Seminars in Oncology Nursing最新文献

{"title":"The Use of Biomarkers in Precision Health Symptom Science—Opportunities and Challenges","authors":"Carolyn S. Harris ,&nbsp;Yvette P. Conley ,&nbsp;Jinbing Bai ,&nbsp;Marilyn J. Hammer","doi":"10.1016/j.soncn.2025.151886","DOIUrl":"10.1016/j.soncn.2025.151886","url":null,"abstract":"<div><h3>Objectives</h3><div>Precision health symptom science applies person-centered approaches to elucidate interindividual differences in patients’ symptom experiences and incorporates omics methods with social, societal, and environmental determinants of health to develop symptom management strategies. By filling scientific gaps related to patients’ symptom experiences and their underlying mechanisms, interventions can be developed to improve quality of life and outcomes. The purposes of this article are to describe symptom phenotype development; review analytical approaches to identify a symptom phenotype; and discuss common and emerging methods for biomarker discovery and their implications in precision health symptom science.</div></div><div><h3>Methods</h3><div>Peer-reviewed research studies, review articles, and scientific expertise were synthesized to provide a broad overview of several methods of biomarker discovery and their implications for precision health symptom science.</div></div><div><h3>Results</h3><div>Approaches to symptom phenotype development and analytical methods for phenotype identification were reviewed. Common (ie, genomic, epigenomic, transcriptomic, proteomic, metabolomic, microbiome) and emerging (ie, polygenic risk scores, microRNA, epigenetic clocks, allostatic load, wearables) methods for biomarker discovery were described. Each method provides unique information to improve our understanding of the complex biological processes that underlie symptoms and may be used for risk prediction, screening, surveillance, and treatment response.</div></div><div><h3>Conclusions</h3><div>While the exemplar approaches to conducting precision health symptom science were shared through an oncology lens, they are generalizable across acute and chronic conditions.</div></div><div><h3>Implications for Nursing Practice</h3><div>Symptom biomarker identification is inherently complex and the methods for biomarker collection, processing, measurement, and analysis are continually evolving. Therefore, symptom scientists need to form transdisciplinary teams with experts in omics methodologies and bioinformatics. Despite the challenges, symptom scientists are well suited to lead the way in precision health symptom science to reduce symptom burden and improve quality of life among patients with various chronic conditions.</div></div>","PeriodicalId":54253,"journal":{"name":"Seminars in Oncology Nursing","volume":"41 4","pages":"Article 151886"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast and Gynecological Cancer Benefit Finding Scale: Turkish Validity and Reliability Study","authors":"Sıdıka Pelit Aksu ,&nbsp;Serap Alkaş ,&nbsp;Şengül Yaman Sözbir","doi":"10.1016/j.soncn.2025.151949","DOIUrl":"10.1016/j.soncn.2025.151949","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to determine the validity and reliability of the “Benefit Finding Scale” (BFS) in Turkish breast and gynecologic cancer patients.</div></div><div><h3>Methods</h3><div>In the methodological research, 322 women were included. Data was collected using the “Descriptive Information Form” and the “BFS.” The language, content, construct, criterion, and convergent validity of the “BFS” were examined. Content validity was assessed using the scale and the item content validity index. Construct validity was determined by Exploratory factor analysis and Confirmatory factor analysis. The reliability of the scale was evaluated using internal consistency analysis, Cronbach’s <em>α</em>, and the test-retest method.</div></div><div><h3>Results</h3><div>Exploratory and confirmatory factor analyses established that the scale consisted of 15 items with three factors, explaining 72.5% of the total variance. Confirmatory Factor Analysis Fit Indices Goodness of Fit Index: 0.96, AGFI: 0.95, NFI: 0.95, PGFI: 0.70, RMR: 0.08. The Cronbach’s <em>α</em> for the total scale is 0.92. Within the scope of the test-retest analysis, an interclass correlation coefficient = 0.961 was determined. The scale evaluation is based on the mean scores of the subdimensions and total scores; as the score obtained from the scale increases, the benefit finding for cancer increases.</div></div><div><h3>Conclusions</h3><div>The findings from this study conducted on a sample of breast and gynecologic cancer showed that the “BFS” is both valid and reliable for the Turkish population.</div></div><div><h3>Implications for Nursing Practice</h3><div>Assessing benefit findings in women with breast and gynecologic cancer may enable nurses to provide care and psychosocial support tailored to patient’s needs, which can enhance their well-being and improve treatment adherence.</div></div>","PeriodicalId":54253,"journal":{"name":"Seminars in Oncology Nursing","volume":"41 4","pages":"Article 151949"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Data-driven Clinical Decision Support to Integrate Precision Cancer Symptom Management Into the Electronic Health Record","authors":"Mary E. Cooley ,&nbsp;Leslie A. Lenert ,&nbsp;Janet L. Abrahm ,&nbsp;David F. Lobach","doi":"10.1016/j.soncn.2025.151937","DOIUrl":"10.1016/j.soncn.2025.151937","url":null,"abstract":"<div><h3>Objectives</h3><div>Electronic patient-reported outcome measures (ePROs) are being implemented in clinical care to monitor symptoms in patients with cancer. Although the use of these measures is associated with improved outcomes, challenges remain with integrating ePROs into the workflow due to burdensome training and unclear roles for who will manage uncontrolled symptoms. The use of clinical decision support (CDS) can mitigate these challenges. This article discusses the use of CDS, the integration of CDS into the electronic health record (EHR), lessons learned, and future directions.</div></div><div><h3>Methods</h3><div>The Sapphire Cancer Symptom Management CDS system is used to illustrate the development, integration, and testing of CDS in the EHR. A team of experts designed this system based on previous experience and research literature. The discussion synthesizes peer-reviewed literature, expert opinion, systematic reviews, and meta-analysis as sources of data.</div></div><div><h3>Results</h3><div>Symptom management algorithms were created for nine cancer symptoms and then programmed into the CDS platform and integrated into the EHR. Integration involved using innovative technologies, which included application programming interfaces and interoperable data standards, to integrate the system into the EHR. Relevant EHR and patient-reported data were used to generate individually tailored symptom management recommendations. Testing of the system was accomplished using test patients that reflected real-world patient experiences. We found that the data needed for the algorithms were complex and some elements were not readily available in the EHR. Having clinicians verify a few critical elements assured accuracy and safety of the recommendations.</div></div><div><h3>Conclusion</h3><div>Innovative technologies enabled the integration of CDS into the EHR and the generation of individually tailored cancer symptom management recommendations. Future testing is needed to evaluate whether the use of CDS improves patient outcomes.</div></div><div><h3>Implications for Nursing Practice</h3><div>CDS has the potential to improve guideline-concordant symptom management and facilitate supportive care referrals at the point-of-care to improve clinical care.</div></div>","PeriodicalId":54253,"journal":{"name":"Seminars in Oncology Nursing","volume":"41 4","pages":"Article 151937"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot Testing an Adapted Version of the Registered Nursing Forecasting (RN4CAST) Nurse Survey in Systemic Anti-Cancer Therapy Day Units: A Mixed-Methods Feasibility Study","authors":"Zhuming Bao ,&nbsp;Jenny Harris ,&nbsp;Anne Marie Rafferty ,&nbsp;Verna Lavender ,&nbsp;Amparo DOMINGO LACASA ,&nbsp;Emma Masters ,&nbsp;Hayley Beer ,&nbsp;Katy Tait ,&nbsp;Rhona Johnson ,&nbsp;Jo Armes","doi":"10.1016/j.soncn.2025.151940","DOIUrl":"10.1016/j.soncn.2025.151940","url":null,"abstract":"<div><h3>Objectives</h3><div>Systemic Anti-Cancer Therapy (SACT) day units are increasingly challenged by workload pressures and workforce shortages. The Registered Nursing Forecasting (RN4CAST) survey, originally developed to predict workforce needs in acute and geriatric inpatient units, was adapted to create the RN4CAST-SACT-D survey specifically for SACT day units. This study aimed to pilot test and evaluate the feasibility of the adapted RN4CAST-SACT-D survey.</div></div><div><h3>Methods</h3><div>A convergent mixed-methods feasibility study was conducted, incorporating an embedded qualitative component through semi-structured interviews. Five SACT day units were invited to participate, with all nurses working on the designated census day invited to complete the RN4CAST-SACT-D survey, followed by a semi-structured interview. Additionally, patients attending for chemotherapy on the census day were invited to complete the Patient-Reported Chemotherapy Indicators of Symptoms and Experience (PR-CISE) survey.</div></div><div><h3>Results</h3><div>A total of 43 nurses completed the RN4CAST-SACT-D survey, yielding a response rate of 69.3%. Of these, 12 nurses participated in semi-structured interviews. Additionally, 172 patients completed the PR-CISE survey, with a response rate of 50%. The study identified key challenges and provided recommendations to refine the survey methodology, informed by both survey responses and interview insights.</div></div><div><h3>Conclusion</h3><div>The findings suggest that the RN4CAST-SACT-D survey is a feasible tool for assessing workforce-related factors in SACT day units. While the survey methodology was generally well-received, certain aspects require further refinement and testing to enhance its applicability and effectiveness.</div></div><div><h3>Implications for Nursing Practice</h3><div>This study highlighted that current staffing levels in SACT day units are largely based on historical data, rather than on present-day needs. This underscores the urgent need for research specifically focused on SACT day unit settings.</div></div>","PeriodicalId":54253,"journal":{"name":"Seminars in Oncology Nursing","volume":"41 4","pages":"Article 151940"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"History Has Its Eyes on Us","authors":"Christine Miaskowski","doi":"10.1016/j.soncn.2025.151945","DOIUrl":"10.1016/j.soncn.2025.151945","url":null,"abstract":"","PeriodicalId":54253,"journal":{"name":"Seminars in Oncology Nursing","volume":"41 4","pages":"Article 151945"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of Patient-Reported Outcomes: The How, When, and Where","authors":"Jo Armes","doi":"10.1016/j.soncn.2025.151941","DOIUrl":"10.1016/j.soncn.2025.151941","url":null,"abstract":"<div><h3>Objectives</h3><div>There is growing evidence that integrating patient-reported outcomes (PRO) into clinical assessments is associated with improved symptom management, patient satisfaction, and survival rates. This report aims to critically examine factors that influence how, when, and where PRO should be assessed in the cancer pathway.</div></div><div><h3>Methods</h3><div>This discussion is grounded in clinical research expertise and supported by relevant literature from peer-reviewed journals.</div></div><div><h3>Results</h3><div>Multiple digital methods for conducting PRO assessments are being used. Evidence increasingly suggests that adopting a hybrid approach is more likely to ensure that diverse populations complete PRO assessments. This will ensure the data generated are more representative of the wider cancer population. Most research focuses on assessing PRO during treatment while less focuses on the postsurgical and survivorship phases in the cancer pathway. During treatment, more frequent PRO assessment is more informative and better able to guide clinical decision-making. This, however, needs to be balanced against respondent burden. Matching the method for capturing PRO assessment to the preferences and requirements of respondents may be more important than the location in which it occurs.</div></div><div><h3>Conclusion</h3><div>Regular assessment of PRO improves patient outcomes during treatment and, based on the limited evidence available, following surgery and during the survivorship phase of the cancer pathway.</div></div><div><h3>Implications for Nursing Practice</h3><div>More research is needed to identify the optimal timing of PRO assessments during treatment to maximize information while minimizing respondent burden. Finally, we need to better understand which methods for capturing PRO assessments best meet the diverse personal requirements and preferences of the wider cancer population.</div></div>","PeriodicalId":54253,"journal":{"name":"Seminars in Oncology Nursing","volume":"41 4","pages":"Article 151941"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Remote Symptom Monitoring, Person-Centered Analytics, and Artificial Intelligence to Advance Precision Health Symptom Science in Oncology","authors":"Rachel A. Pozzar","doi":"10.1016/j.soncn.2025.151901","DOIUrl":"10.1016/j.soncn.2025.151901","url":null,"abstract":"<div><h3>Objectives</h3><div>To summarize the relevance of remote symptom monitoring, person-centered statistical analyses, and artificial intelligence to precision health symptom science in oncology; and propose ways in which these three approaches can be integrated to further advance the field.</div></div><div><h3>Methods</h3><div>The following commentary was adapted from a talk delivered at the Symptom Science Experts Meeting in October 2023 at the University of Lausanne, Switzerland. The commentary and talk were informed by an informal review of recent literature in precision health oncology symptom science.</div></div><div><h3>Results</h3><div><span>Several remote symptom monitoring interventions have demonstrated potential to reduce disease- and treatment-related symptom burden and improve health outcomes in patients with cancer. Data collected passively by wearable and sensor technologies are also being used to characterize patients’ </span>health status<span>. Person-centered statistical analyses have identified interindividual variability in the symptom experiences of patients with cancer. Together with artificial intelligence-based approaches, these analyses have identified factors associated with relatively adverse symptom experiences. Future directions for the field include integrating these approaches to optimize clinical resource allocation, tailor symptom management in real-time, and advance scientific knowledge of the symptom experience.</span></div></div><div><h3>Conclusions</h3><div>Integrating remote symptom monitoring, person-centered statistical analyses and artificial intelligence may provide deeper insights into how patients with cancer experience symptoms.</div></div><div><h3>Implications for Nursing Practice</h3><div>Findings from research that uses remote symptom monitoring, person-centered statistical analyses, and artificial intelligence may enhance clinicians’ ability to deliver personalized symptom management interventions.</div></div>","PeriodicalId":54253,"journal":{"name":"Seminars in Oncology Nursing","volume":"41 4","pages":"Article 151901"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Processing Speed in Patients with Cancer: A Concept Analysis","authors":"Myeong-ga Cho,&nbsp;Catherine M. Bender","doi":"10.1016/j.soncn.2025.151946","DOIUrl":"10.1016/j.soncn.2025.151946","url":null,"abstract":"<div><h3>Objectives</h3><div>Processing speed is a cognitive domain and a crucial predictor of cognitive aging. It frequently deteriorates in patients with cancer, co-occurring with declines of other domains, including attention, executive function, and memory, and negatively impacts health outcomes. However, lack of clarity of the concept limits the development of precise assessments and effective nursing interventions to improve processing speed. Therefore, this concept analysis aims to thoroughly analyze and clarify processing speed with nuanced defining attributes, antecedents, and consequences in the cancer context.</div></div><div><h3>Methods</h3><div>Walker and Avant’s method was used. Records were identified from PubMed, CINAHL, and APAPsycINFO.</div></div><div><h3>Results</h3><div>Defining attributes of processing speed include the proficiency and speed to recognize given sensory stimuli, to make decisions based on the recognition, and to implement the decision with movement. Antecedents of processing speed include aging, brain connectivity, fine motor function, and health conditions, with cancer and cancer treatment. Consequences of processing speed include cognitive capability.</div></div><div><h3>Conclusions</h3><div>With the clarified concept of processing speed, assessment tools and nursing interventions can be refined to ensure comprehensively capturing its full scope and facilitating communication in the care of patients with cancer.</div></div><div><h3>Implications for Nursing Practice</h3><div>This analysis confirms processing speed is a critical domain of cognitive function in cancer care, requiring tailored assessment and intervention strategies. The findings highlight the need to update clinical nursing practices with refined tools to evaluate processing speed, enabling oncology nurses to implement targeted interventions that address cancer-related cognitive decline and enhance health outcomes of patients with cancer.</div></div>","PeriodicalId":54253,"journal":{"name":"Seminars in Oncology Nursing","volume":"41 4","pages":"Article 151946"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations in Selecting, Collecting, and Interpreting Outcome Measures for Symptom Science in Oncology","authors":"Sandra A. Mitchell","doi":"10.1016/j.soncn.2025.151948","DOIUrl":"10.1016/j.soncn.2025.151948","url":null,"abstract":"<div><h3>Objectives</h3><div>To review recent literature about the considerations, challenges and tradeoffs when selecting and interpreting symptom measures in patients diagnosed with cancer.</div></div><div><h3>Method</h3><div>A narrative review of peer-reviewed literature, relevant theory, and international consensus guidance relevant to the measurement of symptoms using patient-reported outcomes, performance-based, instrumented, and clinician-reported measures.</div></div><div><h3>Results/Conclusions</h3><div>Theoretical, psychometric, operational and study design considerations influence symptom instrument selection decisions in observational studies, clinical trials (both supportive care trials and therapeutic trials of anticancer therapies), and population surveillance. Multiple well-validated single symptom and multisymptom measures exist to measure cancer and cancer-treatment related symptoms.</div></div><div><h3>Implications for Nursing Practice</h3><div>Exploration of how contrasting measurement approaches can yield complementary insights into the symptom experience and the effectiveness of symptom management strategies remains an underdeveloped area of cancer symptom science.</div></div>","PeriodicalId":54253,"journal":{"name":"Seminars in Oncology Nursing","volume":"41 4","pages":"Article 151948"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Virtual Reality as an Innovative Intervention for Managing Anxiety in Chemotherapy Patients: A Systematic Literature Review","authors":"Giorgia Gaudino ,&nbsp;Ettore Palma ,&nbsp;Sergio Ferrante ,&nbsp;Diego Lopane ,&nbsp;Chiara Coldani ,&nbsp;Daniela Cattani ,&nbsp;Alessandra Dacomi ,&nbsp;Giuseppina Tomaiuolo ,&nbsp;Stefano Mancin ,&nbsp;Beatrice Mazzoleni","doi":"10.1016/j.soncn.2025.151908","DOIUrl":"10.1016/j.soncn.2025.151908","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the effectiveness of immersive virtual reality (VR) as an innovative non-pharmacological intervention to reduce anxiety and alleviate emotional distress in cancer patients undergoing chemotherapy.</div></div><div><h3>Methods</h3><div>A systematic literature review<span><span><span> was conducted between March and May 2024 across PubMed, CINAHL, </span>Embase, </span>Scopus<span>, and MedRxiv databases, following PRISMA guidelines. The review included studies on immersive and non-immersive VR interventions in chemotherapy settings. Methodological quality was assessed using the Joanna Briggs Institute tools, and the certainty of evidence was evaluated through the Oxford Centre for Evidence-Based Medicine framework.</span></span></div></div><div><h3>Results</h3><div>Seven studies involving a total of 594 participants were included. Across all studies, VR interventions significantly reduced anxiety levels during chemotherapy (P &lt; .05). Immersive VR consistently functioned as a distraction tool, offering relaxation and emotional relief.</div></div><div><h3>Conclusions</h3><div>Immersive virtual reality appears to be an effective and safe complementary intervention to reduce anxiety in oncology patients undergoing chemotherapy. Despite promising findings, further high-quality research is needed to confirm these results and assess long-term effects.</div></div><div><h3>Implications for Nursing Practice</h3><div>VR can be integrated into clinical nursing practice as an innovative, non-invasive strategy to enhance the emotional well-being of patients receiving chemotherapy. Nurses should receive appropriate training to administer VR interventions and contribute to multidisciplinary efforts in supportive cancer care.</div></div>","PeriodicalId":54253,"journal":{"name":"Seminars in Oncology Nursing","volume":"41 4","pages":"Article 151908"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}