Inquiry-The Journal of Health Care Organization Provision and Financing最新文献

{"title":"An 8-Week Virtual Exercise Environment Intervention for People Post-Stroke: A Longitudinal Mixed Methods Single Case Study.","authors":"Christen J Mendonca, Sangeetha Mohanraj, Rebecca R Rogers, Laurie A Malone, Mohanraj Thirumalai, James H Rimmer, David A Brown","doi":"10.1177/00469580251366158","DOIUrl":"10.1177/00469580251366158","url":null,"abstract":"<p><p>Individuals with hemiplegia using a coupled-crank arm cycle may experience nonparetic arm overcompensation and paretic arm resistance due to neuromechanical deficits. Technologies that foster independent limb contributions may increase paretic arm recovery for people post-stroke. To document in a single case study the effects of 8 weeks of training with a smart trainer arm ergometer on power output, pedal speed, pedal synchronicity, quality of life, enjoyment, and engagement. A longitudinal, mixed methods, case study design was used to examine physical and psychosocial changes in an individual post-stroke after an 8-week arm cycling program using the Advanced Virtual Exercise Environment Device (AVEED) in a non-immersive virtual exergaming environment. After a pretest visit, the cycling speed of each arm was collected with open-ended responses over 24 training visits. A posttest visit and semi-structured interview were conducted. The data were mixed for the training visits and posttest to draw meta-inferences. The participant cycled faster bilaterally and used his paretic arm more than at pretest during cycling after 8 weeks of training with the AVEED. The speed difference between his paretic and non-paretic arms steadily decreased and the participant reported increasing enjoyment and engagement over time. The device, environment, and intervention were rated as usable, and the participant attributed several functional improvements with his paretic arm to the program. The AVEED, combined with an exergaming platform, was successful in improving the cycling speed and paretic arm contribution of an individual post-stroke through an 8-week non-immersive virtual exercise environment program.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251366158"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Empowerment, Conscious Mindfulness, and Life Engagement in Seafarers: Mediating Patience and Moderating Hope.","authors":"Nihan Senbursa, Emre Dunder, Ali Tehci, Özkan Uğurlu","doi":"10.1177/00469580251376239","DOIUrl":"10.1177/00469580251376239","url":null,"abstract":"<p><p>This study investigates the complex interrelations between psychological empowerment, conscious mindfulness, and life engagement among active seafarers, explicitly focusing on the mediating and moderating roles of hope and patience. A total of 460 seafarers currently serving on board participated in the study. Demographic variables were collected, including age, marital status, income level, and vessel type. Hope and patience's mediation and moderation effects on the relationships between psychological empowerment, conscious mindfulness, and life engagement were examined using the PROCESS macro within the IBM SPSS version 27 software. The results indicate that neither hope nor patience significantly mediates the relationship between psychological empowerment and life engagement. However, patience partially mediates the relationship between conscious mindfulness and life engagement, while hope does not. Moderation analyses reveal that hope significantly moderates the relationship between conscious mindfulness and life engagement, enhancing its positive effect. In contrast, patience does not exhibit a significant moderating role. The findings highlight patience as a key psychological factor in amplifying the positive effects of conscious mindfulness on life engagement among seafarers. This study contributes to understanding the psychological mechanisms that influence life engagement in high-stress maritime environments. It suggests that cultivating patience may serve as a valuable strategy to support mental well-being and performance in seafaring professionals.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251376239"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Knowledge and Attitudes towards Second-Hand Smoking Exposure Among University Students: An Exploratory Study.","authors":"Md Majharul Islam, Firoj Al-Mamun, Moneerah Mohammad ALmerab, Mst Sabrina Moonajilin, Mohammed A Mamun","doi":"10.1177/00469580251314783","DOIUrl":"10.1177/00469580251314783","url":null,"abstract":"<p><p>Despite extensive global research on second-hand smoking (SHS) exposure, there is a noticeable lack of studies focusing on the knowledge and attitudes of university students in Bangladesh. This cross-sectional study aimed to address this gap by assessing the levels of knowledge and attitudes towards SHS exposure among university students in Bangladesh. Utilizing a convenience sampling technique, data were collected from 383 university students, encompassing socio-demographic information, as well as knowledge and attitude-related inquiries. Statistical analyses were conducted using SPSS software, including independent t-tests and analysis of variance (ANOVA) and multiple linear regression. The findings revealed that participants exhibited a moderate level of knowledge and attitude towards SHS exposure. Multiple linear regression identified age, gender, mother's education, and self-rated health status as significant predictors of knowledge, explaining 12.9% of its variance (R² = 0.129, F = 6.117, <i>P</i> < .001). Furthermore, age, gender, and living with parents emerged as significant predictors of attitude, explaining 14.7% of its variance (R² = 0.147, F = 7.165, <i>P</i> < .001). The study highlights the need for interventions aimed at enhancing awareness and fostering positive attitudes towards SHS exposure among university students in Bangladesh. It is recommended that university authorities organize seminars and implement health education initiatives targeting vulnerable populations to address the findings and promote a smoke-free environment on campus.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251314783"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-sectional Study Reveals Moderate Professional Benefits Among Nurses in a Multicultural Healthcare System.","authors":"Ka Ieng Lai, Pedro Fong, Lirong Meng","doi":"10.1177/00469580251316966","DOIUrl":"10.1177/00469580251316966","url":null,"abstract":"<p><p>The global nursing shortage poses challenges to healthcare accessibility, clinical outcomes, and patient safety. Researchers have explored factors that influence nursing attrition, and the Nurses' Perceived Professional Benefits (NPPB) is one such factor that has gained attention. This cross-sectional study aims to assess the NPPB among registered nurses in Macao, a multicultural city with a unique healthcare system. A 33-item online questionnaire was used to collect data from 279 nurses. The questionnaire measured NPPB across 5 dimensions: positive occupational perception, personal enhancement, recognition from family and friends, decent nurse-patient relationships, and team belongingness. This study indicated that Macao nurses had a moderate level of NPPB. Nurse-patient relationships, income, and job stability received the most positive responses, while team belongingness received the lowest scores. These findings suggest that improvements are needed in team building, providing more opportunities for specialized training, and offering more career advancement opportunities.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251316966"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness Analysis of a Latent Tuberculosis Screening Program Among Healthcare Personnel.","authors":"Niludi Ranwanee Yasaratna, Manuj Chrishantha Weerasinghe","doi":"10.1177/00469580251319931","DOIUrl":"10.1177/00469580251319931","url":null,"abstract":"<p><p>Screening high-risk groups for Latent Tuberculosis Infection (LTBI) is crucial for TB elimination, as the large global reservoir of Mycobacterium tuberculosis bacilli poses a significant challenge to TB control globally. Assessing the cost-effectiveness of LTBI screening strategies is also crucial in determining the optimal approach. In 2022, Sri Lanka initiated a new program to manage latent tuberculosis infection among high-risk groups, including healthcare personnel, which recorded an 18% Latent Tuberculosis prevalence. This study aimed to evaluate the cost-effectiveness of implementing a screening program for Healthcare Personnel as part of this initiative in Sri Lanka. A decision tree model was developed to assess the cost-effectiveness of LTBI screening among Healthcare Personnel from the health system perspective, using secondary data from 2021 to 2022. The decision tree model was used to evaluate the cost-effectiveness of initiating LTBI screening for Healthcare Personnel in government hospitals. The findings are presented as the Incremental Cost-Effectiveness Ratio (ICER), compared to locally appropriate cost-effectiveness thresholds. The direct costs incurred for the standard LTBI tests and prophylaxis were assessed at the program level. The ICER represents the incremental cost of LTBI screening per Disability Adjusted Life Year (DALY) gained by preventing future active TB cases through treatment of latent TB infection. The total cost for managing an active TB case was $80.44, markedly higher than the $20.84 cost for a Latent TB case. The total cost difference between managing an active TB case and a Latent TB case was $59.60. The Incremental Cost-Effectiveness Ratio was $2381.29 per Disability Adjusted Life Year averted. The decision analysis model indicated that screening Healthcare Personnel for latent tuberculosis infection is highly cost-effective and can be recommended for implementation in Sri Lanka.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251319931"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reforming Drug Price Regulation: Using Tools That Work.","authors":"Deborah Williams, Steven C Zima, Brian J Miller","doi":"10.1177/00469580251335844","DOIUrl":"10.1177/00469580251335844","url":null,"abstract":"<p><p>Drug pricing reform to increase affordability has historically relied on increases in regulation often with a focus on administrative pricing for public programs in order to try to lower drug costs. This paper examines the consequences of this strategy, pointing out that regulated prices fail to drive affordability, create unintended, hidden costs to the system, and drive demand for a body of ever-growing regulatory interventions to address shortfalls created by prior policies. Within this context, the paper examines examples of regulations affecting large percentages of government payments the Medicaid Drug Rebate, the Inflation Reduction Act Maximum Fair Price, and the Average Sales Price formula in Medicare B enumerating how each of these programs that direct funds to Medicare or Medicaid only create hidden systematic costs when considered from the total market perspective. Next, a new paradigm for drug pricing reform philosophy is suggested, with a focus on market-based interventions to reform existing government regulation aimed at improving competition and consider examples of effective private market policies including co-insurance/copayment reform, private formularies, specialty pharmacies, and value-based contracting. The paper concludes by arguing that shifting from a programmatic view of affordability to an understanding of the regulatory effect on costs in the drug market, including regulatory burden reduction, is the best way to drive affordability for payers and thus ultimately for employers and consumers.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251335844"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valid and Reliable Attitude Scales for Measuring Clinician's Attitudes Towards Telehealth Assisted Sexual Assault Forensic Exams Using a Pre-Post Survey.","authors":"Wah Wah Myint, Heather R Clark, Kim Zemanek, Kayce Ward, Stacey A Mitchell, Nancy R Downing","doi":"10.1177/00469580251332790","DOIUrl":"10.1177/00469580251332790","url":null,"abstract":"<p><p>The success of telehealth programs to guide clinicians to perform sexual assault medical forensic examinations relies on clinicians' positive attitudes toward telehealth services, though no validated tools to measure these variables exist. This study aims to report validity and reliability of a novel tool with two scales: Positive Beliefs and Acceptance scales for hospital nurse clinicians at sites initiating the Texas Teleforensic Remote Assistance Center (Tex-TRAC). An analysis of pre-post cross-sectional data of hospital nurse clinicians (N = 121) trained in the use of Tex-TRAC telehealth technology at seven participating hospitals in Texas from July 2022 to May 2023 was performed. The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy and Bartlett's test of Sphericity sample size analysis were performed. Exploratory Factor Analysis (EFA) was applied for validity and internal consistency reliability Cronbach alpha (α) values were described for two scales: Positive Beliefs and Acceptance scales. Positive Beliefs scale has a KMO value of 0.810 and Barlett's test of sphericity (χ² (6) = 380.47, <i>P</i> < .001). Acceptance scale has a KMO value of 0.832 and Barlett's test of sphericity (χ² (28) = 432.19, <i>P</i> < .001). After Promax Oblique rotation, the final four-item Positive Beliefs scale had α = .894; the final five-item Acceptance scale had α = .876. Validity and reliability of both scales demonstrated potential usefulness for future telehealth interventions engaging Sexual Assault Nurse Examiners. Continued use of these scales could provide additional information that can be leveraged in training curriculum of similar telehealth programs like Tex-TRAC.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251332790"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Makes a Successful Partnership? Lessons from a Multi-Agency Equity-Focused Maternal and Early Childhood Health Partnership in Victoria, Australia: A Case Study.","authors":"L J Biggs, F Gordon, J Leetham, K Pangli Kaur, F Hearn, G Callandar, J Szwarc, H Brundell, K Diacono, E Riggs, S J Brown","doi":"10.1177/00469580251336098","DOIUrl":"10.1177/00469580251336098","url":null,"abstract":"<p><p>Disparities in maternal and child health outcomes in high-income countries, including Australia, are influenced by complex social determinants of health. We formed a multi-disciplinary multi-agency partnership to improve the capacity of maternity and early childhood health workforces to identify and respond to social factors contributing to poorer perinatal outcomes for families in a Local Government Area in Victoria, Australia. This case study reports our experiences and reflections on working in partnership during the COVID-19 pandemic. An evaluation involving semi-structured interviews and a collaborative workshop attended by 10 partnership group members was undertaken in 2023. Recognising that the pandemic had constrained the implementation of many project activities, the aims of the evaluation were: to understand what had worked well within the partnership group and why, and to identify insights and recommendations to inform government and policy makers, health service managers, and teams seeking to undertake similar work. Partnership members valued the opportunity and time invested in building and maintaining relationships across agencies and between team members. Disruption to services associated with the COVID-19 pandemic amplified established cultural, political, and organisational barriers to service innovation and health equity. Despite the challenges of undertaking this work during the COVID-19 pandemic, our positive collaborative relationships and shared sense of purpose have supported us to remain hopeful about the potential for future health equity initiatives to achieve change. Reflecting our optimism, we have co-produced a set of recommendations for teams seeking to undertake similar work in the future.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251336098"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost Saving and Health Workers Perceptions of Pharmacist Integration in Operating Rooms: A Mixed-Methods Cross-Section Study.","authors":"Deus Buma, Solobi Ngasa, Arnold Ndesangia","doi":"10.1177/00469580251343776","DOIUrl":"10.1177/00469580251343776","url":null,"abstract":"<p><p>Developed nations maximize pharmacists, while developing nations underutilize them, especially in operating rooms (ORs), necessitating cost-effectiveness and feedback evaluations. We investigated the impact of pharmacist involvement in operating rooms (OR) at Muhimbili National Hospital. We contrasted a \"before era\" (BE) without pharmacists to an \"after era\" (AE) with their presence. We conducted a comparative observational analysis. We examined data from April 1, 2016, to June 30, 2018 (BE), and July 1, 2018, to September 2020 (AE). We interviewed 127 OR Health workers to appreciate pharmacist presence during AE. We performed statistical analysis using Stata 12/IC. We used chi-square and Student's <i>t</i>-tests for categorical and continuous data, respectively. We set statistical significance at <i>P</i> < .05. In the BE, 32 568 patients underwent surgery, with 31.7% being male, while in the AE, 40 195 patients were operated on, with 40.2% being male. Patient payment method distribution did not significantly differ between eras (<i>P</i> = .68351). The total medication and medical supply costs decreased from TZS 8 631 547 372 in the BE to TZS 6 695 832 350 in the AE. Despite an additional cost of TZS 1 409 400 000 for pharmacist integration, a net cost saving of TZS 526 315 022 was achieved, resulting in an incremental cost-effectiveness ratio (ICER) of TZS 69 007 cost savings per patient served during AE. Health workers satisfaction regarding the inclusion of 40 pharmacists was high, with 98.4% reporting satisfaction. During the AE, 92.9% of OR Health workers were content with pharmacist performance. However, some Health workers did not understand about pharmacist roles in OR due to their limited numbers and suggested prioritizing supply management over direct OR presence. Pharmacists are indispensable members of healthcare teams, particularly in ORs, where their contributions significantly improve patient outcomes and reduce costs. The findings strongly support increased pharmacist deployment in healthcare facilities and further research to explore their impact on healthcare resource utilization.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251343776"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Affecting Utilization of Primary Healthcare Services in Saudi Arabia.","authors":"Ashraf A'aqoulah, Rasha AlAhmari, Khalid Alahmary, Atika A Al Sudairy, Nisreen Innab, Raghib Abu Saris","doi":"10.1177/00469580251326444","DOIUrl":"10.1177/00469580251326444","url":null,"abstract":"<p><p>PHC should be accessible to the entire population, regardless of their economic or social class and geographical location. The PHC system in Saudi Arabia provides most curative and preventive health services through many centers. This study aims to estimate the percentage of PHC utilization and determine the factors associated with the utilization of PHCCs in Riyadh, Saudi Arabia. A quantitative cross-sectional design was used for community-based PHCs and employer-based PHCs in Riyadh. The study sample consisted of 306 patients and community members attending primary health clinics at National Guard Health Affairs (NGHA) and Ministry of Health (MOH). Data were collected using a self-administered questionnaire adopted from the Agency for Healthcare Research and Quality. Data analysis was conducted using SPSS. Descriptive and inferential statistics were used to achieve the aim of the study. In our study, we found that 53.9% (95% CI = 48.34%, 59.51%) utilized PHCs. Furthermore, females were more likely to utilize PHCs with OR = 1.675 and 95% CI = (1.029, 2.727). Healthcare managers and policymakers should focus their efforts on providing desirable services, consequently changing public opinion about healthcare services, and increasing their satisfaction with existing services.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251326444"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}