Social Science & Medicine最新文献

{"title":"Pain by proxy: An ethnographic study on the relational co-construction of the agency of young children in healthcare encounters","authors":"Esther Lermytte ,&nbsp;Alice Scavarda ,&nbsp;Ana Patrícia Hilário ,&nbsp;Luigi Gariglio ,&nbsp;Joana Mendonça ,&nbsp;Melissa Ceuterick","doi":"10.1016/j.socscimed.2025.118045","DOIUrl":"10.1016/j.socscimed.2025.118045","url":null,"abstract":"<div><div>Access to pain management is a human right. Nevertheless, research consistently reports that children's pain is under-recognised and under-treated compared to that of adults. Additionally, younger children are less likely to receive treatment for their pain. The significance of early-life healthcare experiences is often underestimated due to constructions of young children as passive rather than active agents in healthcare. This study addresses this issue by examining how children's agency is co-constructed within the triad of children, caregivers, and healthcare professionals during childhood vaccination consultations. Field notes were collected describing vaccination consultations involving children aged two months to seven years, with an overrepresentation of children under the age of two due to the study's focus. Ethnographic observations (∼275.5 h) were held in Belgium, Italy, and Portugal, due to their diversity in healthcare system characteristics, vaccination policy, and coverage. Data were analysed using template analysis, a specific type of thematic analysis. Findings illustrate that children inherently possess agency, which can be hindered or facilitated by caregivers and healthcare professionals in the healthcare setting. Although clinical guidelines on pain mitigation for paediatric vaccinations exist, the findings show that these are not consistently applied in practice. Providing a framework for understanding the variability in paediatric pain mitigation, we highlight the socio-cultural conditions by which young children are either socialised into the patient role, or have their status as patients undermined. In pursuit of quality healthcare and pain mitigation for children during vaccination consultations, it is necessary that they are considered and treated as active, embodied healthcare agents.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118045"},"PeriodicalIF":4.9,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social and environmental adversity predict poor mental health in a Milwaukee, WI community sample","authors":"C.W. Tomas ,&nbsp;S. Timmer-Murillo ,&nbsp;K. Vine ,&nbsp;J. Krukowski ,&nbsp;S. Purdle ,&nbsp;J. Janusiak ,&nbsp;J.R. Mantsch ,&nbsp;L. Torres ,&nbsp;J. Harris ,&nbsp;T.A. deRoon-Cassini","doi":"10.1016/j.socscimed.2025.118015","DOIUrl":"10.1016/j.socscimed.2025.118015","url":null,"abstract":"<div><div>Racism functions as a system of continued devaluation, disempowerment, and inequitable allotment driven by racial hierarchy. Operating at multiple levels – individual, interpersonal, community, and societal – racism perpetuates significant mental and physical health disparities. Though evidence evinces the impact of racism across domains, few studies have assessed factors rooted in structural racism simultaneously and how they relate together to predict outcomes. The current study examines how racism impacts the mental health (MH) of Black Americans adults across multiple levels. Risk and protective factors were analyzed to understand the collective impact of racism in this population. Black adults (N = 400) in Milwaukee, WI completed a battery of surveys assessing demographic, mental health, behavioral health, physical/built environment, sociocultural environment, healthcare, and neighborhood context. Bivariate analyses, exploratory factor analyses (EFA), and general linear modeling were conducted, with anxiety, depression, and post-traumatic stress symptoms (PTSS) as outcomes. Participants (M = 43.8 years; 86.1 % earning &lt;$40,000 annually) exhibited elevated depression, anxiety, and PTSD risk. All three mental health outcomes were positively correlated with alcohol/drug use, pain, exposure to violence, housing insecurity, racism-related vigilance, ethnic discrimination, and everyday discrimination while neighborhood social cohesion was negatively correlated. Depression was negatively correlated with social support (p &lt; .05). EFA produced three factor clusters: Social &amp; Environmental Adversity (SEA), Psychosocial Resilience (PR), and Substance Use (SU). SEA and SU were strongly and positively related to all MH outcomes (p &lt; .001) but PR was not. Socioecological frameworks provide a more comprehensive method to evaluate the impact of racism and identify and address mental health disparities. In the current study, results showed that social and environmental factors predicted poor mental health and highlight a need to understand these factors collectively to inform intervention.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118015"},"PeriodicalIF":4.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of potential causal pathways among social determinants of health: A data-informed framework","authors":"Michael Korvink ,&nbsp;Madeleine Biondolillo ,&nbsp;Julie Willems Van Dijk ,&nbsp;Anjishnu Banerjee ,&nbsp;Christopher Simenz ,&nbsp;David Nelson","doi":"10.1016/j.socscimed.2025.118025","DOIUrl":"10.1016/j.socscimed.2025.118025","url":null,"abstract":"<div><h3>Introduction</h3><div>Understanding social determinants of health (SDOH) as a complex system is necessary for designing effective public health interventions. Traditional expert-driven approaches to mapping SDOH relationships, when used in isolation, are susceptible to subjective biases, incomplete knowledge, and inconsistencies across different domains of expertise. Additionally, SDOH variables often contain overlapping information, making it difficult to isolate unique SDOH constructs. A data-driven approach integrating dimensionality reduction and causal discovery can provide a more objective framework for identifying and mapping SDOH factors within a causal system. The data-driven method may serve as a starting point to overcome potential research biases in the development of causal structures.</div></div><div><h3>Methods</h3><div>An observational study was conducted using census tract-level SDOH data from the 2020 Agency for Healthcare Research and Quality (AHRQ) database. Principal Component Analysis (PCA) was applied to derive latent constructs from 157 SDOH variables across 85,528 U.S. census tracts. The Greedy Equivalence Search (GES) algorithm was then used to identify dominant causal pathways between these constructs.</div></div><div><h3>Results</h3><div>PCA-derived components explained substantial variance within each domain, with food access (71.1 %) and income (50.0 %) explaining the most within-domain variance. The causal graph revealed economic stability as a central determinant influencing education, employment, housing, and healthcare access. Education, access to care, and access to technology mediated many pathways.</div></div><div><h3>Discussion</h3><div>Findings highlight the interconnected nature of SDOH, emphasizing financial stability as a foundational determinant. The role of digital equity in health outcomes is increasingly significant. The data-driven approach may serve as an important tool to support researchers in the mapping of SDOH causal structures.</div></div><div><h3>Public Health Implications</h3><div>This study demonstrates the utility of combining PCA and GES to uncover causal pathways among SDOH constructs. Developing causal systems using data-driven methods provides an enhanced method for conducting public health assessments, identify optimal intervention points, and informing policy development.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118025"},"PeriodicalIF":4.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life, service utilisation and costs for anxiety disorders in children and young people: A systematic review and meta-analysis","authors":"Sithara Wanni Arachchige Dona ,&nbsp;Kaitlyn McKenna ,&nbsp;Thi Quynh Anh Ho ,&nbsp;Shalika Bohingamu Mudiyanselage ,&nbsp;Monique Seymour ,&nbsp;Ha N.D. Le ,&nbsp;Lisa Gold","doi":"10.1016/j.socscimed.2025.118023","DOIUrl":"10.1016/j.socscimed.2025.118023","url":null,"abstract":"<div><h3>Background</h3><div>Anxiety disorders (ADs) are common mental health issues in children and young people (CYP). The literature on its overall economic burden regarding health-related quality of life (HRQoL), service use and costs is limited. This study synthesises the literature on how ADs are associated with these outcomes in CYP (0–24 years) and caregivers.</div></div><div><h3>Method</h3><div>A systematic search was undertaken across six databases from January 2013 to the end of December 2024. Grey literature was also searched. Dual-independent screening and quality assessment were conducted. An adapted version of the Effective Public Health Practice Project tool was used for quality assessment. Narrative synthesis and meta-analysis were conducted.</div></div><div><h3>Results</h3><div>Of 41,166 studies identified, 24 studies were included. Most were cross-sectional; only four were longitudinal, with 1.5- to 6-year follow-up periods. Studies found poorer HRQoL in CYP with ADs compared to those without ADs or healthy peers. The meta-analysis found a strong effect on the psychological/emotional and social functioning of HRQoL. Comorbid ADs were also associated with poor overall HRQoL, with a particularly very large effect on emotional functioning. Limited studies show that childhood ADs were associated with increased health service use and costs, with mixed findings on caregivers’ HRQoL.</div></div><div><h3>Conclusion</h3><div>ADs in CYP were associated with lower HRQoL for CYP and their caregivers, and with increased health service use and costs. This review highlights the need for future research to examine the burden on caregivers and the long-term impact on CYP's HRQoL, service use and costs.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118023"},"PeriodicalIF":4.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738519","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":"Healthy competition? Market structure and the quality of clinical care given to standardised patients in Tanzania","authors":"Timothy Powell-Jackson ,&nbsp;Jessica J.C. King ,&nbsp;Christina Makungu ,&nbsp;Catherine Goodman","doi":"10.1016/j.socscimed.2025.118008","DOIUrl":"10.1016/j.socscimed.2025.118008","url":null,"abstract":"<div><div>The private health care sector in many low- and middle-income countries is rapidly expanding. Private sector advocates have long argued that market competition drives private providers to become more efficient and responsive to patients but empirical studies are limited to mostly high-income settings. We examine whether the number of competing health facilities in close proximity is associated with quality and prices, in a sample of 228 private for-profit and faith-based facilities in Tanzania. Primary data collection took place in the health facilities between February and June 2018. By exploiting data on the quality of clinical care given to unannounced standardised patients, we are able to compare quality across providers without confounding due to patient characteristics. We find that more local competition is associated with poorer clinical quality. The former is driven by an increase in unnecessary care rather than a reduction in appropriate care. Policymakers in such settings should be cautious in assuming that market competition will drive up quality of care.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118008"},"PeriodicalIF":4.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-cultural validation and psychometric testing of the Indonesian version of the Medical Outcomes Study Social Support Survey for people living with diabetes","authors":"Anggi Lukman Wicaksana ,&nbsp;Raden Bowo Pramono ,&nbsp;Pei-Shan Tsai","doi":"10.1016/j.socscimed.2025.118017","DOIUrl":"10.1016/j.socscimed.2025.118017","url":null,"abstract":"<div><div>Social support plays a crucial role in diabetes management. However, few valid tools are available for evaluating social support in Indonesia. Therefore, this study determined the psychometric properties of the Indonesian version of the Medical Outcomes Study Social Support Survey (IMOS-SSS) in people with diabetes. 539 Indonesian adults with diabetes completed the initial survey. In total, 142 participants completed two rounds of testing on the IMOS-SSS. The Cronbach's alpha of the IMOS-SSS was 0.938; with the interclass coefficient of correlation between the results for the first and second tests was 0.954 (p &lt; 0.001). The IMOS-SSS was independently and significantly associated with the mental component of quality of life (β = 0.164, 95 % confidence interval = 0.079–0.217, p &lt; 0.001) after adjustment for confounders. The IMOS-SSS was positively correlated with the Duke Social Support Index (r = 0.362, p &lt; 0.001) and health-status (r = 0.099, p = 0.022) and was negatively correlated with loneliness (r = −0.186, p &lt; 0.001) and depression (r = −0.087, p &lt; 0.001). Factor loadings indicated adequate sampling (Kaiser–Meyer–Olkin = 0.941, Bartlett's test = 6839.87, p &lt; 0.001). Four factors were retained; they explained approximately 69.75 % of the variance and model fit indices were satisfactory (NFI = 0.907, CFI = 0.928, RMSEA = 0.077, GFI = 0.888). These findings support the reliability and validity of the IMOS-SSS in adults with diabetes.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118017"},"PeriodicalIF":4.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traditional medicine in Filipino patients’ therapeutic itineraries","authors":"Gideon Lasco ,&nbsp;Vincen Gregory Yu ,&nbsp;Classisa David","doi":"10.1016/j.socscimed.2025.118022","DOIUrl":"10.1016/j.socscimed.2025.118022","url":null,"abstract":"<div><div>In medical anthropology and public health, there has been a longstanding scholarly focus on the different forms of traditional medicine (TM); how they can collaborate with biomedical health systems; and how people actually embrace both as part of their medical pluralism. However, less attention has been paid on the temporal relationships between TM and biomedicine within individual patient pathways. This paper charts the roles that TM play within the therapeutic itineraries of Filipino patients. In unearthing these connections, we draw from an extensive, multi-sited qualitative study featuring over 30 FGDs involving various demographics and geographic settings in the Philippines. We find that TM figures in people's therapeutic itineraries before, alongside, and after treatment; and that even before consulting traditional healers, people engage in traditional practices on their own. Some diseases are perceived as not warranting biomedical help, while others are seen as deserving a ‘trial’ of TM before biomedical consult; there are also conditions that are seen to be benefit from both - and traditional medicine is also considered a ‘last resort’ if biomedical treatments fail. By identifying the ways in which the temporalities of TM interact with biomedicine, our findings can inform health communications and other public health efforts, while providing a contemporary picture of TM in the country.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118022"},"PeriodicalIF":4.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of place-based consciousness in COVID-19 vaccine hesitancy: A survey analysis across rural and urban subgroups in the U.S.","authors":"Ramsey W. Ash ,&nbsp;Elizabeth Carpenter-Song ,&nbsp;Anne N. Sosin ,&nbsp;Erika L. Moen ,&nbsp;Christine Gunn","doi":"10.1016/j.socscimed.2025.118019","DOIUrl":"10.1016/j.socscimed.2025.118019","url":null,"abstract":"<div><h3>Background</h3><div>Nuanced understandings of the origins of vaccine hesitancy are imperative to increasing vaccine uptake in hesitant populations. This paper examines the viability of the framework of place-based consciousness and its components (out-group resentment and in-group identity) to predict vaccine hesitancy across rural and urban subgroups.</div></div><div><h3>Methods</h3><div>We conducted a national survey of 300 U.S. adults (150 urban, 150 rural) from February 12 to March 5, 2024. We used bivariate correlation tests to assess differences in urban and rural place-based consciousness and regression models to assess the relationship between place-based consciousness and influenza and COVID-19 vaccine hesitancy, controlling for measured personal characteristics.</div></div><div><h3>Results</h3><div>The relationship between place-based consciousness and vaccine hesitancy was significantly modified by rurality for COVID-19 but not influenza vaccine hesitancy. Rural, but not urban, place-based consciousness was a significant predictor of greater odds of COVID-19 vaccine hesitancy. Out-group resentment among rural participants (anti-urban resentment) significantly predicted greater COVID-19 vaccine hesitancy while strength of rural in-group identity was a significant predictor of decreased COVID-19 vaccine hesitancy, both controlling for measured personal characteristics including political leaning, race, and education level.</div></div><div><h3>Conclusions</h3><div>Our finding that rural resentment, but not identity, predicted greater odds of COVID-19 vaccine hesitancy suggests a rural ethos which encourages rural community members to protect their community health via vaccination while rural resentment toward urban-appearing vaccines and their dissemination may be an important facet of rural vaccine hesitancy. Further exploration into these relationships should adopt ethnographic methods of deep inquiry to render visible the mechanisms through whichthey may operate.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118019"},"PeriodicalIF":4.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making sense of absent-yet-present others: Representing the liminal vegetative state beyond life and death","authors":"Edoardo Zulato ,&nbsp;Paula Castro ,&nbsp;Carolina Silvia Quagliarella ,&nbsp;Lorenzo Montali","doi":"10.1016/j.socscimed.2025.118021","DOIUrl":"10.1016/j.socscimed.2025.118021","url":null,"abstract":"<div><div>Clinically alive yet enduringly unaware, individuals in a vegetative state are caught in their transition between life and death. In turn, their carers struggle to signify the ontological and interactional dilemmas emerging from their liminal relations with an <em>absent-yet-present</em> other and their suspension in time. Drawing on social representations and liminality theories, this study investigates how relatives and professionals deal with these dilemmas. In doing so, the study focuses on the role of relations and time in signifying an <em>absent-yet-present other</em>. We analysed 65 semi-structured interviews with relatives (n = 35) and professionals (n = 30) recruited from five Italian nursing homes between February 2019 and September 2021. A discourse-oriented thematic analysis shows how carers de-anchor patients from dichotomous categories and temporalities (e.g., life/death, person/body, past/future), representing them as existing in an ontological paradox: <em>both</em>/<em>neither</em> and <em>and</em>/<em>nor</em>. The analysis also shows how carers deal with the dilemmas of interacting with a voiceless patient by engaging in collaborative identity work. On the one hand, relatives draw on – and share – memories from the patient's past to construct a ‘new identity’ and ‘present’ for their loved ones. On the other, professionals add ‘clinical identities’ rooted in medical characteristics and promote corporeal communication with voiceless patients. The study highlights how carers can signify their (shared) present, everyday caring activities, and deal with an only apparently meaningless situation by mobilising the patients' pasts and promoting a corporeal sociality.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118021"},"PeriodicalIF":4.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783864","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":"“We have a good neighbor policy”: How street vendors access (or not) water and toilets","authors":"Fernanda Deister Moreira ,&nbsp;Marcilia Maria Germano Alves ,&nbsp;Leo Heller ,&nbsp;Sonaly Rezende","doi":"10.1016/j.socscimed.2025.118020","DOIUrl":"10.1016/j.socscimed.2025.118020","url":null,"abstract":"<div><div>This article explores the essential yet often overlooked challenges faced by street vendors in accessing water and toilet facilities in public spaces. This study investigates the three dimensions of barriers (informational, physical, and services) to accessing these services and their potential effects on health and work and the relationship between formal-informal commerce related to the services barrier. Through a focused ethnography held between 2021 and 2023, interviews and participant observation with 24 street vendors were analyzed using qualitative content analysis. The findings reveal complex informal-formal networks and community relationships that enable vendors to find a way to access water and sanitation services, being the exchange of favors the main pillar of this relationship. However, not all workers establish a relationship, potentializing the violation of the right to water and sanitation at work. One type of barrier (informational) was not identified for both water and toilet access in this study. The physical barrier was not identified for water access, since a barrier would presuppose the existence of facilities. The services barrier was identified for both water and toilets. Headaches, tiredness, and urinal infections were reported as symptoms of inadequate access to water and toilets in this type of workplace. Also, workers with disability and women are more affected as they have specific needs to be addressed.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118020"},"PeriodicalIF":4.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}