Social Science & Medicine最新文献

{"title":"The persistence of the hegemonic and patriarchal healthcare model during women-centered reforms of Costa Rica's public health system","authors":"Ingrid Gómez-Duarte ,&nbsp;Karol Rojas Araya ,&nbsp;Verónica Gamboa Lizano ,&nbsp;Rocío Sáenz Madrigal ,&nbsp;Wendy López Vargas ,&nbsp;Wilmer Sancho ,&nbsp;Silvia Salazar Villegas ,&nbsp;Jeimy Torres ,&nbsp;Arachu Castro","doi":"10.1016/j.socscimed.2025.118083","DOIUrl":"10.1016/j.socscimed.2025.118083","url":null,"abstract":"<div><div>This study examines how hegemonic medical models and patriarchal structures persist within healthcare reforms ostensibly designed to promote women-centered maternity care. Following obstetric violence complaints in Costa Rican public hospitals in 2015, health authorities developed a comprehensive maternity care model based on nine principles, including human rights, gender focus, and person-centered care. We analyze the tensions between reform intentions and implementation realities through in-depth interviews with ten participants representing three stakeholder groups: policymakers who formulated the model (n = 3), clinicians who implemented it (n = 4), and feminist advocates (n = 3). Data collection occurred during 2020–2022 at the implementation site of the Puntarenas Hospital in Costa Rica. Through triangulation of perspectives, we demonstrate how the authoritarian medical habitus persists despite explicit reform efforts, with women continuing to be perceived as objects rather than rightsholders. Our findings contribute to social science theory by illustrating how biomedical hegemony absorbs progressive reforms while maintaining fundamental power relations, confirming Menéndez's theories on medical hegemony and bringing Bourdieu's practice theory into healthcare institutions. We argue that transforming maternity care requires addressing both individual practices and the structural conditions that normalize obstetric violence, advancing theoretical understandings of institutional change in gender-based healthcare contexts.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"377 ","pages":"Article 118083"},"PeriodicalIF":4.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902571","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":"Socioeconomic position and type 2 diabetes: Examining the mediating role of social cohesion—The Maastricht Study","authors":"Jeroen D. Albers ,&nbsp;Annemarie Koster ,&nbsp;Bengisu Sezer ,&nbsp;Rachelle Meisters ,&nbsp;Jeffrey A. Chan ,&nbsp;Anke Wesselius ,&nbsp;Miranda T. Schram ,&nbsp;Bastiaan E. de Galan ,&nbsp;Jeroen Lakerveld ,&nbsp;Hans Bosma","doi":"10.1016/j.socscimed.2025.118046","DOIUrl":"10.1016/j.socscimed.2025.118046","url":null,"abstract":"<div><div>The relationship between socioeconomic position and type 2 diabetes is well-established; individuals of lower socioeconomic position experience substantially higher rates of the disease. This study investigated the mediating role of perceived and ecometric area-level social cohesion in the association between socioeconomic position and incident type 2 diabetes.</div><div>In a prospective population-based cohort, The Maastricht Study, we analyzed data from 6,604 participants (<span><math><mover><mrow><mi>age</mi></mrow><mo>¯</mo></mover></math></span> = 58.6 years, 55% female) with a median follow-up of 8.1 (IQR 5.1–10.1) years. We examined whether perceived or area-level social cohesion (in 500 m squares, five-character postal code areas, and neighborhood areas) mediated the association between socioeconomic position (represented by educational attainment, occupational status, or income) and incident type 2 diabetes. We employed a causal mediation approach based on linear regression and Cox proportional hazards models.</div><div>Individuals with lower socioeconomic position were more likely to perceive lower social cohesion and to live in areas with diminished social cohesion. Lower area-level social cohesion was associated with an increased risk of developing type 2 diabetes. The mediating effect of social cohesion was more pronounced in urban areas. In urban areas, the total effect of education (contrasting the 83rd and 17th percentiles) on type 2 diabetes incidence was a hazard ratio (HR) of 2.03 (95% CI: 1.62–2.58), with area-level social cohesion mediating 24.4% (11.1%–40.3%) of this effect. In less urban areas, social cohesion mediated 12.6% (5.2%–23.0%) of a HR of 1.89 (1.50–2.40). Similar findings were observed with occupational status and income, and across other aggregation levels.</div><div>Socioeconomic position is linked to lower social cohesion, which is associated with an increased risk of type 2 diabetes. Enhancing social cohesion in disadvantaged areas may help reduce diabetes-related health disparities, particularly in urban settings. Further research is needed to better understand the mechanisms underlying these relationships.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"376 ","pages":"Article 118046"},"PeriodicalIF":4.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870821","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":"Provision of primary healthcare centers and women's healthcare-seeking behaviour: Evidence from Bangladesh","authors":"Mohammad Riaz Uddin","doi":"10.1016/j.socscimed.2025.118079","DOIUrl":"10.1016/j.socscimed.2025.118079","url":null,"abstract":"<div><div>This study examines the association between the establishment of primary healthcare providers- community clinics (CCs)- and healthcare-seeking behavior in Bangladesh. Initiated in 1998, CCs aim to provide accessible healthcare services to remote households, particularly focusing on women and children. Using cluster-level data on healthcare provider availability alongside individual-level data from the Bangladesh Demographic and Health Survey (BDHS) for 2011, 2014, and 2017-18, the respective sample sizes are 17842, 17886, and 20127 ever-married women, the study offers robust estimates that address endogeneity concerns present in individual-level analyses. Lagged health indicators are utilized to consider contextual factors influencing CC establishment in specific regions. Results indicate positive associations between CC presence and various healthcare-seeking behaviors, such as increased contraceptive use, higher attendance at antenatal care visits, and improved treatment-seeking for children's illnesses. Notably, rural-urban disparities in healthcare-seeking behavior highlight existing access inequalities. To mitigate this divide, the study recommends expanding CCs nationwide, demonstrating that low-cost healthcare interventions can enhance healthcare-seeking behaviors and suggest potential scalability in similar contexts.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"375 ","pages":"Article 118079"},"PeriodicalIF":4.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850114","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":"Web and/or MD?: Empirically testing the relationships between internet use and visits to healthcare professionals","authors":"Cayley Ryan-Claytor","doi":"10.1016/j.socscimed.2025.118071","DOIUrl":"10.1016/j.socscimed.2025.118071","url":null,"abstract":"<div><div>The proliferation of the internet as a widely accessible repository of health information has sparked theoretical and empirical concerns about its potential use as a replacement for traditional healthcare services. Existing research highlights how use of the internet as a health information resource has influenced individuals' experiences in healthcare settings, but has not yet explored its relationship with use of healthcare services. Using data from the National Health Interview Survey, I find a significant positive association between use of the internet to seek health information and visits to traditional healthcare providers. This association is not explained by factors related to respondents' social and demographic characteristics, health status, or access to health services. This relationship is strongest among adults aged 18–39, suggesting that younger adults may be more inclined than their older counterparts to address health concerns using both the internet and traditional medical services. In line with Fundamental Cause Theory, the relationship is strongest among the highly educated, such that individuals with a Bachelor's degree are more likely than their peers to use both the internet and traditional healthcare services as health resources. This study provides evidence in favor of the hypothesis that U.S. adults – and especially young adults with college degrees – are largely using the internet as a <em>complement</em> to the information and services provided by traditional medical providers, rather than a replacement.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"376 ","pages":"Article 118071"},"PeriodicalIF":4.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864335","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":"Efficacy of a culturally tailored intervention on perceived stigma among women living with HIV/AIDS in China: A randomized clinical trial","authors":"Zhongfang Yang ,&nbsp;Shuyu Han ,&nbsp;Xiang Qi ,&nbsp;Jing Wang ,&nbsp;Zhijing Xu ,&nbsp;Weiyu Mao ,&nbsp;Yaguang Zheng ,&nbsp;Yue Zhang ,&nbsp;Bei Wu ,&nbsp;Yan Hu","doi":"10.1016/j.socscimed.2025.118072","DOIUrl":"10.1016/j.socscimed.2025.118072","url":null,"abstract":"<div><h3>Background</h3><div>Despite evidence supporting the efficacy of culturally tailored interventions in reducing stigma, such approaches are lacking for women living with HIV/AIDS (WLWHAs) in China. We conducted this study to determine the efficacy of the culturally tailored Helping Overcome Perceived Stigma (HOPES) intervention in reducing perceived stigma among WLWHAs in China.</div></div><div><h3>Methods</h3><div>A single-blinded, two-arm parallel-group randomized clinical trial was conducted from 2023 to 2024 in South and Southwest China. WLWHAs from four hospitals were assigned using a WeChat-embedded randomization application to the control group (usual care) or the HOPES intervention. Data analysts remained blinded. Interventions were conducted virtually using Leave No One Behind (LNOB) platform for 3 months. The primary outcome, perceived stigma score, was assessed at baseline, immediately after the intervention and at 3 months post-intervention using 7 items from the HIV/AIDS Stigma Experience Questionnaire (HASEQ), with data analyzed through repeated measures analysis.</div></div><div><h3>Results</h3><div>Of 136 WLWHAs screened, we randomized 101 WLWHAs (50 HOPES; 51 controls). The HOPES group demonstrated a statistically significant reduction in perceived stigma scores immediately after the intervention (−3.86 points, 95 % CI: 5.34 to −2.38, P &lt; .001) and at three months post-intervention (−5.83 points, 95 % CI: 7.20 to −4.47, P &lt; .001) compared to the control group.</div></div><div><h3>Conclusion</h3><div>The findings demonstrate HOPES' efficacy in reducing perceived stigma in WLWHA. However, the clinical significance of these changes needs further investigation. Future research should focus on defining meaningful patient-reported thresholds, assessing long-term impact, and optimizing delivery methods.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"374 ","pages":"Article 118072"},"PeriodicalIF":4.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834885","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":"Under pressure: Assessing the relationship between job loss and mental health of young adults in Vietnam","authors":"Richard Freund ,&nbsp;Marta Favara ,&nbsp;Catherine Porter ,&nbsp;Douglas Scott ,&nbsp;Le Thuc Duc","doi":"10.1016/j.socscimed.2025.118073","DOIUrl":"10.1016/j.socscimed.2025.118073","url":null,"abstract":"<div><div>We examine the association between job loss and mental health among young people in Vietnam using longitudinal data from the Young Lives survey. We exploit the timing of the first severe wave of COVID-19 which occurred between rounds of a phone survey, allowing comparison of pre- and post-wave job status and mental health for the same individuals. Using fixed effects regressions, our findings suggest that job loss is associated with increased levels of anxiety but not depression, in the short run. Specifically, job loss is linked to a 5.9 percentage point (pp) rise in the probability of experiencing symptoms of mild or severe anxiety, nearly double the pre-wave baseline. This association is particularly evident among individuals in the top earnings tercile who no longer live in their natal household, who experience nearly a 17pp increase in the probability of at least mild anxiety. Additional analysis suggests that financial strain and food insecurity may explain just over 20% of the observed associations. These findings highlight the need for targeted mental health and psychosocial support interventions for young people experiencing job loss, particularly among those who are under financial pressure as primary earners in their household.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"375 ","pages":"Article 118073"},"PeriodicalIF":4.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859720","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 impact of minimum wages on overall health and well-being: Global evidence from the Gallup World Poll","authors":"Panagiotis Sotirakopoulos ,&nbsp;Cahit Guven ,&nbsp;Aydogan Ulker ,&nbsp;Carol Graham","doi":"10.1016/j.socscimed.2025.118064","DOIUrl":"10.1016/j.socscimed.2025.118064","url":null,"abstract":"<div><div>We examine the impact of minimum wage increases on the overall self-reported health and subjective well-being of low-skilled workers using the Gallup World Poll from 2009 to 2020. We identify effects using within-country changes over time and cross-country variations in the timing and intensity of minimum wage increases across 87 countries. Our findings suggest that minimum wage increases benefit health and certain dimensions of subjective well-being. Specifically, we estimate a range of specifications and find that a 10 percent increase in the minimum wage leads to an increase in self-reported health ranging from 0 % to 1 % and an increase in satisfaction with the standard of living between 1 % and 6 %, at the outcome means. Minimum wage increases are linked to higher incomes, a lower likelihood of overtime work, enhanced social interactions, and more positive daily experiences. These benefits are especially significant in countries with stronger rule of law, among male workers, and for individuals in nations with free and universal healthcare access. A series of sensitivity and placebo tests confirm the robustness of these findings.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"375 ","pages":"Article 118064"},"PeriodicalIF":4.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834219","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":"Evaluate the health risks and impact pathways of precarious employment in the context of globalization: A national longitudinal research from 2017 to 2023 in Japan","authors":"Dan Li ,&nbsp;Masaaki Yamada ,&nbsp;Wenmeng Feng ,&nbsp;Liuchun Xiang ,&nbsp;Shuang Gao ,&nbsp;Haisong Nie","doi":"10.1016/j.socscimed.2025.118063","DOIUrl":"10.1016/j.socscimed.2025.118063","url":null,"abstract":"<div><h3>Background</h3><div>Since the 1970s, neoliberalism has transformed the global economy, replacing full-time, long-term employment with flexible work arrangements, contributing to precarious employment (PE). PE has been linked to negative health outcomes, but research on the multiple dimensions of PE remains limited.</div></div><div><h3>Methods</h3><div>This study employed a longitudinal cohort design using data from the Japanese Panel Study of Employment Dynamics (JPSED) from 2017 to 2023, focusing on individuals aged 16–65 who were employed but not on full-time permanent contracts. We developed a modified Employment Precariousness Scale (EPRES-JP) for evaluation. The entropy-based TOPSIS method with adjustable weight coefficients (Ea-TOPSIS) method was applied to calculate the Precarious Employment Index (PEI), and logistic regression analyzed its association with health outcomes, while Structural Equation Modeling (SEM) explored potential mediating pathways.</div></div><div><h3>Results</h3><div>The study found that the \"Rights\" dimension (social insurance and leave access) had the highest average weight at 40.2 %, with the impact of COVID-19 (introduced in 2021) significantly contributing to the PEI. Higher PEI was associated with greater risks of headaches (OR_0.1 = 1.11, 95 % CI [1.06, 1.16]), fatigue (OR_0.1 = 1.09, 95 % CI [1.04, 1.14]), anxiety (OR_0.1 = 1.12, 95 % CI [1.07, 1.17]), depression (OR_0.1 = 1.18, 95 % CI [1.13,1.24]), loss of appetite (OR_0.1 = 1.22, 95 % CI [1.16, 1.28]), and sleep disturbances (OR_0.1 = 1.20, 95 % CI [1.15, 1.25]). SEM identified mediating pathways between PE, job and life satisfaction, and health outcomes.</div></div><div><h3>Conclusion</h3><div>These findings deepen our understanding of how PE affects worker health. Enhancing job characteristics and life satisfaction may mitigate the health risks of PE. Broader labor policies are essential to improve job security and worker well-being.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"374 ","pages":"Article 118063"},"PeriodicalIF":4.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829586","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":"Queer Tax: Examining 2SLGBTQ+ Black, Indigenous, and People of Colour's experiences of accessing assisted reproductive technologies","authors":"Michelle W. Tam,&nbsp;Amaya Perez-Brumer,&nbsp;Lori E. Ross","doi":"10.1016/j.socscimed.2025.118053","DOIUrl":"10.1016/j.socscimed.2025.118053","url":null,"abstract":"<div><div>The use of assisted reproductive technologies (ART) has risen steadily over the past two decades. In Canada, up to 25 % of assisted reproductive technologies (ART) users identify as Two-Spirit, lesbian, gay, bisexual, trans, and/or queer (2SLGBTQ+). Despite evidence of inequitable ART access for 2SLGBTQ+ communities, scant research has explored the intersectional experiences of 2SLGBTQ+ Black, Indigenous, and People of Colour (BIPOC). Theoretically grounded in reproductive justice and critical political economy, this study examines ART access and clinical experiences for 2SLGBTQ+ BIPOC communities. Interviews were conducted with BIPOC and 2SLGBTQ+ people who had undergone or were seeking ART in Ontario, Canada<strong>.</strong> Data analysis, guided by constructivist grounded theory and situational analysis, was coded using MAXQDA. The findings reveal structural powers and systemic inequalities shaping the ART process and parenthood. Participants identified four key barriers faced by 2SLGBTQ+ BIPOC families: (1) normative practices (re)produced through ART; (2) mandatory counselling as gatekeeping and disciplining; (3) regulation of known donor sperm augmenting legal, financial, and timeliness barriers; and (4) limited availability of Black, Indigenous, and People of Colour donor sperm. These intersectional barriers highlight the urgent need for ART providers to offer competent and inclusive care. Additionally, the study underscores the necessity for clinical policy reforms to challenge heteronormative and racist practices, ensuring equitable access and improving availability of BIPOC donor sperm for diverse family structures.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"376 ","pages":"Article 118053"},"PeriodicalIF":4.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870851","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":"Identifying the need for care in rheumatoid arthritis: A Candidacy 2.0 analysis of lived experiences","authors":"Sharon Koehn ,&nbsp;C. Allyson Jones ,&nbsp;Anh Pham ,&nbsp;Claire E.H. Barber ,&nbsp;Jessica Widdifield ,&nbsp;Lisa Jasper ,&nbsp;Douglas Klein ,&nbsp;Neil Drummond","doi":"10.1016/j.socscimed.2025.118040","DOIUrl":"10.1016/j.socscimed.2025.118040","url":null,"abstract":"<div><div>This study explores how individuals with rheumatoid arthritis (RA) come to identify themselves as candidates for medical care, using the newly developed Candidacy 2.0 model. Candidacy 2.0 extends the original Candidacy Framework by emphasizing the role of the embodied intersectional relational self in healthcare access, providing a theoretical framework that transcends specific healthcare systems. Through semi-structured interviews with 33 individuals living with RA across six Canadian provinces, we examined how embodied experiences, social identities, and relational contexts shape initial recognition of care needs. Analysis revealed distinct 'tipping points' where symptom progression from single to multiple joints and unmanageable pain forced recognition of care needs. Age and gender identities created distinct barriers to care-seeking: younger individuals dismissed symptoms as affecting only older adults, while gendered expectations about caregiving delayed help-seeking among women. Professional identity emerged as particularly significant, offering knowledge advantages but sometimes hindering patient-centered care. Support networks proved crucial in symptom interpretation and help-seeking, with their importance highlighted by COVID-19-related disruptions. The study demonstrates how Candidacy 2.0's emphasis on embodied, intersectional, and relational aspects of healthcare access enhances understanding of help-seeking behaviors in chronic conditions. Findings suggest the need for targeted public health campaigns addressing age-related misconceptions, gender-sensitive clinical approaches, flexible care delivery models that accommodate support networks, and educational resources helping patients identify and act upon significant symptom changes.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"374 ","pages":"Article 118040"},"PeriodicalIF":4.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824286","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}