European Geriatric Medicine最新文献

{"title":"Awareness of national dementia guidelines and management of oldest-old and frail people living with dementia: a European survey of geriatricians.","authors":"Elke De Bondt, Phaedra Locquet, María González López, Pinar Soysal, Tomas Welsh, Susan D Shenkin, Jos Tournoy","doi":"10.1007/s41999-025-01165-4","DOIUrl":"https://doi.org/10.1007/s41999-025-01165-4","url":null,"abstract":"<p><strong>Background: </strong>Management of dementia, particularly the use of pharmacological treatments, in the oldest old and those with frailty is complex because of the multiple types of dementia, comorbidities, polypharmacy, and side effects. Current national dementia guidelines lack recommendations for this group. This study assessed guideline awareness, usage, and pharmacological management practices for dementia in the oldest old and frail across Europe.</p><p><strong>Methods: </strong>An online anonymous survey was distributed in 2023 to the European Geriatric Medicine Society Dementia Special Interest Group and their contacts to investigate guideline awareness and pharmacological practices for the oldest old and frail. The CHERRIES checklist was followed for reporting. Responses were summarized using descriptive statistics and quotations of free text responses.</p><p><strong>Results: </strong>Forty-nine responses from fourteen countries were received. A total of 76.6% were aware of a national dementia guideline and 86.9% applied it frequently. Acetylcholinesterase inhibitors (AChEIs) were generally used as a first-line treatment in mild-to-moderate Alzheimer's disease (AD) (91.6% and 93.4%). Memantine was added or replaced AChEIs as dementia severity progresses. Gingko biloba was considered in mild and moderate AD (23.6% and 22.7%, respectively). Off-label drug use was common in other types of dementia. 88.5% of respondents reported no difference in treatment compared with a younger population.</p><p><strong>Conclusion: </strong>There was awareness of various dementia guidelines, but none addressed the management of the oldest old and frail. Most respondents did not adapt their practices for this group, but many reported off-label treatments which resulted in non-evidence-based prescribing, overprescribing, and a lack of deprescribing. European consensus to guide the management of dementia in this complex population is needed.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469695","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":"Management of behavioural and psychological symptoms of dementia: a pragmatic scoping review of European guidelines and literature.","authors":"Alessandra Coin, Elsa Brew-Girard, Ellen Tracey, Vincenza Frisardi, Federica Piccione, Costanza Muraro, Eleonora Mizzon, Susan D Shenkin, Pinar Soysal, Tomas Welsh, Hanna-Maria Roitto","doi":"10.1007/s41999-025-01155-6","DOIUrl":"https://doi.org/10.1007/s41999-025-01155-6","url":null,"abstract":"<p><strong>Purpose: </strong>Dementia prevalence within the European Union (EU) is expected to double by 2050. Behavioural and Psychological Symptoms of Dementia (BPSD) are common, causing burden to patients and caregivers. This pragmatic scoping review aims to synthesize recommendations of European BPSD management guidelines and literature, highlighting areas of consensus and disagreement.</p><p><strong>Methods: </strong>An electronic literature search, including Medline, PsychINFO, and CINAHL, and Internet search for grey literature were undertaken to identify published BPSD guidelines from the EU, European Economic Area (EEA) and UK, supplemented by contacting EU member countries of European Geriatric Medicine Society (EuGMS).</p><p><strong>Results: </strong>The literature search found 11 papers describing BPSD management. Of the 32 countries of interest, 22 guidelines were sourced (five confirmed no guidelines, five did not respond). There was a general consensus between the guidelines, as all recommended comprehensive assessment and individualised approaches, with non-pharmacological therapies as first line, but there was disagreement around specific therapies. Psycho-education was most commonly recommended (15 countries). There was general agreement that pharmacological treatment should be used as an adjunct to non-pharmacological interventions, but recommendations differed between medication groups. Short-term atypical antipsychotics were most commonly recommended, especially risperidone (18 countries). 15 countries recommended acetylcholinesterase inhibitors and 12 memantine. 16 countries recommended the use of SSRIs. Recommendations for the use of sedative medications and antiepileptics varied.</p><p><strong>Conclusions: </strong>This study provides a broad, inclusive overview of current European guidelines for the management of BPSD, demonstrating significant variability. Clinical practice in dementia care throughout Europe needs to be optimised and standardised.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450791","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":"Caregiving outcomes among informal caregivers of persons with multimorbidity and dementia: a scoping review.","authors":"Ruotong Liu, Katherine Peak, Em Trubits, Ana R Quionones","doi":"10.1007/s41999-024-01150-3","DOIUrl":"https://doi.org/10.1007/s41999-024-01150-3","url":null,"abstract":"<p><strong>Purpose: </strong>An emerging field of research involves caregiving outcomes for persons with Alzheimer's disease and related dementias (ADRD) and co-occurring multimorbidity (ADRD-multimorbidity). This scoping review aims to assess and synthesize the body of literature on caregiving outcomes among informal caregivers of individuals with ADRD-multimorbidity.</p><p><strong>Methods: </strong>We adhered to the scoping review framework by Arksey and O'Malley (2005) and Levac and colleagues (2010), which encompassed five steps: (1) identify the research question(s), delineate the inclusion and exclusion criteria, (2) search for relevant studies, (3) select studies, (4) chart the data, and (5) collate, summarize, and report results. Electronic databases including Ovid Medline, CINAHL, Embase, and PsycINFO were employed to identify relevant studies.</p><p><strong>Results: </strong>A total of 1,856 articles were identified and 29 were included in the final review. The majority of studies were quantitative, cross-sectional studies. The two most commonly examined caregiving outcomes were caregiver burden and psychological well-being. Most research on caregiver outcomes treated care recipients' cognitive impairment and chronic conditions separately, rather than exploring their interaction. Most studies examining caregiver burden utilized Zarit Burden Index and its variants. Specific psychological well-being outcomes displayed great variability across studies.</p><p><strong>Conclusion: </strong>Despite challenges in synthesizing the extensive variability in the way cognitive status, ADRD-multimorbidity, and caregiving outcomes were measured, included, and reported, this review underscores the intricate challenges of caregiving, especially when dealing with both cognitive impairments and co-occurring chronic conditions. This complexity underscores the need for a deeper understanding of the diverse needs facing caregivers of people with ADRD-multimorbidity.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460378","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":"Building a pan-European network to bridge gaps in geriatric medicine education: the PROGRAMMING COST Action 21,122-a call for endorsement.","authors":"Sofia Duque, Karolina Piotrowicz, Tahir Masud, Anne Wissendorff Ekdahl, Anna Marie Herghelegiu, Tajana Pavic, Evrydiki Kravvariti, Nenad Bogdanović, Sylvie Bonin-Guillaume, Nicolas Martínez Velilla, Regina Roller Wirnsberger, Michael Vassallo, Anastassia Kossioni, Rachael Frost, Jurate Macijauskiene, Meltem Koca, Athanase Benetos, Mirko Petrovic, Marina Kotsani","doi":"10.1007/s41999-024-01137-0","DOIUrl":"https://doi.org/10.1007/s41999-024-01137-0","url":null,"abstract":"<p><strong>Background: </strong>The growing challenges of population aging create a pressing need for specialized geriatric medicine services to effectively address the complex health needs of older adults and influence supportive healthcare policies. Older patients may present clinical complexity with multimorbidity, disability, and/or frailty, necessitating a shift from the traditional organ-oriented clinical approach to a holistic, patient-centered care model.</p><p><strong>Rationale of the action: </strong>Despite recommendations from the World Health Organization and scientific and professional societies, geriatric medicine is not universally recognized as a distinct specialty in Europe, and education in this field remains heterogeneous. A notable discrepancy in the availability of geriatric services and education in this field across European countries can be found. Many healthcare professionals lack basic training in geriatric medicine, contributing to fragmented care and poorer health outcomes. To address these challenges, it is essential to integrate geriatric medicine into undergraduate and postgraduate curricula for all healthcare professionals.</p><p><strong>Expected outcomes: </strong>The COST Action 21,122 PROGRAMMING (PROmoting GeRiAtric Medicine in countries where it is still eMergING) initiative aims to promote geriatric medicine by developing targeted educational goals and programs and fostering interdisciplinary collaboration. This initiative aims to assess the current state of geriatric medicine education and identify both global and local educational needs for developing clinical skills among healthcare professionals. In addition, it seeks to establish consensus on core curricula tailored to local contexts and disseminate findings and recommendations to stakeholders, policymakers, and the public. By uniting diverse stakeholders, PROGRAMMING aspires to create sustainable changes in geriatric care across Europe.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460375","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":"Validation of the revised multi-sensor-based electronic Short Physical Performance Battery (eSPPB) kiosk in community-dwelling older adults.","authors":"Daphne Zihui Yang, Edbert Edric Rodrigues, Herb Howard C Hernandez, Eng Hui Ong, Louise Heyzer, Cai Ning Tan, Joanne Kua, Noor Hafizah Ismail, Wee Shiong Lim","doi":"10.1007/s41999-024-01151-2","DOIUrl":"https://doi.org/10.1007/s41999-024-01151-2","url":null,"abstract":"<p><strong>Purpose: </strong>Recent studies highlight how technology can mitigate the reliance on trained staff for scalability of the Short Physical Performance Battery (SPPB). Although the original multi-sensor-based electronic SPPB (eSPPB) kiosk was previously validated in the outpatient setting, technical limitations and lack of user-friendliness impeded scalability to community settings where SPPB assessments are most often performed. We aim to evaluate the revised eSPPB kiosk in terms of construct validity, agreement, inter-rater, and test-retest reliability vis-à-vis manual SPPB (mSPPB) in community-dwelling older adults.</p><p><strong>Methods: </strong>Fifty-eight community-dwelling older adults (81% women, mean age = 75.0 ± 5.5, median FRAIL = 0 [range 0-2]) from active ageing centers performed the mSPPB and eSPPB concurrently. Twenty (34%) had a repeat assessment 2 weeks later for test-retest reliability. Convergent validity, discriminant ability, agreement, inter-rater, and test-retest reliability were evaluated using partial correlation adjusted for age and gender, independent sample t tests using SPPB cutoff ≤ 9, and cross-tabulation of mSPPB against eSPPB, Bland-Altman plots, and intra-class correlation coefficients (ICC), respectively.</p><p><strong>Results: </strong>eSPPB demonstrated excellent correlation with mSPPB (r = 0.922, p < 0.001); weak-moderate correlation with frailty and sarcopenia; and good discriminant ability for sarcopenia and frailty using SPPB cutoff ≤ 9. Bland-Altman plots showed good agreement between eSPPB and mSPPB (mean difference = 0.12, 95%CI - 1.10 to 1.34; r = -0.035, p = 0.505). Inter-rater reliability was excellent (ICC = 0.92, 95%CI 0.87-0.95), while test-retest reliability was comparable between mSPPB and eSPPB (ICC = 0.66, 95%CI 0.33-0.85 versus 0.61, 95%CI 0.25-0.82 respectively).</p><p><strong>Conclusion: </strong>Our study corroborates the construct validity, agreement, inter-rater, and test-retest reliability between the eSPPB kiosk and mSPPB in healthy community-dwelling older adults. This paves the way for scalability studies examining real-world eSPPB screening of sarcopenia and frailty in the community setting.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450793","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":"The effect of dexamethasone on the prevalence of delirium in older COVID-19 patients: a retrospective cohort study.","authors":"Chris van der Laan, Kristel Goossens, Sarah H M Robben, Mariette H W Kappers","doi":"10.1007/s41999-024-01033-7","DOIUrl":"https://doi.org/10.1007/s41999-024-01033-7","url":null,"abstract":"<p><strong>Purpose: </strong>Corticosteroids decrease mortality in patients with COVID-19 in need of oxygen therapy. However, corticosteroids are known to increase the risk of delirium in older patients. We studied whether dexamethasone increased the risk of delirium in older patients hospitalized with COVID-19.</p><p><strong>Methods: </strong>Single centre, retrospective cohort study including patients ≥ 70 years hospitalized in a large teaching hospital with COVID-19 during the first (control group) and second wave (dexamethasone group, receiving dexamethasone) of the COVID-19 pandemic. Only patients on regular (non-ICU) wards were included. Delirium was defined as having a mean delirium observation screening (DOS)-score of ≥ 3 or having an altered mental state on day 3 of admission.</p><p><strong>Results: </strong>We included 233 patients. The mean age in the dexamethasone group was 78.83 years [SD 6.5] compared to 79.43 years [SD 6.3] in the control group. In the dexamethasone group (n = 114), less patients developed delirium compared to the control group (n = 119) on day 3 of admission (5.3% vs 15.1%; p = 0.01). The Odds ratio of dexamethasone use for delirium was 0.23 (95% CI 0.08-0.64).</p><p><strong>Conclusion: </strong>In this study, dexamethasone did not increase the risk of delirium in older patients with COVID-19.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450792","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":"Systemic inflammation is associated with gut microbiota diversity in post-stroke patients.","authors":"Yoshihiro Yoshimura, Hidetaka Wakabayashi, Fumihiko Nagano, Ayaka Matsumoto, Sayuri Shimazu, Ai Shiraishi, Yoshifumi Kido, Takahiro Bise, Takenori Hamada, Kouki Yoneda, Keisuke Maeda","doi":"10.1007/s41999-025-01159-2","DOIUrl":"https://doi.org/10.1007/s41999-025-01159-2","url":null,"abstract":"<p><strong>Background: </strong>There is growing interest in gut microbiota and health outcomes. However, the relationship between systemic inflammation and gut microbiota diversity in hospitalized patients remains unclear. This study aimed to investigate the association in post-stroke rehabilitation patients.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on post-stroke patients admitted to a rehabilitation hospital. Systemic inflammation was assessed using the modified Glasgow Prognostic Score (mGPS). Gut microbiota diversity was evaluated using three indices: Shannon index, Operational Taxonomic Unit (OTU) richness, and Faith's Phylogenetic Diversity (PD). Multiple linear regression analyses were performed to examine the relationship between mGPS and gut microbiota diversity indices, adjusting for potential confounders.</p><p><strong>Results: </strong>A total of 156 patients (mean age 78.4 years; 55.7% men) were analyzed. The median mGPS was 0 (interquartile range: 0-1), with GPS distribution: 61.8% scored 0, 25.7% scored 1, and 12.5% scored 2. After adjusting for confounders, mGPS was significantly and negatively associated with the Shannon index (B = -0.143, 95% CI -0.288 to -0.002, β = -0.177) and OTU richness (B = -17.832, 95% CI -24.349 to -3.951, β = -0.208). However, no significant association was observed between mGPS and Faith's PD (B = -1.155, 95% CI -2.464 to 0.189, β = -0.155).</p><p><strong>Conclusion: </strong>This study demonstrates a significant negative association between systemic inflammation and both quantitative and qualitative gut microbiota diversity in post-stroke patients.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400398","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":"Hippocratic considerations about statin treatment for patients over 75 years of age.","authors":"Timo E Strandberg, Athanase Benetos","doi":"10.1007/s41999-025-01160-9","DOIUrl":"https://doi.org/10.1007/s41999-025-01160-9","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391947","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":"Palliative care for cardiovascular patients: comparison of the motives of referral by cardiologists and the actual care provided by the mobile palliative care team.","authors":"Mathilde Giffard, Liesbet Van Bulck, Fatimata Seydou Sall, Nicolas Becoulet, Marie-France Seronde, Fiona Ecarnot","doi":"10.1007/s41999-024-01143-2","DOIUrl":"https://doi.org/10.1007/s41999-024-01143-2","url":null,"abstract":"<p><strong>Background: </strong>Palliative care for cardiovascular patients remains suboptimal, with few referrals to palliative care, often late in the disease. We investigated why cardiologists request palliative care and described the palliative care team's responses.</p><p><strong>Methods: </strong>This retrospective study included cardiovascular patients referred to the mobile palliative care team of a French University Hospital from 2010 to 2020 and compared cardiologists' referral motives with the care provided by the palliative care team.</p><p><strong>Results: </strong>Among 142 patients, almost half (47%) were women. The mean age at the time of death was 76 ± 14 years. For the 142 patients, 29.6% of referrals were unspecific, 24.6% involved ethical dilemmas, and 16.2% focused on symptom management. Conversely, the palliative care team addressed ethical dilemmas in 48.6% and symptom management in 19.7%, revealing a 56% mismatch between requests and interventions delivered.</p><p><strong>Conclusion: </strong>Cardiologists often lack specific motives when referring patients to palliative care and may be unaware of ethical issues in cardiology care, highlighting need to raise awareness among cardiologists about ethical issues and palliative care services.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374781","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":"Defining optimal orthogeriatric hip fracture care: a delphi consensus approach.","authors":"H E van Bremen, L J Seppala, E A Gans, J H Hegeman, N van der Velde, H C Willems","doi":"10.1007/s41999-025-01156-5","DOIUrl":"https://doi.org/10.1007/s41999-025-01156-5","url":null,"abstract":"<p><strong>Purpose: </strong>Development of consensus-based recommendations on core and optimal elements of orthogeriatric hip-fracture care.</p><p><strong>Methods: </strong>An online Delphi survey was performed in the Netherlands. A total of 72 statements were derived from a framework encompassing all phases of care for older patients with a hip fracture. These statements were presented to the panelists in two rounds to identify elements for minimal and optimal orthogeriatric care. Panelists included professionals with experience in hip-fracture care and patient representatives. The level of agreement was measured using a 5-point Likert scale. Consensus was considered if > 75% of the panelists agreed or disagreed.</p><p><strong>Results: </strong>Ninety-two persons were invited to participate in the survey; 63 participated in the first round and 55 in the second round. One statement was added in the second round. Most participants had a background in geriatrics (36% in the second round) or trauma surgery/orthopaedics (20% in the second round). Consensus was reached on 48 statements for minimal orthogeriatric care and 60 statements for optimal orthogeriatric care.</p><p><strong>Conclusion: </strong>This study supports previously established recommendations for older adults with hip fractures. In addition, it offers practical recommendations for implementation of orthogeriatric care regarding both core and optimal care elements for hospitals at every different level of maturity and at every step in the care process. This may decrease the intra- and inter-hospital variability of clinical management of hip-fracture patients. Organizational and logistical elements present a barrier to overcoming the gap between the current practice and the optimal situation.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257192","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}