Administration and Policy in Mental Health and Mental Health Services Research最新文献

{"title":"Clinical Supervision Models for Non-specialist Providers Delivering Psychotherapy: A Qualitative Analysis","authors":"Nicole Andrejek,&nbsp;Paula Ravitz,&nbsp;Kaspars Mikelsteins,&nbsp;Laura La Porte,&nbsp;J. Jo Kim,&nbsp;Crystal E. Schiller,&nbsp;Mae Lynn Reyes-Rodríguez,&nbsp;Lucy C. Barker,&nbsp;Cindy-Lee Dennis,&nbsp;Richard K. Silver,&nbsp;Samantha Meltzer-Brody,&nbsp;Daisy R. Singla","doi":"10.1007/s10488-025-01450-1","DOIUrl":"10.1007/s10488-025-01450-1","url":null,"abstract":"<div><p>Trained non-specialist providers (NSPs), with no formal degree in mental healthcare, can deliver effective psychotherapies for task-sharing. Clinical supervision is important in this process to facilitate quality-assured psychotherapy. We explored three group supervision models within a large, multi-site trial that leveraged NSPs to deliver a brief psychotherapy. In-depth, semi-structured interviews with NSPs (n = 15) explored facilitators and barriers of group supervision models in a stepwise approach, that progressed from expert-led to peer-led, with monthly measurement-based supervision throughout. A focus group on measurement-based supervision was also conducted with clinical experts who provided supervision (n = 4). Qualitative data were analyzed using content and thematic analysis. In <i>expert-led supervision</i>, perceived facilitators among NSPs (n = 15) included educational and professional development (n = 14/15, 93.33%), emotional support (n = 11/15, 77.33%), and expert advice in specific delivery techniques (n = 4/15, 26.67%). A barrier was scheduling (n = 6/15, 40.00%). In peer-led supervision, perceived facilitators among participating NSPs (n = 12) included learning opportunities with peers from diverse backgrounds (n = 10/12, 83.33%), fostering peer connections (n = 9/12, 75.00%), and professional growth (n = 6/12, 50.00%). Barriers included reduced structure (n = 6/12, 50.00%) and attendance (n = 3/12, 25.00%). In <i>measurement-based supervision</i>, reported facilitators included listening to peer’s audio-recorded sessions (n = 14/15, 93.33%), receiving and providing feedback (n = 13/15, 86.67%), and the supervision model’s structure and tools (n = 5/15, 33.33%). Barriers included low self-ratings (n = 12/15, 80.00%) and initial uncertainty on how to provide constructive feedback (n = 6/15, 40.00%). These facilitators and barriers were also reported by the clinical experts (n = 4). Our results highlight the need to produce clear and concrete guidelines to facilitate peer-led and measurement-based supervision, which will support the implementation of task-sharing.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"52 5","pages":"932 - 949"},"PeriodicalIF":2.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207361","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":"Sociodemographic Factors Associated with Autistic Youth’s Psychotherapy Service Use","authors":"Jessica V. Smith,&nbsp;Rose Nevill,&nbsp;Pamela B. DeGuzman,&nbsp;Michelle Menezes,&nbsp;Micah O. Mazurek","doi":"10.1007/s10488-025-01448-9","DOIUrl":"10.1007/s10488-025-01448-9","url":null,"abstract":"<div><p>Autistic youth have a high co-occurrence of mental health challenges and a resultant high need for mental health treatment. However, they experience mental health service disparities compared to non-autistic youth. Social determinants of health (SDH) may contribute to mental health service disparities among autistic youth, yet this has not been previously examined. Therefore, the present study utilized a validated composite of children’s SDH to examine whether autistic youth with better SDH were more likely to use psychotherapy services compared to those with poor SDH using state-level records of insurance billing claims data (2019 All-Payer Claims Database). 700 autistic youth with a co-occurring mental health condition were included in analyses. One or more claim records for psychotherapy CPT codes were used as indicators of psychotherapy service use. SDH was assessed using the Childhood Opportunity Index, a continuous composite measure of neighborhood SDH. The predictive effect of SDH on psychotherapy use were examined, while examining covariates of insurance type and age. Approximately 70% of the sample did not use any psychotherapy services. Inconsistent with findings from non-autistic samples, autistic youth’s SDH did not predict their likelihood of using psychotherapy services; rather, those with low and high opportunity alike did not access psychotherapy. Age increased the likelihood, and using Medicaid decreased the likelihood of psychotherapy service use. These results may highlight the compounded barriers to psychotherapy that autistic youth may experience, including the paucity of mental health providers who accept Medicaid and accept autistic youth clients.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"52 4","pages":"714 - 726"},"PeriodicalIF":2.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge Access to Action: Care Extender Models to Promote Youth Mental Health in Under-Resourced Schools","authors":"A. C. Goodman,&nbsp;K. N. Bryant,&nbsp;E. M. Schiavone,&nbsp;R. R. Ouellette,&nbsp;A. S. Gutierrez,&nbsp;R. Millan,&nbsp;S. L. Frazier","doi":"10.1007/s10488-025-01449-8","DOIUrl":"10.1007/s10488-025-01449-8","url":null,"abstract":"<div><p>One school psychologist is recommended for every 500 students; in practice there is ~one school psychologist for every 1,500-2,000 students. Care extenders can help decrease the number of students needing one-on-one support by implementing universal mental health prevention and promotion practices. Their impact and success relies on empirically informed models for workforce support. The present study extends partnership with City Year Miami, an education non-profit that supports students in low-performing public schools to stay on-track and on-time to graduation. We delivered four weekly 1-hour sessions of Cognitive Triangle training (i.e., brief training applying the Triangle to promote staff and youth emotional well-being) to their AmeriCorps Members (ACMs, <i>n</i> = 19) and collected three sources of data: (1) pre-training quantitative survey data (<i>n</i> = 14 to inform qualitative inquiry), (2) training-generated data (e.g., attendance, text nudge replies), and (3) post-training semi-structured interviews with ACMs (<i>n</i> = 13, ~60 min). We used theoretical thematic analysis to explore, <i>“What will it take to infuse mental health knowledge into routine practice?”</i> informed by the Consolidated Framework for Implementation Research emphasis on provider characteristics and perceptions of mental health knowledge. Results illustrate the interplay between innovation and individual characteristics for infusing knowledge into student support routines. Discussion points to findings advancing the science of transportability and workforce support.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"52 :","pages":"1087 - 1107"},"PeriodicalIF":2.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126465","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":"Correction To: User Satisfaction with Child and Adolescent Mental Health Services: Factor Structure of the Experience of Service Questionnaire (ESQ) in Norway and the UK","authors":"Yngvild Arnesen,&nbsp;Bjørn Helge Handegård,&nbsp;Børge Mathiassen,&nbsp;Kjersti Lillevoll,&nbsp;Monica Martinussen,&nbsp;Luís Costa da Silva,&nbsp;Jasmine Harju-Seppänen,&nbsp;Abigail Rennick,&nbsp;Jenna Jacob,&nbsp;Julian Edbrooke-Childs","doi":"10.1007/s10488-025-01447-w","DOIUrl":"10.1007/s10488-025-01447-w","url":null,"abstract":"","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"52 3","pages":"583 - 583"},"PeriodicalIF":2.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Unmet Need for Care and Barriers to Care Among Individuals with Mental Health Issues: A Meta-analysis","authors":"Bahram Armoon,&nbsp;Alain Lesage,&nbsp;Rasool Mohammadi,&nbsp;Zahedeh Khoshnazar,&nbsp;Mehran Rostami Varnosfaderani,&nbsp;Aida Hosseini,&nbsp;Fatemeh Fotovvati,&nbsp;Fatemeh Mohammadjani,&nbsp;Leila khosravi,&nbsp;Mehran Beigzadeh,&nbsp;Mark D. Griffiths","doi":"10.1007/s10488-025-01446-x","DOIUrl":"10.1007/s10488-025-01446-x","url":null,"abstract":"<div><p>Unmet needs refer to the gap between the health services individuals require and what they receive. Individuals with mental health issues often face barriers preventing them from accessing the care they need. A meta-analysis was conducted to estimate the pooled prevalence of unmet needs for care and barriers to care among individuals with mental health issues. The databases <i>PubMed, Scopus, Web of Science</i>, and <i>Cochrane Library</i> were searched for relevant studies published from December 1, 1985 to August 1, 2024. Following the screening process, 204 included studies remained for meta-analysis. Individuals with mental health issues reported significant pooled prevalence rate of unmet care needs over the past year, with the most common being related to work/occupation (43%), dental care (41%), counseling (40%), social intervention (37%), mental health (34%), physical health needs (33%), skills training (32%), social network (32%), psychological distress (31%), information (27%), intimate relationships (27%), benefits (26%), harm reduction (25%), psychotic symptoms (24%), housing (24%), money and food (21%), education (20%), sexual expression (19%), home care (16%), safety (15%), self-care (15%), telephone support (9%), and child care (8%). The pooled prevalence rates of barriers to accessing care were motivational (38%), structural (37%), financial (31%), and stigmatization (25%). The findings indicated that patients with substance use disorders experienced a significantly higher prevalence of unmet care needs and barriers to accessing care compared to those with mental health disorders and homeless individuals. The results showed that unmet care needs were highest among those in established adulthood, while harm reduction was more common among adolescents and emerging adults. Physical health and food needs were most prevalent among midlife adults. Barriers to care were most common among adolescents and emerging adults, except for structural barriers, which were most frequent among midlife adults. To address the unmet employment needs of Individuals with mental health issues, comprehensive training in essential skills is recommended. Enhancing dentists’ mental health understanding and fostering collaboration among healthcare providers is crucial. Government-funded, low-barrier service models for substance use disorder patients is suggested to enhance accessibility and effectiveness, while improving health service affordability and acceptability is essential.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"52 4","pages":"653 - 686"},"PeriodicalIF":2.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960351","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":"Professionals’ and Families’ Perspectives on Essential Elements of Shared Decision-Making: A Qualitative Analysis on Families with Multiple and Enduring Problems in Integrated Youth Care","authors":"Anne Marie Barnhoorn-Bos,&nbsp;Eva A. Mulder,&nbsp;Laura A. Nooteboom,&nbsp;E. H. Alet Meurs,&nbsp;Robert R.J.M. Vermeiren","doi":"10.1007/s10488-025-01443-0","DOIUrl":"10.1007/s10488-025-01443-0","url":null,"abstract":"<div><p>Shared decision-making (SDM), known to improve client engagement in care and its quality, is crucial to achieve family-tailored care. However, when providing integrated youth care, SDM can be challenged by the complexity of families’ problems and the multiple family members and professionals involved. Commonly used SDM models may not adequately address these specific challenges. Therefore, this qualitative study explores families’ and professionals’ perspectives on essential elements of SDM with families experiencing multiple and enduring problems on different life domains (e.g., mental health, parenting, financial, and social problems). Semi-structured interviews were conducted with 18 parents, 3 youth, and 22 professionals from Specialist Integrated care Teams in four regions of the Netherlands. A framework method - comprising essential elements of SDM - was applied to systematically code the transcripts both deductively and inductively. Our study shows the nine essential elements of SDM require a specific interpretation in the context of integrated youth care, regarding the diversity of participants in decision-making, the complexity of the problems, and SDM as a continuous process of multiple decisions. In addition, families and professionals mentioned three complementary elements: (1) build collaborative relationships, (2) prioritize problems, goals and actions, and (3) interprofessional consultation. Thus, in integrated youth care professionals are recommended to consider SDM as a cyclical process of larger and smaller decisions and take time to build collaborative relationships with families and the care network. Throughout the care process families and professionals balance their mutual roles in decision-making in line with the changing needs and preferences of families.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"52 4","pages":"640 - 652"},"PeriodicalIF":2.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using a Single Measure To Assess Adherence and Differentiation in Family Therapy for Adolescent Externalizing Problems","authors":"Stephanie Violante,&nbsp;Bryce D. McLeod,&nbsp;Aaron Hogue","doi":"10.1007/s10488-025-01445-y","DOIUrl":"10.1007/s10488-025-01445-y","url":null,"abstract":"<div><p>The interpretation of effectiveness research can be enhanced by understanding what prescribed (i.e., adherence) and non-prescribed (i.e., differentiation) techniques were delivered. However, few measures exist that can assess both adherence and differentiation. The current study examined how the Therapy Process Observational Coding System for Child Psychotherapy Revised Strategies Scale (TPOCS-RS) can assess adherence to and differentiation from family therapy for youth with externalizing problems. Treatment sessions (<i>N</i> = 103) from 42 adolescents (<i>M</i> age = 15.0, <i>SD</i> = 1.4; 47.6% female; 59.5% Hispanic/Latinx/e, 19.0% Black, 11.9% multiracial, 4.8% other race) with primary externalizing problems treated by 24 clinicians (<i>M</i> age = 33.2, <i>SD</i> = 8.3; 66.7% female; 33.3% Hispanic/Latinx/e, 20.8% White, 12.5% Asian, 8.3% multiracial, 8.3% other race) in routine practice settings were coded with the TPOCS-RS. Treatment sessions were from three groups: (a) routine family therapy, (b) routine family therapy plus the medication integration protocol, or (c) usual care. Interrater reliability for the TPOCS-RS Family Therapy subscale was ICC = 0.90, and scores demonstrated evidence of convergent and discriminant validity via associations with treatment integrity and alliance measures. The TPOCS-RS Family Therapy subscale also demonstrated evidence of discriminative validity by identifying expected group differences. Results provide preliminary evidence that the TPOCS-RS can measure adherence to and differentiation from family therapy.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"52 4","pages":"687 - 700"},"PeriodicalIF":2.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision Mental Healthcare: Identifying Service Preferences Through Discrete-Choice Experiments in Chinese Megacities","authors":"Juan Chen,&nbsp;Luqi Yuan,&nbsp;Bo Li,&nbsp;Jie Yan,&nbsp;Liying Ren","doi":"10.1007/s10488-025-01444-z","DOIUrl":"10.1007/s10488-025-01444-z","url":null,"abstract":"<div><p>Designing mental health services that align with individual preferences is a cornerstone of patient-centered care, enhancing both service utilization and treatment outcomes. This study applied the precision framework of mental healthcare to explore preferences for first-contact mental health services among community residents and family members with mild psychiatric symptoms in Chinese megacities. Using a discrete choice experiment, an online survey was conducted with 4,057 participants from Beijing, Shanghai, Guangzhou, and Shenzhen. Mixed logit analysis identified service providers as a key determinant of mental health service utilization across cities. While both potential patients and family members favored lower-cost public services, notable variations emerged in preferences for psychological counseling/therapy across cities and between patient and family contexts. Latent class analysis further revealed four distinct preference groups among potential patients. Psychological distress levels and hukou type were significantly associated with preferences. These findings highlight the importance of tailored interventions that accommodate patient and family needs, leveraging the unique features of China’s mental healthcare system to improve access, quality, and equity in mental health services.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"52 4","pages":"619 - 639"},"PeriodicalIF":2.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peer Perspectives on Challenges Encountered During a Multi-Site Digital Mental Health Intervention Project","authors":"Biblia S. Cha,&nbsp;Elizabeth V. Eikey,&nbsp;Dana B. Mukamel,&nbsp;Kristy J. Palomares,&nbsp;Stephen M. Schueller,&nbsp;Dara H. Sorkin,&nbsp;Nicole A. Stadnick,&nbsp;Sarah Elizabeth Stoeckl,&nbsp;Kai Zheng,&nbsp;Margaret L. Schneider","doi":"10.1007/s10488-025-01441-2","DOIUrl":"10.1007/s10488-025-01441-2","url":null,"abstract":"<div><p>Peers are individuals with lived experience of mental health challenges trained to provide support to others with similar challenges. Help@Hand was a multi-site project that integrated peers into digital mental health intervention (DMHI) implementation. This study uses the Consolidated Framework for Implementation Research (CFIR) to frame challenges reported by peers when implementing DMHIs. Individuals leading the local peer workforce completed quarterly online surveys about perceived challenges to DMHI implementation. Biannual interviews probed for details on survey-reported challenges. 103 quarterly surveys and 39 bi-annual interviews were collected from key informants at 11 Help@Hand sites between Summer 2020 and Fall 2022. One challenge was tied directly to DMHIs; namely, device distribution. Several related to the Implementation Process, including challenges with recruiting qualified peers and integrating peers into DMHI implementations; communication and collaboration; and translation. Challenges in the Individual domain included unclear peer roles and multi-tasking across various projects. Inner Setting challenges included structural barriers to hiring peers, issues with communication and project management, and workforce turnover. Outer Setting challenges related to environmental technology readiness, COVID-19, unclear decision-making processes across the collaborative, and uneven communication between sites’ peers. Funding uncertainty bridged the Inner and Outer Settings. Using the CFIR model to frame challenges to DMHI implementation yielded useful lessons, especially when peers are engaged as partners in planning and implementation process. Successful implementation will be enhanced by ensuring adequate environmental readiness for tech-based interventions, clear role definition, streamlined peer hiring processes, and well-delineated lines of communication locally and across sites.</p></div>","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"52 4","pages":"603 - 618"},"PeriodicalIF":2.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Scaling Out a Digital-First Behavioral Health Care Model to Primary Care","authors":"Soo Jeong Youn,&nbsp;Keke Schuler,&nbsp;Pratha Sah,&nbsp;Brittany Jaso-Yim,&nbsp;Mariesa Pennine,&nbsp;Heather O’Dea,&nbsp;Mara Eyllon,&nbsp;J. Ben Barnes,&nbsp;Lily Murillo,&nbsp;Laura Orth,&nbsp;Georgia H. Hoyler,&nbsp;Samuel S. Nordberg","doi":"10.1007/s10488-025-01442-1","DOIUrl":"10.1007/s10488-025-01442-1","url":null,"abstract":"","PeriodicalId":7195,"journal":{"name":"Administration and Policy in Mental Health and Mental Health Services Research","volume":"52 :","pages":"1057 - 1060"},"PeriodicalIF":2.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956379","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}