Social Science & Medicine最新文献

{"title":"Testing “the science”: A comparative analysis of COVID-19 testing policy across four Canadian provinces","authors":"Katherine Fierlbeck ,&nbsp;Lara Gautier ,&nbsp;Susan Usher ,&nbsp;Sara Allin ,&nbsp;Veena Sriram ,&nbsp;Peter Berman","doi":"10.1016/j.socscimed.2025.117880","DOIUrl":"10.1016/j.socscimed.2025.117880","url":null,"abstract":"<div><div>Following the COVID-19 pandemic, scholarship has focused on the intersection of politics and scientific evidence in the development, distribution and uptake of vaccines; border closures; and interventions such as public space closures or masking. But there is a significant gap in the examination of the political choices which informed how discrete jurisdictions chose to undertake and support COVID-19 testing. Using a qualitative, multiple-case study nested in a larger comparative, mixed-method explanatory case study, this research addresses this gap in the literature through a qualitative analysis based on 103 key stakeholder interviews to inform the narrative of testing strategy across four Canadian provinces. Despite the perception that testing is a largely “scientific” process relatively insulated from political choices and pressures, this study shows that jurisdictions had to address an array of variables, often specific to their region, which strongly influenced policy choices in this area. Testing policy, rather than a simple and straightforward clinical exercise, is a highly complex and nuanced process that must take into account a wide variety of non-clinical variables.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"371 ","pages":"Article 117880"},"PeriodicalIF":4.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601242","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":"Effort-reward imbalance and problem drinking among workers: Differences in gender and the gender composition of industries and main job activities in a prospective cohort study from Sweden","authors":"Aziz Mensah ,&nbsp;Anna Nyberg ,&nbsp;Peter Wennberg ,&nbsp;Susanna Toivanen","doi":"10.1016/j.socscimed.2025.117911","DOIUrl":"10.1016/j.socscimed.2025.117911","url":null,"abstract":"<div><div>Effort-reward imbalance (ERI) is a form of psychosocial work stress known to contribute to health problems among working populations. Given that men and women tend to work in different industries and job activities, the labour market remains gender segregated. This study investigated the relationships between effort, reward, ERI, overcommitment and problem drinking in a sample of the Swedish working population over time and simultaneously explored whether these relationships differ by gender and the gender composition of industries and main job activities. Data were drawn from the <em>Swedish Longitudinal Occupational Survey of Health</em>, collected biennially from 2010 to 2022, comprising 18 017 workers. Work stress and problem drinking were measured with the ERI questionnaire and the Cut-down-Annoyed-Guilty-Eye opener instrument, respectively. A logistic-generalised estimating equation was used to perform the analysis. The results showed that higher scores of all the components of the ERI–model are significantly associated with problem drinking <span><math><mrow><mrow><mo>(</mo><mrow><mi>p</mi><mo>&lt;</mo><mn>0.01</mn></mrow><mo>)</mo></mrow></mrow></math></span>. However, these associations did not significantly differ by gender and the gender composition of industries and main job activities <span><math><mrow><mo>(</mo><mrow><mi>p</mi><mo>&gt;</mo><mn>0.10</mn></mrow><mo>)</mo></mrow></math></span>. Also, overcommitment did not significantly moderate the association between ERI and problem drinking <span><math><mrow><mo>(</mo><mrow><mi>p</mi><mo>&gt;</mo><mn>0.10</mn></mrow><mo>)</mo></mrow></math></span>. Our findings demonstrated that all the components of the ERI–model contribute to problem drinking in working populations and highlight the need for organisations and stakeholders to consider gender as a social structure when developing strategies and interventions aimed at improving work stress and reducing problem drinking.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"372 ","pages":"Article 117911"},"PeriodicalIF":4.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637006","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":"Work-family interface and mental health inequalities between women and men: A gendered exposure model across Canadian provinces","authors":"Jaunathan Bilodeau ,&nbsp;Nancy Beauregard ,&nbsp;Victor Y. Haines III ,&nbsp;Amélie Quesnel-Vallée","doi":"10.1016/j.socscimed.2025.117935","DOIUrl":"10.1016/j.socscimed.2025.117935","url":null,"abstract":"<div><div>Women face a higher risk of common mental health disorders than men, an association that has largely been attributed to their greater exposure to stressors. However, studies testing the exposure hypothesis among the employed population rarely take into account the work-family interface and neglect the macro-social context in the construction of gender.</div><div>This study examines a gendered exposure model, stratified by Canadian province, in which differences between working women and men in work and family conditions, work-family conflict, and work-family enrichment are linked to self-reported mental health inequalities. Path analyses were conducted for Alberta, British Columbia, Quebec, and Ontario using data from 6,786 employed respondents to the 2022 Canadian Community Health Survey. The exposure hypothesis was tested through indirect associations between sex categories and mental health via work and family conditions and the work-family interface.</div><div>Findings show that in Quebec, women report higher work stress, which is indirectly linked to poorer mental health through increased work-to-family conflict. In Alberta, women report more work stress, which is associated with poorer mental health. Women also work fewer hours than men, a factor linked to poorer mental health in Quebec and Ontario.</div><div>Overall, the results indicate that work-family stressors and resources contribute more to provincial differences in mental health than in gendered mental health inequalities, highlighting the need to differentiate between general determinants of mental health and the factors driving mental health disparities. This study emphasizes the importance of integrating the work-family interface when documenting the structuring influence of gender on mental health inequalities.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 117935"},"PeriodicalIF":4.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716136","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":"Using spatial Bayesian models to estimate associations between structural racial discrimination and disparities in severe maternal morbidity","authors":"Jasmin A. Darville ,&nbsp;Katherine Campbell ,&nbsp;Kaitlyn K. Stanhope ,&nbsp;Alexis Kendall ,&nbsp;Sierra Carter ,&nbsp;Michael R. Kramer ,&nbsp;Ran Zhang ,&nbsp;Sheree L. Boulet","doi":"10.1016/j.socscimed.2025.117932","DOIUrl":"10.1016/j.socscimed.2025.117932","url":null,"abstract":"<div><h3>Introduction</h3><div>The United States maternal health crisis is especially profound in Georgia, disproportionately affecting Black birthing people. In Georgia, 35% of all births are to Black-identifying people, with rates of severe maternal morbidity (SMM) significantly exceeding national averages.</div></div><div><h3>Methods</h3><div>The sample population comprised Georgia linked live birth/fetal death certificate and hospital discharge data for deliveries from 2013 to 2021. Structural racial discrimination (SRD) was defined at the county level using four domains. We estimated county-specific rates of SMM using Bayesian conditional autoregressive Poisson models and compared the rate difference in SMM for Black versus white birthing people across domain-specific strata of SRD.</div></div><div><h3>Results</h3><div>The sample included 709,335 deliveries to Black and white birthing people. The prevalence of SMM was higher among births to Black individuals compared to white counterparts (3.2% vs. 1.7%), with a mean risk difference of 13.1 per 1000 deliveries between race groups. Results of the SRD-SMM regression demonstrated larger Black-white racial disparities in counties with the highest concentration of resource deprivation compared to the highest concentration of affluence (B: 4.5, 95% CI: 1.1, 8.0). Similarly, in counties with a greater polarization of Black and low-income residents, the disparity was larger compared to counties with greater racial and income homogeneity (B: 3.84, 95% CI: 0.22, 7.44).</div></div><div><h3>Conclusions</h3><div>Our results highlight the nuanced relationship between structural racism and health outcomes in Georgia. SMM rates were higher among Black birthing people compared to their white counterparts.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"371 ","pages":"Article 117932"},"PeriodicalIF":4.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601243","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":"Exploring the drivers of unsustainable pressures in health and social care: A qualitative system dynamics approach","authors":"Le Khanh Ngan Nguyen ,&nbsp;Holly McCabe ,&nbsp;Susan Howick ,&nbsp;Itamar Megiddo ,&nbsp;Soumen Sengupta ,&nbsp;Alec Morton","doi":"10.1016/j.socscimed.2025.117913","DOIUrl":"10.1016/j.socscimed.2025.117913","url":null,"abstract":"<div><div>Health and social care systems face immense pressures that emerge from complex interdependencies between system components, transcending conventional explanations of demand-capacity mismatches. Although multiple theoretic perspectives (e.g., “complex adaptive systems”, “sociotechnical systems”) have been advocated as ways to capture and characterise the nature of that complexity, consolidating it into actionable insights for coordinated stakeholder efforts remains challenging, perpetuating implementation failure. This study introduces a novel application of qualitative system dynamics, using Causal Loop Diagrams (CLDs), to reveal the deeper structural patterns that drive persistent challenges and explain why policies have often fallen short.</div><div>Developed through stakeholder interviews in South Lanarkshire, Scotland (24 interviews conducted between February and June 2023), triangulated with UK-wide evidence, our CLD reveals how well-intentioned interventions generate cross-sectoral ripple effects. While stakeholders may recognise isolated consequences, organisational silos and temporal delays obscure the full complexity of feedback structures. Our findings expose inherent trade-offs, demonstrating how multiple, competing perspectives and reactive coping measures create emergent system properties that fundamentally challenge the oversimplified notion of “whole system working”, often hailed as a “magic bullet” solution. Significantly, we uncover a paradoxical tension: cross-sector collaboration initiatives can undermine personalised care delivery, highlighting the risk of conflicting strategic and political goals weakening intended outcomes.</div><div>Our study advances system dynamics methodology by combining individual and cascaded system archetypes, enhancing clarity in communication of complex issues without losing critical feedback loops. This advancement provides decision-makers with a sophisticated yet accessible tool to visualise and understand complex system behaviour, engaging stakeholders through iterative feedback loop refinements, and steering towards an equitable, improved state.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"371 ","pages":"Article 117913"},"PeriodicalIF":4.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601244","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":"Family participation in geriatric decision-making: Marginalization of older patients’ autonomy in Chinese outpatient consultation","authors":"Tianxin Yan,&nbsp;Min Yang","doi":"10.1016/j.socscimed.2025.117908","DOIUrl":"10.1016/j.socscimed.2025.117908","url":null,"abstract":"<div><div>Family participation is regarded as crucial for promoting patient well-being, particularly in geriatric care, where patients often face greater challenges and require additional support in making medical decisions. The importance of family participation is frequently framed within a cultural context that acknowledges differing conceptions of autonomy. However, it remains unclear how family members are actually prompted or discouraged in their participation in medical decision-making. This article aims to identify the interactional patterns of decision-making during accompanied geriatric consultations and to examine the underlying mechanisms shaping these dynamics. Focusing on audio recordings of 86 geriatric encounters, the mixed-method study identified four decision-making patterns through nuanced Conversation Analysis: <em>direct family surrogation, substitute family surrogation</em>, and <em>patient-centered collaboration</em>. A subsequent quantitative analysis was conducted to explore factors influencing these decision-making patterns, in which the identity of the companion emerged as a key factor shaping interactional dynamics, with adult children being significantly more likely to assume a surrogate role than spouses. These findings are discussed in the context of the broader social structure of elder care and the institutional constraints present in the Chinese medical system. This study emphasizes the need for caution in overemphasizing cultural characteristics, as doing so risks systematically marginalizing the social agency and self-efficacy of older adults. We call for greater efforts to ensure the meaningful participation of older individuals in healthcare decisions.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"372 ","pages":"Article 117908"},"PeriodicalIF":4.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621304","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 insurance, race, and receipt of a postpartum visit among patients giving birth in a referral hospital in the US South","authors":"Jesse Rattan ,&nbsp;Justin M. Leach ,&nbsp;Christina Blanchard ,&nbsp;Meghan Tipre ,&nbsp;T. Robin Bartlett ,&nbsp;Azita Amiri ,&nbsp;Monica L. Baskin ,&nbsp;Rachel Sinkey ,&nbsp;Janet M. Turan","doi":"10.1016/j.socscimed.2025.117922","DOIUrl":"10.1016/j.socscimed.2025.117922","url":null,"abstract":"<div><h3>Background</h3><div>The United States faces a maternal mortality crisis with stark and unacceptable disparities. Postpartum care (PPC) is crucial for identifying and managing complications after childbirth. However, access to PPC is inconsistent, especially for marginalized individuals such as Black birthing people and Medicaid beneficiaries. We examined the effect of the intersection of race and insurance type on the patients’ receipt of postpartum care (PPC) in a large referral hospital in the Southeast US.</div></div><div><h3>Methods</h3><div>In this cross-sectional retrospective cohort study, we analyzed data from electronic health records for 14,531 people who gave birth from January 2014 to March 2020 in a labor and delivery unit caring for more than 4000 births per year in the Southern US. Variables included race/ethnicity, insurance status, maternal age, number of living children, mode of delivery, and presence of chronic conditions. We produced descriptive statistics and used multivariable log-binomial models to estimate adjusted risk ratios (RR) for receiving PPC, including interaction terms between race and insurance.</div></div><div><h3>Results</h3><div>In a retrospective analysis of electronic health records of 14,531 patients who gave birth in a large health system in the US South, 53.0% of patients received a clinic-based PPC visit. Having private insurance, compared to Medicaid insurance, was associated with a higher likelihood of receiving clinic-based PPC but a lower likelihood of visiting the Maternity Evaluation Unit, a special unit for urgent or emergency care.</div></div><div><h3>Conclusion</h3><div>Type of insurance is associated with receipt of postpartum care. Disparities in PPC are modestly influenced by the interaction between race and insurance type. Private insurance, as compared to Medicaid insurance, increases the likelihood of postpartum care across all racial groups with some differences in this relationship by race/ethnicity. Next steps should include qualitative research that helps us better understand the differences in receipt of PPC by insurance coverage and the interactions between insurance status and race. Implementation research should also test practical strategies to increase access to postpartum care, particularly for Medicaid-insured and other marginalized individuals.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"372 ","pages":"Article 117922"},"PeriodicalIF":4.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681767","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 disparity among older adults in Urban China: Does labor migration Matter?","authors":"Zehan Pan ,&nbsp;Feiyang Yang ,&nbsp;Nan Yang ,&nbsp;Riming Nie","doi":"10.1016/j.socscimed.2025.117925","DOIUrl":"10.1016/j.socscimed.2025.117925","url":null,"abstract":"<div><div>China has seen a surge in labor migration and widening regional health disparities among urban older residents since the late 1990. However, the relationship between labor migration and these disparities remains unknown. This study employs the shift-share instrument method to explore the association between labor migration and the self-rated health among urban older residents with the microdata from the 1% National Population Sample Survey (2005 and 2015) and provincial panel data (2010–2020). The results indicate that regions with higher net labor inflow exhibit improved average health levels and reduced health inequality among local older adults with varying socioeconomic statuses. Between 2010 and 2015, labor migration led to a 9.21 percentage point increase in the regional disparity of self-rated “healthy” probabilities among urban older residents. The key mechanism underlying these effects is the positive effects of labor migration on the wellbeing of certain group of urban older residents. The findings of this study suggest that social benefits access inequality between migrants and non-migrants, and the health disparities among urban older adults underscore broader structural inequality in China.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"371 ","pages":"Article 117925"},"PeriodicalIF":4.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578441","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":"Where there are no visitors: Improvising care in a pediatric hospital in Zambia","authors":"Jean Hunleth ,&nbsp;Lindsey Kaufman ,&nbsp;Emma Bunkley ,&nbsp;Sarah Burack ,&nbsp;Sam Miti ,&nbsp;Comfort Asante","doi":"10.1016/j.socscimed.2025.117931","DOIUrl":"10.1016/j.socscimed.2025.117931","url":null,"abstract":"<div><div>In hospitals in Zambia, family members carry out intimate and care procedures, run errands, and offer emotional and practical support to patients. However, their presence also creates challenges when they use resources, take up space dedicated to patients, and contribute to disease spread. The COVID-19 pandemic brought such tensions into view and drove hospital administrators, clinicians, and researchers to draw a bright line between family as caregivers (considered necessary) and family as visitors (considered extraneous). In this article, we ask: If caregivers are not visitors, then who are visitors? What is the work of visiting? From 2020 to 2021, we carried out research in a Zambian pediatric hospital when visitors were not allowed to enter the hospital, but a singular caregiver was required at the bedside of each child admitted. Our findings from interviews with 44 healthcare workers and 30 caregivers revealed several themes—that the care work required in hospitals surpasses the ability of a single caregiver; that ephemeral encounters between caregivers and visitors facilitate sympathy driven care; and that witnessing need could catalyze and exhibit support. We expand on these themes, focusing on one grandmother's months-long stay with her granddaughter in the hospital, to show how caregiver, visitor, and healthcare worker roles were improvised and reworked. Ultimately, this research breaks down binaries commonly cited in discussions of family caregiving, such as essential and non-essential, helpful and wasteful, caregiver and visitor. This has policy implications because ignoring or dismissing visitors as extraneous will further disadvantage caregivers and patients and disenfranchise families.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 117931"},"PeriodicalIF":4.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716134","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":"Moving away from volunteerism in community health? Motivations and wellbeing among urban and rural Ethiopian volunteers","authors":"Kenneth Maes ,&nbsp;Svea Closser ,&nbsp;Yihenew Tesfaye ,&nbsp;Roza Abesha","doi":"10.1016/j.socscimed.2025.117928","DOIUrl":"10.1016/j.socscimed.2025.117928","url":null,"abstract":"<div><div>Questions about the fairness, efficacy, and sustainability of volunteerism in community health have led some states and programs to attempt to scale back their reliance on “volunteer” labor. Such attempts demand theory-driven, comparative ethnographic research that makes sense of how such moves unfold and impact the lives of CHWs and the programs surrounding them. Guided by theory of the interaction of political and moral economies, this article comparatively analyzes two predominantly female community health workforces in Ethiopia, who worked as unpaid volunteers when their federal government was supposedly “moving away from volunteerism” in community health: (1) HIV/AIDS-focused, home-based caregivers in Addis Ababa (2007-9) organized by NGOs; and (2) primary health care-focused members of the Women's Development Army in rural Amhara (2012–16) organized by the state. Ethnographic and mixed methods, including surveys of volunteers' wellbeing (n = 110 in Addis Ababa; n = 73 in rural Amhara), were used to assemble each dataset. These data show 1) how exploitation of “volunteer” community health labor by states, NGOs, and partnerships between them is maintained through discourses of sacrifice and related notions; 2) what the deprivation, distress, and desires of community health workers reveal about the “voluntariness” of their labor; 3) how CHWs organize themselves into collectives seeking better working conditions; and 4) how these experiences and processes are gendered. In this post-COVID-19 era of persistent inequalities in health globally, comparative ethnographic research of efforts to move away from volunteerism can provide useful lessons for CHWs, policymakers, and advocates.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"371 ","pages":"Article 117928"},"PeriodicalIF":4.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578445","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}