European Geriatric Medicine最新文献

{"title":"Characteristics and care trajectories of older patients in temporary stays in Denmark.","authors":"Hanin Harbi, Carina Lundby, Peter Bjødstrup Jensen, Søren Post Larsen, Linda Grouleff Rørbæk, Lene Vestergaard Ravn-Nielsen, Jesper Ryg, Mette Reilev, Kasper Edwards, Anton Pottegård","doi":"10.1007/s41999-025-01209-9","DOIUrl":"https://doi.org/10.1007/s41999-025-01209-9","url":null,"abstract":"<p><strong>Purpose: </strong>Temporary stays for patients requiring short-term care outside the home, often following hospital discharge, has gained increasing importance. This study aimed to describe the characteristics and care trajectories of older patients in Danish temporary stays to improve care delivery and patient safety.</p><p><strong>Methods: </strong>We conducted a descriptive study on a cohort of patients in temporary stays across 14 Danish municipalities from 2016 to 2023, using data from national health registries.</p><p><strong>Results: </strong>We identified 11,424 patients with a median age of 81 years (interquartile range [IQR] 73-87 years); 54% were women. Patients exhibited a high level of comorbidity, with a median Charlson Comorbidity Index of 1 (IQR 0-2), and a median of 3 hospital admissions (IQR 2-6) in the year preceding their move into temporary care. The majority (70%) transitioned to temporary stays following hospital discharge, while 30% were admitted directly from their homes. The median duration of temporary stays was 24 days (IQR 11-49 days), with 9.1% staying ≥ 90 days. Additionally, 7.0% of patients were hospitalised directly from the temporary stay facility, with a median time to hospital admission of 13 days (IQR 5-28 days). Median survival after admission to a temporary stay was 23 months (IQR 3.6-57 months). Predictors of mortality included male sex, older age, higher comorbidity burden, and increased number of hospital admissions prior to temporary stay.</p><p><strong>Conclusion: </strong>Patients in temporary stays are generally older individuals with multimorbidity and limited life expectancy. Most patients are admitted following hospital discharge, and their stays are often prolonged.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between early mobilization after hip fracture surgery and risk of long-term opioid therapy.","authors":"Yasmina Maria Tudorache, Ina Trolle Andersen, Thomas J Hjelholt, Morten Tange Kristensen, Katie J Sheehan, Alma B Pedersen","doi":"10.1007/s41999-025-01227-7","DOIUrl":"https://doi.org/10.1007/s41999-025-01227-7","url":null,"abstract":"<p><strong>Aim: </strong>To examine the association between early mobilization after hip fracture surgery and the risk of long-term opioid therapy at 1-year follow-up.</p><p><strong>Findings: </strong>Long-term opioid therapy is a common complication after hip fracture surgery. Mobilization within 24 h after surgery is associated with a lower risk of long-term opioid therapy compared to mobilization between 24 and 36 h.</p><p><strong>Message: </strong>Early mobilization is one of the key elements of the successful patient recovery for reducing risk of complications and mortality after hip fracture surgery.</p><p><strong>Purpose: </strong>Early mobilization after hip fracture operation is associated with better clinical outcomes, but its impact on long-term opioid therapy (LTOT) remains unclear.</p><p><strong>Methods: </strong>Using Danish population-based registries we included patients aged ≥ 65 who underwent surgery for a first-time hip fracture between 2016 and 2021 (n = 36,229). LTOT was defined as redeeming ≥ 2 prescriptions between 31 and 365 days of surgery. Using stabilized inverse probability of treatment (sIPT) weighing, we calculated risks and risk differences with 95% confidence intervals (CI) for opioid use balancing mobilization groups ≤ 24 h vs 24-36 h on measured confounders and taking death into consideration.</p><p><strong>Results: </strong>67.3% of all patients were women and the median age was 82.6 years (75.8; 88.6). 75% of patients were mobilized ≤ 24 h of surgery, whereas 8% were mobilized between 24 and 36 h, 4.9% > 36 h, and 12.1% had missing data on mobilization. Patients mobilized ≤ 24 h and 24-36 h were similar in age, fracture type, and marital status, but those mobilized ≤ 24 h had fewer comorbidities, better pre-fracture mobility, and a higher social position. They also had a lower risk of LTOT (29.99%) compared to those mobilized 24-36 h (33.42%), with a weighted risk difference of 3.44% (95% CI 1.58-5.30).</p><p><strong>Conclusions: </strong>LTOT is common after hip fracture surgery. Mobilization ≤ 24 h after surgery is associated with a lower risk of LTOT compared to mobilization between 24 and 36 h. Early mobilization is one of the key elements of successful patient recovery for reducing complications and mortality after hip fracture surgery.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a care pathway for older adults presenting with nonspecific complaints at the emergency department: a before-and-after study.","authors":"M G A M van der Velde, M A C Jansen, F Derkx-Verhagen, I P B Tournoij, F S Jonkers, H R Haak, M N T Kremers","doi":"10.1007/s41999-025-01226-8","DOIUrl":"https://doi.org/10.1007/s41999-025-01226-8","url":null,"abstract":"<p><strong>Purpose: </strong>Managing older patients presenting at the Emergency Department (ED) poses challenges due to their predisposition to present with nonspecific complaints (NSC). With an ageing population and ED overcrowding, significance of NSC is expected to grow. Therefore, we implemented a structured care pathway to address the complexity of NSC presentations. The aim of this study is to evaluate the effectivity of this care pathway.</p><p><strong>Methods: </strong>We conducted a before-and-after study to evaluate the NSC care pathway, which included risk stratification, standardized assessment and diagnostic measurements. A control group receiving standard care was established in two hospitals (hospital 1 and 2) before implementation. Patient enrollment occurred from April 2021 to November 2024. Outcomes included length of stay in the ED (LOS-ED) and in hospital (LOS-H), revisits, diagnostic completeness (i.e. 100% agreement between all ED and hospital discharge diagnoses) and perceived quality of care.</p><p><strong>Results: </strong>In total, 164 control and 235 intervention patients were included in this study. Median LOS-ED and LOS-H did not show significant differences between the control and intervention patients. Implementation of the care pathway showed non-significant trends towards improved diagnostic completeness (47.1% vs 37.2%, p = 0.096). This might be associated with the non-significant observed decrease in 30-day readmissions (7.5% vs. 12.7%, p = 0.256). Patient-reported outcomes indicated a positive experience with the quality of care.</p><p><strong>Conclusion: </strong>The care pathway did not improve LOS-ED and LOS-H as hypothesized, possibly due to logistical barriers and patient variability. However, trends suggested improved diagnostic completeness and fewer 30-day readmission rates. Further research initiatives are needed to enhance patient outcomes and care for NSC patients.</p><p><strong>Trial registry number: </strong>NL8960, date 9-10-2020.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editing geriatric medicine journals: perspectives from the editors-in-chief of Age and Ageing, European Geriatric Medicine and the Journal of the American Geriatrics Society.","authors":"Roy L Soiza, Alfonso J Cruz Jentoft, Joseph G Ouslander","doi":"10.1007/s41999-025-01211-1","DOIUrl":"https://doi.org/10.1007/s41999-025-01211-1","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication use patterns among older patients in temporary stays in Denmark.","authors":"Hanin Harbi, Carina Lundby, Peter Bjødstrup Jensen, Søren Post Larsen, Linda Grouleff Rørbæk, Lene Vestergaard Ravn-Nielsen, Jesper Ryg, Mette Reilev, Kasper Edwards, Anton Pottegård","doi":"10.1007/s41999-025-01210-2","DOIUrl":"https://doi.org/10.1007/s41999-025-01210-2","url":null,"abstract":"<p><strong>Purpose: </strong>Patients in temporary stays are typically older individuals with frailty and multimorbidity. However, limited knowledge exists about their medication use. This study aimed to describe prescription drug use among patients in temporary stays in Denmark.</p><p><strong>Methods: </strong>We conducted a drug utilisation study on 11,424 patients in public healthcare-operated temporary stay units across 14 Danish municipalities between 2016 and 2023 (median age 81 years; 54% women). Prescription data were sourced from the Danish National Prescription Registry.</p><p><strong>Results: </strong>Patients used a median of six drug classes (interquartile range [IQR] 4-10) in the four months before moving into a temporary stay facility; 68% used ≥ 5 drug classes, and 26% used ≥ 10. The most commonly used drug classes were paracetamol (49%), statins (30%), and proton pump inhibitors (29%). The monthly rate of new drug use increased from 23/100 patients six months before move-in to a peak of 262/100 patients in the first month after move-in, driven primarily by laxatives, analgesics, and antibiotics. High-risk drug use increased from 70 to 83% following move-in, with 49% of patients initiating at least one new high-risk drug, most commonly opioids (28%), potassium (17%), and anticoagulants and platelet inhibitors (15%). General practitioners initiated 60-70% of treatments and maintained 80-90%. Hospital physician prescriptions increased around move-in, peaking at 55% for initiation and 25% for maintenance in the first month after move-in.</p><p><strong>Conclusion: </strong>Patients in temporary stays in Denmark demonstrate high medication use, including high-risk drugs, with a notable increase in treatment initiations around the time of move-in.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resuscitation discussion practices: a survey of European geriatricians.","authors":"Johannes Trabert, Caterina Trevisan, Nienke Golüke, Guillaume Chapelet, Elisabet Sanchez-Garcia, Mary Ni Lochlainn","doi":"10.1007/s41999-025-01218-8","DOIUrl":"https://doi.org/10.1007/s41999-025-01218-8","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiopulmonary resuscitation (CPR) is a life-saving treatment, yet outcomes in frail older adults are poor. Despite this, decision-making around resuscitation remains complex, influenced by misperceptions among patients, families, and physicians. We aimed to describe current practices, identify difficulties and barriers regarding do-not-resuscitate (DNR) decisions, and to assess differences across Europe.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted between September and December 2023, targeting geriatricians across Europe. The survey, disseminated via professional networks, assessed frequency and confidence in discussing DNR orders, barriers to discussions, and inter-country differences. Sociodemographic data and responses were analysed using descriptive statistics and logistic regression to identify factors influencing resuscitation discussions.</p><p><strong>Results: </strong>A total of 473 geriatricians participated across 22 countries (65% female, mean age 41.8 years, mean experience 10.5 years). Discussions of DNR orders occurred with ≥ 60% of hospitalised patients for 40% of respondents, with confidence discussing DNR orders reported by 80%. Reported barriers included time constraints (50%), cultural beliefs (25%), and lack of training (41%). Patients were kept 'for resuscitation' despite medical futility in an estimated 38% of cases at the request of patients or next of kin. Western European geriatricians discussed DNR orders more frequently and confidently than peers in other regions. Experience (> 20 years) was strongly associated with confidence (OR 7.53, 95% CI 1.93-32.35).</p><p><strong>Conclusion: </strong>Significant variability exists in resuscitation discussions among European geriatricians, influenced by region, gender, and experience. Enhanced physician training, societal awareness, and standardised protocols could improve resuscitation decision-making and reduce inappropriate resuscitation attempts.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Securing tomorrow's workforce: insights from a Danish survey on factors influencing junior doctors' specialization in geriatric medicine.","authors":"Lene Holst Andersen, Emil Lykke Lundgren, Pernille Holm Ellegaard, Siri Aas Smedemark, Karen Andersen-Ranberg","doi":"10.1007/s41999-025-01195-y","DOIUrl":"https://doi.org/10.1007/s41999-025-01195-y","url":null,"abstract":"<p><strong>Purpose: </strong>With aging populations, more geriatricians are needed. Despite the demand, filling specialist-training positions remains challenging, and the factors influencing junior doctors' career choices in Denmark are not well understood. This study aimed to investigate the factors influencing junior doctors' decisions to choose geriatric specialist training.</p><p><strong>Methods: </strong>A literature review informed the development of a survey, which included demographic and open-ended questions about prior geriatric training, reasons for pursuing geriatric positions, and perspectives on geriatric specialist training. The survey targeted junior doctors completing their introductory year positions in Internal Medicine and Geriatrics at Danish hospitals from March to September 2023. Qualitative data were analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>Out of approximately 130 eligible respondents, 75 provided responses. Among them, 13% (n = 10) expressed interest in pursuing a geriatric career, and 44% (n = 33) indicated a potential interest. In total, 60% (n = 45) reported having received geriatric training during medical school. Thematic analysis generated three themes. 1) Achieving core geriatric medicine competencies: This included receiving geriatric education and practicing in specialized geriatric services, e.g., hospital-at-home. 2) Achieving work-life balance: This appeared particularly important in multi-center training programs or during emergency department rotations. 3) Enhancing recruitment strategies: This involved acknowledging talents, utilizing role models, increasing visibility in medical school curricula, and strengthening the specialty's professional reputation. Finally, ten recommendations were generated.</p><p><strong>Conclusion: </strong>Recruiting junior doctors to pursue a career in geriatric medicine may benefit from targeted learning in geriatric competencies, the presence of role models, and ensuring that clinical training practices support work-life balance.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and care profile of patients admitted to an intermediate stay palliative care unit (UCPME) in the community of Madrid.","authors":"Concepción Jiménez Rojas, Gemma Cuesta Castellón, Saleta Goñi Rosón, Lucía Gómez González, Elena Cano Esteban, Javier Gómez Pavón","doi":"10.1007/s41999-025-01216-w","DOIUrl":"https://doi.org/10.1007/s41999-025-01216-w","url":null,"abstract":"<p><strong>Introduction: </strong>We present data on the clinical care activity and trajectories of a prospective cohort of 400 patients admitted to an intermediate stay palliative care unit (UCPME) in Madrid.</p><p><strong>Materials and methods: </strong>Epidemiological data and clinical progression variables were collected. The main differences between oncological and non-oncological patients and age-related differences were described.</p><p><strong>Results: </strong>295 oncologic and 105 non-oncological patients were admitted to palliative care. Patients with non-oncological conditions were older (p < 0.001). The referral source was home in 38% and hospital departments in 63%. 350 patients (87.5%) died. Early mortality occurred in 48%. Occupational therapy was provided to 13.8%. Intravenous continuous drug was used in 41% and subcutaneous in 48.5%. Palliative sedation for refractory symptoms was required in 54.5%. Advance care planning was conducted in 96% of admissions.</p><p><strong>Conclusions: </strong>The care processes revealed a few differences in clinical trajectories between oncological and non-oncological conditions or across age groups.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Falls prevention and management for older adults in home care services in Norway: a retrospective patient record review.","authors":"Rune Solli, Nina Rydland Olsen, Linda Aimée Hartford Kvæl, Kristin Taraldsen, Therese Brovold","doi":"10.1007/s41999-025-01224-w","DOIUrl":"https://doi.org/10.1007/s41999-025-01224-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate Norwegian home care services' adherence to the World Falls Guidelines 2022 (WFG2022) recommendations on assessment and management of falls among older adults with a history of falling, and to evaluate the degree to which identified fall risk factors were addressed with interventions to prevent falls.</p><p><strong>Methods: </strong>We conducted a retrospective patient record review of older adults who receive home care services and have a history of falls from four municipal home care service city districts in Oslo, Norway. We collected data from electronic patient records on patient characteristics, the assessed fall risk factors, and implemented interventions to prevent falls. Adherence was analysed as the proportion of patients who received fall prevention care in line with WGF2022 recommendations.</p><p><strong>Results: </strong>The records of 225 patients were reviewed, of which 157 (70%) patients were between the ages of 70 and 89 years, and 131 (58%) were women. A total of 54 (24%) patients had intermediate fall-risk and 171 (76%) patients had high fall-risk. Of the 54 patients with intermediate fall-risk, 50% received an assessment of balance, gait, or muscle strength, and 22% were subsequently offered exercise. Sixty-one percent of intermediate-risk patients received multifactorial fall risk assessments, and 19% received multifactorial interventions. Exercise was the most used intervention to prevent falls, but it was provided to fewer than half of the patients. Other relevant interventions, such as osteoporosis treatment and medication management, were provided to fewer than 10% of patients.</p><p><strong>Conclusion: </strong>The results highlight substantial gaps in the comprehensive management of fall prevention where considerably fewer patients received follow-up interventions to prevent falls compared to those who had fall risk factors identified. These results underscore the urgent need for enhanced implementation of fall prevention care within municipal home care services.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a nurse-led swallowing risk assessment tool in care-home residents: a prospective diagnostic accuracy study.","authors":"Patricia Heaney, Deborah Annis-Marley, William Gray, Louise Jones, Julia Scott, Miles D Witham","doi":"10.1007/s41999-025-01194-z","DOIUrl":"https://doi.org/10.1007/s41999-025-01194-z","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and test a screening tool enabling care-home staff to identify residents with high-risk swallowing problems (dysphagia).</p><p><strong>Methods: </strong>The Nurse Dysphagia Screening Tool (NDST) was developed via an iterative, participatory process. A diagnostic evaluation study was performed in North-East of England care homes. We compared NDST with gold-standard speech and language therapist swallowing assessment risk category to derive sensitivity, specificity, and positive and negative predictive values.</p><p><strong>Results: </strong>One hundred and seventy two residents (101 women) were included from 14 care homes, mean age 82.1 years (SD 10.6). Residents known to SLT, or with Percutaneous Endoscopic Gastrostomy (PEG) were excluded. 18/172 (11%) had high-risk swallow by gold-standard assessment. NDST was completed successfully on all participants. Sensitivity, specificity, and positive and negative predictive values were 72%, 92%, 50%, and 97%, respectively. Sensitivity was higher (100%) in high-volume care homes and for those recruited late in the study, suggesting a learning curve.</p><p><strong>Conclusion: </strong>NDST requires additional testing but can potentially identify high-risk dysphagia in care homes.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}