing systems factors.</p><p><strong>Methods: </strong>Trained researchers directly observed the count process in 22 general and gynecological surgical cases and collected data including the people; tasks; tools; environmental; and organizational factors. Ad hoc in situ interviews were conducted as the tools were being iteratively constructed during observations.</p><p><strong>Results: </strong>The journey map found 6 different phases of the counting process, conducted in 4 different environments, consisting of multiple tasks performed by 3 OR team members. The people map identified 8 people influencing the counting process, many requiring bidirectional communication. The tasks and tools matrix found 4 high-frequency use tools across key tasks, with medium to low ease of access and/or usability. The PETT scan revealed 56 individual barriers and 31 individual facilitators.</p><p><strong>Conclusions: </strong>Our results reveal the variety of systems factors and their complex interactions during the count process, challenge current thinking in RFO avoidance, and reveal new ways to intervene. They demonstrate the hidden contribution that resilience plays in prevention and how not only adhering to count policies and best practice guidelines can prevent RFOs, which by necessity challenges the value of deviations, adaptations, and descriptions of error as a reasonable explanation to why RFOs occur.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715163","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}

{"title":"A National Position Paper for the Strategic Development of HealthCare Simulation in Italy.","authors":"Pier Luigi Ingrassia, Alessandro Barelli, Enrico Benedetti, Silvia Bressan, Luca Carenzo, Fausto D'Agostino, Francesco DiMeco, Giovanni Esposito, Alessandro Perin, Alfonso Piro, Giovanni Scambia, Andrea Silenzi, Stefano Sironi, Antonio Ursone, Pierpaolo Sileri","doi":"10.1097/PTS.0000000000001393","DOIUrl":"https://doi.org/10.1097/PTS.0000000000001393","url":null,"abstract":"<p><strong>Background: </strong>Simulation-based education is an essential tool in modern health care, enhancing technical, behavioral, and decision-making skills while improving patient safety and clinical outcomes. In Italy, health care simulation has developed over the past 2 decades, with multiple scientific societies and educational initiatives promoting its use. However, the absence of national data and standardized educational frameworks presents a barrier to its widespread adoption. Recognizing these challenges, the Italian Ministry of Health convened a panel of experts to establish a strategic framework for simulation in health care, aiming to standardize methodologies, promote quality assurance, and foster collaboration across institutions.</p><p><strong>Methods: </strong>The panel, composed of experts in health care simulation, clinical practice, and risk management, conducted a series of telematic meetings from April 2022 to July 2022. A consensus-driven approach was adopted to review existing literature, identify key areas for development, and formulate practical recommendations.</p><p><strong>Results: </strong>Key recommendations include: establishing a national registry of simulation programs, defining accreditation criteria for simulation-based education, standardizing professional competencies for simulation educators, integrating simulation into health care curricula and continuous professional development, developing national standards for simulation-based training in new technologies and clinical procedures, utilizing simulation in public health preparedness and emergency response planning, promoting research funding and inter-institutional collaborations.</p><p><strong>Conclusion: </strong>This position paper provides a strategic roadmap for standardizing simulation-based education across the Italian health care system. By establishing national standards and fostering collaboration, simulation can significantly improve patient safety, care quality, and health care system resilience.</p>","PeriodicalId":48901,"journal":{"name":"Journal of Patient Safety","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627425","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}