BMC Palliative Care最新文献

{"title":"Palliative care models in primary health care system of India: a scoping review.","authors":"Shalu R Chaudhary, Ankith Thomas","doi":"10.1186/s12904-025-01859-3","DOIUrl":"10.1186/s12904-025-01859-3","url":null,"abstract":"","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"221"},"PeriodicalIF":2.5,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862573","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":"Between host country and homeland: a grounded theory study on place of dying and death in migrant cancer patients.","authors":"Simona Sacchi, Loredana Buonaccorso, Silvia Tanzi, Giulietta Luul Balestra, Luca Ghirotto","doi":"10.1186/s12904-025-01821-3","DOIUrl":"10.1186/s12904-025-01821-3","url":null,"abstract":"<p><strong>Background: </strong>Migrant cancer patients face unique challenges in end-of-life decision-making. One key yet underexplored aspect is the decision-making process surrounding the place of dying and death. This study explores the factors influencing these decisions involving migrant cancer patients in Italy.</p><p><strong>Methods: </strong>A constructivist grounded theory approach was employed. Data were collected through semi-structured interviews with 28 participants (patients, family members, cultural mediators, and other key informants, some from a previous grounded theory study). Theoretical sampling guided participant selection for this study, and data analysis followed an iterative coding process, leading to the development of a conceptual model.</p><p><strong>Results: </strong>The decision-making process was conceptualized as a gradient field in which three forces interact to shape outcomes: (1) Healthcare as an Attracting/Holding Force-quality medical care in Italy encouraged patients to stay, though its influence diminished as curative treatments ended; (2) Bureaucratic and Financial Barriers as an Obstructing Force-challenges related to residency, access to care, and financial constraints often complicated decision-making, particularly for those considering repatriation; and (3) Social Networks as a Stabilizing Force-the strength of familial and community ties in host country and homeland played a decisive role in shaping preferences. A fundamental opacity about terminality was present, with limited communication and awareness regarding prognosis, further expanding the circle of decision-makers.</p><p><strong>Conclusions: </strong>Palliative care professionals should recognize the importance of transnational networks, consider bureaucratic barriers, and encourage open discussions regarding place of dying and death decision. To navigate these complexities, we propose a question guide for specialists during consultations. This tool aims to enhance culturally sensitive communication, promote shared decision-making, and address the challenges of cross-border end-of-life care. By accommodating transnational ties, palliative care services can better align with the realities of migrant cancer patients, fostering equitable and dignified end-of-life care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"220"},"PeriodicalIF":2.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805139","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":"Key themes and approaches in palliative and end-of-life care education for the general public: a systematic review.","authors":"Muzeyyen Seckin, Rumandeep Tiwana, David Fry, Cara Bailey","doi":"10.1186/s12904-025-01852-w","DOIUrl":"10.1186/s12904-025-01852-w","url":null,"abstract":"<p><strong>Background: </strong>Families, friends, and communities play a vital role in supporting individuals facing declining health, caregiving duties, loss, or grief, especially with the growing desire to die at home. The general public can significantly impact end-of-life care and offer essential support mechanisms. This review aimed to explore and identify key educational components related to palliative and end-of-life care for citizens, volunteers, and the general public.</p><p><strong>Methods: </strong>A mixed-method systematic review was conducted, incorporating four electronic databases (MEDLINE, PsycINFO, CINAHL, and the Cochrane Library) and grey literature searches, and quality was assessed using Hawker et al.'s (2002) critical appraisal checklists.</p><p><strong>Results: </strong>Twenty studies published between 2011 and 2023 were included, covering topics in palliative, end-of-life care, and bereavement education. These studies involved a total of 10,307 participants and identified 16 different educational programmes for the public, volunteers, and lay caregivers. The analysis revealed six main themes: foundational concepts and philosophies, communication and decision-making, planning and preparation, symptom management, end-of-life care practices, and caregiving support.</p><p><strong>Conclusions: </strong>This review highlights the importance of training programmes to improve community involvement in caregiving and enhance the quality of care for individuals with life-limiting conditions. Expanding access to such educational resources can empower more people to contribute confidently to end-of-life care in their communities.</p><p><strong>Prospero-id: </strong>CRD42024533124.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"219"},"PeriodicalIF":2.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800750","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":"Resilience among parents whose child died of cancer - investigating its role on psychological distress and prolonged grief disorder: results from a cross-sectional survey in Switzerland.","authors":"Peter Francis Raguindin, Eva De Clercq, Anna Katharina Vokinger, Eddy Carolina Pedraza, Céline Bolliger, Katrin Scheinemann, Eva Maria Tinner, Eva Bergstraesser, Andre Oscar von Bueren, Gisela Michel","doi":"10.1186/s12904-025-01854-8","DOIUrl":"10.1186/s12904-025-01854-8","url":null,"abstract":"<p><strong>Introduction: </strong>The death of a child profoundly impacts parents, often leading to anxiety, depression, and posttraumatic stress. However, factors such as resilience-defined as the capacity to adapt to adversity-are less explored. Resilience may mitigate grief-related distress. This study aimed to: (a) describe and compare resilience levels between bereaved parents and parents of childhood cancer survivors (CCS parents), (b) identify sociodemographic and cancer-related determinants of resilience among bereaved parents, and (c) investigate resilience's association with psychological distress and prolonged grief disorder.</p><p><strong>Methods: </strong>This is a cross-sectional study done in Switzerland. Bereaved parents were recruited from three hospitals and through patient advocacy groups. CCS parents were taken from a nationwide, population-based study (Swiss Childhood Cancer Survivor Study-Parents). Resilience, psychological distress, and prolonged grief disorder were assessed using the Connor-Davidson Resilience Scale (CD-RISC 10), Brief Symptom Inventory-18 (BSI-18), and Prolonged Grief 13 (PG-13), respectively. Regression analysis (linear and logistic) was used to identify factors associated with resilience, and the association of resilience with psychological distress and prolonged grief disorder (adjusted for age, sex, and time since death).</p><p><strong>Results: </strong>We included 103 bereaved parents and 345 CCS parents in the analysis. Bereaved parents were younger compared to CCS parents (mean 53.7, SD 8.3 vs. 62.5, SD 6.7 years, p < 0.001), with both groups predominantly female (66% and 58%). Bereaved parents reported higher resilience scores than CCS parents (crude mean: 29.8 vs. 27.9; p = 0.005), with adjusted analyses confirming this finding. High risk of poverty was the only significant determinant of lower resilience (adjusted β = -7.37, 95% CI: -11.21, -3.54; p < 0.001). Higher resilience was associated with lower likelihood to report psychological distress (adjusted OR = 0.83, 95% CI: 0.74, 0.93, p = 0.002) and prolonged grief disorder (adjusted OR = 0.73, 95% CI: 0.58, 0.92, p = 0.008).</p><p><strong>Conclusion: </strong>Bereaved parents exhibited higher resilience than CCS parents. Resilience in bereaved parents was strongly associated with reduced psychological distress and lower likelihood of having prolonged grief disorder. Targeting modifiable factors such as poverty may enhance resilience and thereby help to improve mental health outcomes for bereaved parents.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"218"},"PeriodicalIF":2.5,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785739","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":"Correction: The heart of palliative care is relational: a scoping review of the ethics of care in palliative medicine.","authors":"Sophie Bertaud, Dominic Wilkinson, Maureen Kelley","doi":"10.1186/s12904-025-01818-y","DOIUrl":"10.1186/s12904-025-01818-y","url":null,"abstract":"","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"217"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765668","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":"Testing the study protocol and interrater reliability of a new end-of-life wound assessment tool: a feasibility study.","authors":"Sharon Latimer, Rachel M Walker, Jayne Hewitt, Gillian Ray-Barruel, Joanie Shaw, Tracey Hunt, Brigid M Gillespie","doi":"10.1186/s12904-025-01853-9","DOIUrl":"10.1186/s12904-025-01853-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Some dying individuals can develop skin injuries at the end-of-life (EOL) due to factors associated with the disease processes, aging or both. These EOL wounds, which include Kennedy terminal ulcers, Trombley-Brennan terminal tissue injuries, Skin Changes at Life's End and end-stage skin failure, have distinguishing features. Yet, they can appear similar to pressure injuries (PIs), making assessment difficult. Compounding this was the lack of clinical assessment tool for EOL wounds. In 2022, we conducted a modified Delphi panel to develop a new EOL wound assessment tool for use in dying adults and established the face and content validity of the items. The new tool does not differentiate between a PI and EOL wound; rather, it aids clinicians' assessment of EOL wound characteristics and suggests the development of a multidisciplinary management plan. The next step in the tool development is to determine its reliability. The aim of this study was to test the study protocol and interrater reliability of a new EOL wound assessment tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This feasibility study was conducted in dying hospitalised adult patients admitted to medical and palliative care units at three hospitals across southeast Queensland, Australia. We gathered quantitative data according to the study protocol including participant screening, recruitment, consent, data collection and interrater reliability. Our four research assistants (RAs) and an independent blinded outcome assessor were trained in the study protocol and use of the new EOL wound assessment tool. Using a pragmatic approach, patients with a new reported PI were screened for study eligibility. For recruited participants, clinical data, skin blanching, and a deidentified wound photograph were first collected. Next, the RAs used the new tool to assess the patient and the skin to determine the presence of an EOL wound (Yes/No). An off-site independent blinded outcome assessor accessed the participant research data and, using the new tool, undertook the same assessment as the RA. Frequencies and percentages were computed for the feasibility outcomes. Cohen's kappa statistic was calculated to determine the interrater reliability agreement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Over 20 months, 140 patients were screened, with 23 (16.4%) eligible for recruitment, exceeding our ≥ 10% target. Ten (43.5%) participants were recruited, which fell short of our ≥ 50% target, with study refusal and imminent death the reasons for non-recruitment. Among the 10 recruited study participants, 13 wounds were observed on the sacrum, coccyx, and lower extremities. The interrater reliability between the two assessors was moderate (n = 8/13; 61.5%), with disagreement on five wounds, all located on the heels and toes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Assessing for EOL wounds in dying patients is a clinical imperative. With minor study protocol adjustments, such as having two clinicians c","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"216"},"PeriodicalIF":2.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745614","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":"Improving specialist palliative care discharges from hospitals and hospices to community settings: a qualitative interview study of the communication experiences of patients, carers, and primary care professionals.","authors":"Katharine Weetman, Catherine Grimley, Cara Bailey, Celia J Bernstein, Jeremy Dale, Aprella Fitch, Sarah Mitchell, Rumandeep Tiwana, John I MacArtney","doi":"10.1186/s12904-025-01851-x","DOIUrl":"10.1186/s12904-025-01851-x","url":null,"abstract":"<p><strong>Background: </strong>Patients who have received specialist intervention during periods of complex symptom and palliative care needs (e.g. pain crisis) may be discharged from specialist palliative care services to primary care. Despite such discharges being reasonably common, little is known about what happens during this process. We sought to explore patient, carer and healthcare professional experiences, identifying ways to improve this crucial and time-sensitive part of the healthcare journey.</p><p><strong>Methods: </strong>A qualitative interview study designed using an interpretive approach and reflexive thematic analysis methods. Sampling was purposive across six specialist palliative care sites (hospitals and hospices) and six general practices.</p><p><strong>Results: </strong>A total of 38 participants took part in interviews:15 patients, 8 carers and 15 primary care professionals. Two overarching key themes were developed. The first described the multiple ways that 'discharge' was understood depending on the setting and circumstances of the patient. The second explored what was associated with better or worse transitions to primary care. Discharge communications that were accurate and complete were described as effective whereby written information reinforced verbal instructions and acted as a reminder. Participant suggestions for improving these discharge communications included: incorporating the patient's palliative care preferences (e.g. advanced directives); offering letters to patients and, where appropriate, carers; providing post-discharge follow-up and contact details; ensuring medication instructions are accessible to patients and carers.</p><p><strong>Conclusions: </strong>Current specialist palliative care discharge communications risk confusion, distress, and increased workload post-discharge. The study identified numerous suggestions professionals could take to improve this process.</p><p><strong>Trial registration: </strong>Registered in ISRCTN Registry on 29.12.2023 ref: ISRCTN18098027.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"214"},"PeriodicalIF":2.5,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718886","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":"The transition from oncology to palliative care: barriers and facilitators explored through an integrative review.","authors":"Barbara Gonçalves, Tamara Radojičić, Carlos Centeno, Eduardo Garralda, Marina Martínez, Nancy Preston, Jeroen Hasselaar, María Arantzamendi","doi":"10.1186/s12904-025-01819-x","DOIUrl":"10.1186/s12904-025-01819-x","url":null,"abstract":"<p><strong>Background: </strong>Patients with advanced cancer often experience difficult symptoms near the end of life, yet the beneficial integration of oncology and palliative care is frequently lacking or poorly coordinated. Transitioning from curative treatments to palliative care focused on symptom relief and quality of life remains a common challenge. Palliative care is often underused or introduced late in the cancer treatment process, leading to suboptimal care outcomes. Understanding the factors influencing this transition is crucial for improving patients' overall care experience. This review aims to explore barriers and facilitators involved in a comprehensive transition process from oncology to palliative care of patients with advanced cancer.</p><p><strong>Methods: </strong>This integrative review explored empirical research from 2010 to 2023 sourced from PubMed, PsycINFO, CINAHL and Cochrane databases, adhering to PRISMA guidelines. Search strategy combined concepts of advanced cancer, transition in palliative care, palliative care, and barriers and facilitators. Blind review software facilitated article selection based on criteria, with data extracted using a predefined sheet. Themes were identified through inductive thematic analysis.</p><p><strong>Results: </strong>38 studies met inclusion criteria out of 180 screened records. These studies were conducted in 13 countries and data collection methods ranged from interviews and focus groups to surveys and analysis of electronic medical records. In the analysis, six key themes emerged: (1) knowledge and understanding about the disease trajectory and palliative care, (2) cultural aspects of providing palliative care, (3) shortcomings in economic coverage for services, (4) characteristics of the patients' clinical situation, (5) relational dynamics between patients and professionals and among professionals and (6) organisational issues involving limitations and fragmentation of care.</p><p><strong>Conclusions: </strong>This review highlights the multifaceted factors affecting the transition to palliative care. Addressing these challenges requires improvements in communication, cultural competence, financial support and organisational structure. Effective integration of palliative care into oncology practices requires collaboration among various stakeholders, including healthcare professionals, policymakers, patients, and caregivers. Through enhanced education initiatives, a more patient-centric approach to managing advanced cancer can be achieved.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"215"},"PeriodicalIF":2.5,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718888","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":"Pressure injury risk assessment for palliative care patients in the acute hospital setting: a scoping review.","authors":"Saroeun Ven, Paul Fulbrook, Adam Burston, Josephine Lovegrove, Sandra J Miles","doi":"10.1186/s12904-025-01842-y","DOIUrl":"10.1186/s12904-025-01842-y","url":null,"abstract":"<p><strong>Background: </strong>Hospitalised palliative care patients are at risk of pressure injury. The development of pressure injuries causes physical and psychological distress for patients. Therefore, the prevention of hospital-acquired pressure injury is a nursing priority. The first step in prevention is conducting a risk assessment, which should be population-specific. In Australia, four palliative care phases guide care planning for appropriate clinical management of palliative care patients. In phases 1-3, the palliative patient cohort is based on acute care, where patients require medical treatment and/or symptom management, whereas Phase 4 refers to end-of-life care.</p><p><strong>Objectives: </strong>To review and analyse contemporary literature to determine what is known about pressure injury risk assessment for acute palliative care patients and identify which pressure injury risk assessment tools are most appropriate for this cohort.</p><p><strong>Methods: </strong>This scoping review was conducted according to Joanna Briggs Institute methodology. The search strategy was developed based on the Population-Concept-Context mnemonic. Studies of any design, articles and guidelines relating to pressure injury risk assessment in acute palliative care patients were included. Publications from 2002 to 2023 from Google Advanced Search, three grey literature and five nursing/health databases (Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Scopus, Web of Science, EMBASE) were searched. The protocol was prospectively registered with Open Science Framework.</p><p><strong>Results: </strong>From 2,576 search results, 15 articles met the inclusion criteria. None reported the use of a pressure injury risk assessment tool designed specifically for acute palliative care patients. However, 20 pressure injury risk assessment tools/methods were identified. Furthermore, the definition of palliative care patients was inconsistent, and no articles clearly defined the differences between acute palliative care patients and those at end-of-life.</p><p><strong>Conclusions: </strong>The results of this review indicate a need to develop a new pressure injury risk assessment tool for acute palliative care patients that considers their specific risk factors. Further research is needed to address the knowledge gap relating to pressure injury risk assessment and prevention for hospitalised acute palliative care patients.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"212"},"PeriodicalIF":2.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718887","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":"Correction: Latent profile analysis of anticipatory grief in family caregivers of patients with chronic heart failure and its influencing factors.","authors":"Ting Chen, Li Su, Jiajie Yu, Huiming Zhao, Haoran Xiao, Yali Wang","doi":"10.1186/s12904-025-01856-6","DOIUrl":"10.1186/s12904-025-01856-6","url":null,"abstract":"","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"213"},"PeriodicalIF":2.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718885","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}