BMC Palliative Care最新文献

{"title":"Use of dignity therapy in palliative care: a comprehensive scoping review.","authors":"Romel Jonathan Velasco Yanez, Erilaine de Freitas Corpes, Judith Sixsmith, Ana Fátima Carvalho Fernandes, Priscila de Souza Aquino, Régia Christina Moura Barbosa Castro, Herla Maria Furtardo Jorge","doi":"10.1186/s12904-025-01812-4","DOIUrl":"10.1186/s12904-025-01812-4","url":null,"abstract":"","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"177"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545737","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":"Ethical aspects of limiting end-of-Life treatment of adult patients at the primary healthcare level in family and emergency medicine: a systematic review.","authors":"Meta Krajnc, Urh Grošelj, Erika Zelko","doi":"10.1186/s12904-025-01807-1","DOIUrl":"10.1186/s12904-025-01807-1","url":null,"abstract":"<p><strong>Background: </strong>Decisions to limit treatment near the end of life are challenging and common in primary healthcare, especially in family and emergency medicine.</p><p><strong>Objectives: </strong>This review aimed to [1] examine the evidence on the decision-making process regarding treatment limitation in end-of-life care in family and emergency medicine [2], identify associated ethical considerations, and [3] compare the evidence between family and emergency medicine.</p><p><strong>Methods: </strong>A systematic search of PubMed and Embase was conducted for studies published between 2004 and 2024. Eligible studies focused on ethical aspects of limiting treatment in end-of-life care in family and emergency medicine, such as decision-making processes, influencing factors, and ethical considerations. Quality was assessed using adapted Critical Appraisal Skills Programme checklists.</p><p><strong>Results: </strong>Of the 477 identified studies, 12 met the inclusion criteria. Eight papers reported research on treatment limitations in emergency medical care, two in family/general medicine, one on medication discontinuation in end-of-life care, and one on goals-of-care conversations in emergency departments. Patients, families and colleagues were involved to varying degrees. Family physicians were rarely included in emergency care decisions, despite their potential to align care with patient preferences. Decision-making in emergency medicine was characterized by rapid, protocol-driven processes, often constrained by time and workload, while decisions in family medicine relied on longitudinal patient relationships and clinical judgment, though lacking formalized guidelines. Key factors influencing decisions on limiting treatment included patient and family wishes and values, illness severity, prognosis, previous functional limitation, age, poor predicted quality of life and cultural and religious contexts.</p><p><strong>Conclusion: </strong>Our review showed that decisions regarding treatment limitations in primary care settings remain underexplored, particularly in family medicine. More research and development of clearer guidelines, as well as enhanced collaboration between family and emergency physicians, could improve primary end-of-life care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"169"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545729","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":"Exploring pediatric palliative care in Luxembourg: a mixed-methods study.","authors":"Micha Massaad, Julia Downing, Emilie Allard, Marie Friedel","doi":"10.1186/s12904-025-01813-3","DOIUrl":"10.1186/s12904-025-01813-3","url":null,"abstract":"<p><strong>Background: </strong>An estimated 170,000 children in the WHO European Region have no access to palliative care annually. In Luxembourg, there is a lack of data on children needing palliative care, and the existing structure appears limited. This study aims to assess the current state of pediatric palliative care in Luxembourg.</p><p><strong>Methods: </strong>We used a parallel convergent mixed-methods approach, collecting qualitative and quantitative data simultaneously and analyzing them independently. Snowball and purposive sampling methods were employed. The qualitative data, including documents, email correspondence, and open-ended interviews with participants caring for children with life-limiting or life-threatening conditions, followed the COREQ guidelines and were analyzed using thematic analysis. Quantitative data were analyzed using both descriptive and inferential statistical methods.</p><p><strong>Results: </strong>The analysis highlights a significant gap in the provision of care at all levels of pediatric palliative care in Luxembourg. Approximately 500 to 600 children up to 19 years old require palliative care each year, which exceeds previous estimates. Existing legal frameworks are predominantly designed for adults and end-of-life care, and do not sufficiently address the holistic needs of children requiring palliative care and their families. Homecare services are in the early development phase, and specialized pediatric palliative care options are limited across all levels. A pediatric palliative care course, set to be introduced in 2025 for university pediatric nursing students as outlined in the national plan, aims to address some of these gaps by developing competencies. However, until sufficient specialized care is established, many children are transferred to neighboring countries where there are better resources and expertise or remain at home, receiving limited services.</p><p><strong>Conclusion: </strong>This study presents, for the first time, data on pediatric palliative care in Luxembourg, with a focus on service availability, the legal framework, and the estimated number of children requiring care. The findings highlight the urgent need for a structured pediatric palliative care service to address this country's growing demand and unmet needs. In addition, it is essential to support the implementation of the \"National Plan for End of Life and Palliative Care\" from 2023 to 2026, which includes a dedicated focus on children.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"170"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545730","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 impacts of visitor restrictions for palliative patients during the COVID-19 pandemic on family members and healthcare providers: a Canadian qualitative study.","authors":"Natasha Hanson, Leanne Skerry, Morgan Nesbitt, Tracy Freeze, Robin Williams, Emily Love, Julia Wildish","doi":"10.1186/s12904-025-01803-5","DOIUrl":"10.1186/s12904-025-01803-5","url":null,"abstract":"<p><strong>Background: </strong>Visitor restrictions to healthcare facilities were enacted throughout the course of the COVID-19 pandemic and changed over time. Further research on the consequences of restrictions, particularly in relation to palliative care and from multiple key stakeholder perspectives, is needed. We investigated the impact of COVID-19 visitor restrictions on family members of patients with a life limiting diagnosis or who received palliative care during the pandemic, and health care providers (HCPs) for patients with life limiting diagnoses within New Brunswick, Canada.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 12 family members and 11 HCPs. Reflexive thematic analysis was used to allow for the inductive generation of themes from the qualitative data, while investigating and comparing participants' experiences.</p><p><strong>Results: </strong>The analysis found that HCP and family member themes had a great deal of similarities. The themes developed for family members were: Visitor restrictions have negative impacts on palliative patients and their families; Visitor restrictions impacted patient-family care decisions and timing; Family members had more positive experiences when a patient-centred approach to care was used; Exceptions need to be made when it comes to palliative care and visitation; COVID restrictions didn't make sense; and, COVID led to healthcare providers being further overextended. HCP themes developed were: COVID restrictions and policies impacted satisfaction with work life; The impact of not visiting on families was terrible; HCP had to figure out new ways of providing care; We believe that patients need their families; Patients are lonely and miss family; Weren't always made clearly aware of the changes happening in hospital visitor restrictions; and, COVID restrictions led to people keeping loved ones at home.</p><p><strong>Conclusions: </strong>Results unveiled dynamic relationships between HCPs and family members, whose perspectives on the impacts of visitor restrictions overlapped. Main findings emphasized the overall negative impacts of visitor restrictions and a clear need to enact policies with a particular focus on understanding the need for a flexible patient and family-centred approach and quality of life considerations. Clear and consistent communication with all stakeholders regarding policies is recommended, as well as consistent exceptions for patients with life-limiting diagnoses.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"178"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12217996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545735","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":"Adult specialist palliative care services caring for children in the community: a scoping review.","authors":"Muireann McDonnell, Michael Connolly, Mary Bell, Fiona Lawler","doi":"10.1186/s12904-025-01792-5","DOIUrl":"10.1186/s12904-025-01792-5","url":null,"abstract":"<p><strong>Background: </strong>Adult specialist palliative care professionals have played a key role in the care of children with palliative care needs in the community. However, there is little known on their perceived level of preparedness or training in providing children's palliative care in the community setting. The aim of this scoping review is to appraise the current literature and identify any existing gaps in knowledge on the level of preparedness and training of adult specialist palliative care professionals caring for children in the community. The review question asks: \"Do adult specialist palliative care professionals feel sufficiently prepared to deliver their services to children in the community?\".</p><p><strong>Methods: </strong>In order to address the review question, a scoping review was conducted. This was guided by the framework of Arksey and O'Malley and further enhanced by the methodology of the Joanna Brigg's Institute in order to report the findings.</p><p><strong>Results: </strong>Twenty studies were identified from the database searches. Common areas identified from the literature were that adult specialist palliative care professionals perceived that they had a lack of training or experience in children's palliative care, lack of knowledge or preparedness, and that they faced barriers preventing them from providing effective children's palliative care.</p><p><strong>Conclusion: </strong>This review highlights the lack of empirical research on adult specialist palliative care professionals providing children's palliative care in the community. While the available literature demonstrates both their limited training, experience and preparedness in caring for children.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"167"},"PeriodicalIF":2.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477530","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":"Addressing the spiritual needs of patients with serious illness in Lebanon: perspectives and practices of palliative care professionals.","authors":"Yahya Wehbeh, Rana Yamout, Zhimeng Jia, Hibah Osman","doi":"10.1186/s12904-025-01802-6","DOIUrl":"10.1186/s12904-025-01802-6","url":null,"abstract":"<p><strong>Background: </strong>Spiritual care is an essential component of palliative care, supporting the existential and spiritual wellbeing of patients with serious illnesses. Yet, its effective implementation remains challenging in many healthcare systems. This study examines the experiences and practices of palliative care clinicians in Lebanon, a country characterized by religious diversity, high religiosity, and a complex political landscape.</p><p><strong>Methods: </strong>A qualitative focus group study rooted in constructionist ontology. Palliative care clinicians were recruited from community and acute settings in Lebanon. Data were analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>Three overarching themes: (1) the political context and religious tensions create sensitivities around spiritual care provision, (2) existing spiritual assessment tools are incompatible with local needs, and (3) the desire to safeguard therapeutic connection drives adaptations in spiritual care provision. Participants highlighted how religious and political tensions in Lebanon complicate spiritual care delivery, with concerns about judgment, religious discordance, and cultural misalignment. Western-developed approaches were deemed culturally incongruent, prompting providers to adapt or abandon standardized approaches in favor of personalized, context-sensitive methods. Adaptations included fostering environments for spontaneous spiritual discussions and tailoring assessments to individual patient needs.</p><p><strong>Conclusions: </strong>This study contributes to the growing discourse on the importance of contextualizing palliative care to meet the unique needs of diverse populations, particularly in settings marked by religious and political complexity. Future research should focus on developing context-specific approaches. Training programs should support providers in delivering effective, culturally sensitive spiritual care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"166"},"PeriodicalIF":2.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310647","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 current state of knowledge, attitudes, behaviors and training needs regarding palliative care among ICU nurses in China: a cross-sectional study.","authors":"Wei-Wei Cai, Fei Wang, Chang-Chun Song","doi":"10.1186/s12904-025-01767-6","DOIUrl":"10.1186/s12904-025-01767-6","url":null,"abstract":"<p><strong>Background: </strong>Intensive care unit (ICU) nurses exhibit gaps in their knowledge, attitudes, and behaviors regarding palliative care. In China, there is a lack of standardized training programs for palliative care among ICU nurses, and corresponding research on the needs and impact of such training is also limited.</p><p><strong>Objective: </strong>Through the investigation and analysis of ICU nurses' knowledge, attitudes, behaviors, and training needs regarding palliative care, this study explored the specific knowledge gaps and training needs of ICU nurses in palliative care.</p><p><strong>Methods: </strong>A convenience sampling method was employed to survey ICU nurses at 23 tertiary (tier-A) hospitals in Anhui Province, adhering to the specified criteria, between December 2023 and April 2024. The study utilized a general demographic survey and a comprehensive questionnaire to assess ICU nurses' knowledge, attitudes, behaviors, and training requirements in palliative care.</p><p><strong>Results: </strong>Among the 693 ICU nurses surveyed, the scores for knowledge (73.67), attitude (77.1), behavior (75.84), and training needs (78.16) regarding palliative care were all below the middle level. Multivariate linear regression analysis indicated that gender, professional rank, prior attendance at death education or palliative care training, engagement with literature on death, experience caring for patients in advanced stages, and the number of terminally ill patients cared for in the past year significantly influence nurses' knowledge, attitudes, behaviors, and training needs in palliative care (P < 0.05).</p><p><strong>Conclusion: </strong>Training and education in palliative care should be enhanced for male and lower-level ICU nurses to address the specific knowledge gaps in this area. Chinese nursing managers should implement targeted and practical palliative care training programs to meet the specific training needs of ICU nurses.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"165"},"PeriodicalIF":2.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310648","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":"Variability of sedation practices in palliative care unit in France: a six units retrospective analysis.","authors":"Gary Pommier, Matthieu Frasca, Lydie Chain, Simon Piroddi, Kevin Legueult, Flora Tremellat-Falière, Guillaume Economos","doi":"10.1186/s12904-025-01777-4","DOIUrl":"10.1186/s12904-025-01777-4","url":null,"abstract":"<p><strong>Background: </strong>Palliative sedation is the monitored use of medications intended to reduce consciousness to relieve the burden of otherwise intractable suffering. Since 2016, the French Leonetti-Claeys law has granted patients the right to receive continuous deep sedation until death (CDSUD) for some indications. There are relatively few data in the literature assessing sedation practices in palliative care units (PCUs).</p><p><strong>Methods: </strong>This study aimed to compare sedation practices in six French PCUs, analyzing the frequency, types of sedation (CDSUD vs. proportional sedation), and use of sedative medications during the last 72 h of life. This retrospective study examined the data of patients who died in these units between July and December 2021.</p><p><strong>Results: </strong>The results revealed statistically significant variability in sedation practices. The overall prevalence of sedation practices (all types) was 22%. The prevalence for CDSUD was 12%. Some units had much higher or lower rates of sedation, suggesting differences in the interpretation of guidelines and regulations, possibly because of cultural or individual factors within the units. The study also found important variability in the use of sedative medication in terms of molecules and dosage. Midazolam was the most commonly used benzodiazepine but the dosage varied significantly depending on the units.</p><p><strong>Conclusions: </strong>Further qualitative research is needed to understand the reasons for the observed variability in sedation practices and improve the standardization and clarity of palliative sedation.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"164"},"PeriodicalIF":2.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276399","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":"E-CARE as core competencies for palliative social workers: a systematic review.","authors":"Hong Yao, Wang Jingyue, Zhu Rui, Yajie Hou, Yang Hui","doi":"10.1186/s12904-025-01735-0","DOIUrl":"10.1186/s12904-025-01735-0","url":null,"abstract":"<p><strong>Purpose: </strong>To identify the core competencies of social workers in palliative care.</p><p><strong>Method: </strong>A systematic review of 19 high-quality studies published in English and Chinese up to February 2025 was conducted.</p><p><strong>Results: </strong>The study identified five core competencies-Ethics, Coordination, Assessment, Resource Allocation, and Education-establishing the core competencies of social workers. They serve as interdisciplinary coordinators, communication facilitators, and educators, addressing psychosocial, emotional, and environmental challenges while navigating systemic resource constraints. The framework emphasizes ongoing assessment, resource allocation, and educational interventions, positioning social workers as system navigators and existential educators essential to compassionate, patient- and family-centered care.</p><p><strong>Discussion: </strong>E-CARE framework equips social workers to navigate complex care ecosystems, foster team cohesion, mediate conflicts, advocate for patient autonomy, destigmatize end-of-life discussions, and promote resilience through ongoing training, particularly in resource-constrained settings.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"163"},"PeriodicalIF":2.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259134","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":"\"Is this sedation?\" - a Group Delphi process to define cut-off doses and dosing intervals for potentially sedating drugs in palliative care.","authors":"Sabine H Krauss, Constanze Rémi, Claudia Bausewein, Jeremias Bazata, Alina Grebe, Christoph Ostgathe, Jan Schildmann, Eva Schildmann","doi":"10.1186/s12904-025-01781-8","DOIUrl":"10.1186/s12904-025-01781-8","url":null,"abstract":"<p><strong>Background: </strong>In palliative care, it can be challenging to distinguish between reduced consciousness related to the illness and sedation due to a potentially sedating drug (intended, or unintended). These differentiations are important because unintended sedation requires consideration of alternative treatment options, and intentional sedation demands compliance with guidelines. The aim of the study, which was part of the consortium project iSedPall, was to determine cut-off values for drugs' doses/dosing intervals which are expected to result in defined depth of sedation/continuous effect.</p><p><strong>Methods: </strong>Group Delphi conducted in Germany with prior online survey. Based on a review of the literature, statements regarding cut-off values for drugs´ doses/dosing intervals which are expected to result in a defined depth of sedation/continuous effect were developed for 11 drugs. Consensus was defined as ≥ 75% agreement. Statements with lower agreement entered the next round of discussion. Between the rounds (5 small groups, 3 - 4 participants each), the results were presented and discussed. If necessary, statements were adapted for the following round. Participating experts were physicians, pharmacists, and nurses experienced in palliative care, mostly with over 10 years of professional experience.</p><p><strong>Results: </strong>25/30 invited experts participated in the online survey, 17 in the Group Delphi. 12/33 statements were consented in the survey. The initial questionnaire for the Group Delphi comprised 22 statements on ten drugs. After three rounds, consensus was reached for all statements, determining cut-off doses/dosing intervals for lorazepam, midazolam, diazepam, levomepromazine, haloperidol, melperone, pipamperone, propofol, dexmedetomidine, and trazodone.</p><p><strong>Conclusions: </strong>This study for the first time provides evidence- and expert consensus-based data to support clinical judgements regarding sedating effects of a range of potentially sedating drugs commonly used in palliative care.</p>","PeriodicalId":48945,"journal":{"name":"BMC Palliative Care","volume":"24 1","pages":"159"},"PeriodicalIF":2.5,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250517","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}