Age and ageing最新文献

{"title":"We should not fear assisted dying","authors":"Rowan H Harwood","doi":"10.1093/ageing/afaf029","DOIUrl":"https://doi.org/10.1093/ageing/afaf029","url":null,"abstract":"The argument for allowing assisted dying (ad) is based on two principles: (i) respect for autonomy and (ii) adequate safeguards to avoid coercion or abuse. We should ensure that ad is accessible, equitable and regulated. It is wrong, without very good reason, to impose a set of beliefs on other people who do not hold those views. We should therefore not impose an obligation to go on living if an individual considers that it is associated with unwanted suffering, distress, dependency, indignity or cost. We should accept, and provide for, diversity and variation in people’s views on ad. The right to refuse life-prolonging therapies, or to have drugs to control distressing symptoms that incidentally shorten life, is well-established. The ethical distinction between these and ad is arguable. Worldwide, most people who choose to end their lives, are already close to death. Some people need protection from the possibility of their lives being ended when they did not intend or want it. However, older people are capable of making informed decisions on serious matters, with or without the support of others. To suggest otherwise is paternalistic and ageist. Multiple jurisdictions worldwide have developed and use effective safeguards. In these countries, ad is mostly welcomed and has not led to undue legal, social or human rights problems. Legal provision for ad is both desirable and necessary.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"12 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting older people through Hospital at Home care: a systematic review of patient, carer and healthcare professionals’ perspectives","authors":"Anita Wong, Claudia Cooper, Catherine J Evans, Mark James Rawle, Kate Walters, Simon Paul Conroy, Nathan Davies","doi":"10.1093/ageing/afaf033","DOIUrl":"https://doi.org/10.1093/ageing/afaf033","url":null,"abstract":"Introduction Hospital at Home provides hospital-level type care at home, both remote and face-to-face by a multidisciplinary team of healthcare professionals. In practice, various different models are employed, but we do not know what older people, their family carers (carers) and healthcare professionals think of what works best for them. This review aimed to describe the various Hospital at Home models and synthesise literature exploring patient, carer and staff perspectives of Hospital at Home care for older people. Methods and analysis A systematic review of UK studies. Medline, Embase and CINAHL and grey literature were searched from 1991 to 2024, using predetermined inclusion and exclusion criteria; data were extracted from included papers. Tabulation, thematic grouping and concept mapping of themes were used to narratively synthesise the literature. Results Twenty studies met eligibility. Hospital at Home models included admission avoidance and early discharge. Studies were largely positive regarding Hospital at Home, with benefits including home familiarity, enabling person-centred care and shared decision-making and provision of family carer support. Challenges included staff accessibility, patient and carer anxieties regarding the safety of virtual wards, coordination across sectors and older people using technology. Conclusion Provision of holistic, accessible and continuous care for older people in Hospital at Home services facilitated patient and carer empowerment, dignity and autonomy. There are gaps in our understanding and evidence surrounding paid care workers and informal carers’ perspectives in UK settings, especially within rigorous Hospital at Home literature.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"209 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of hospitalisation settings and exercise interventions in acute care: a systematic review and meta-analysis","authors":"Paula Etayo-Urtasun, Mikel L Sáez de Asteasu, Mikel Izquierdo","doi":"10.1093/ageing/afaf035","DOIUrl":"https://doi.org/10.1093/ageing/afaf035","url":null,"abstract":"Background Inpatient hospitalisation is associated with adverse outcomes in older adults, including hospital-associated deconditioning. The hospital-at-home (HaH) model may promote physical activity. This systematic review and meta-analysis compares functional outcomes between inpatient and HaH settings and evaluates the efficacy of exercise interventions in both settings. Methods Systematic searches of PubMed, Scopus, Web of Science and ScienceDirect were conducted on 27 April 2024. Three distinct searches were performed: (i) studies comparing HaH and inpatient hospitalisation, (ii) trials evaluating inpatient exercise interventions and (iii) research on HaH exercise interventions. Two reviewers independently selected studies published from 2014 onwards using the PICOS framework and they assessed quality using PEDro scale. A meta-analysis was performed using a random effects model to analyse exercise interventions. This systematic review with meta-analysis was conducted according to PRISMA 2020 guidelines and was registered on PROSPERO (CRD42024598286). Results Among the 9470 studies identified, nine studies comparing acute-care settings and 21 studies on exercise interventions (one in HaH) were included. Findings suggest that HaH may positively affect functional and cognitive outcomes. Inpatient exercise interventions significantly improved physical performance [standardised mean difference (SMD) = 0.42, 95% confidence interval (CI) = 0.12–0.72] and functional independence (SMD = 0.45, 95% CI = 0.14–0.77) at discharge. Conclusion HaH may contribute to preserving physical and cognitive status. Supervised exercise interventions during inpatient hospitalisation are safe and effective for improving older adults’ functional status, although further research in the HaH model is needed.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"19 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143462813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilisation of nursing home care before and after the 2015 Dutch national reform: an interrupted time series analysis","authors":"Janet L MacNeil Vroomen, Joost D Wammes, Bram Wouterse, Martin Smalbrugge, Terrence E Murphy","doi":"10.1093/ageing/afaf018","DOIUrl":"https://doi.org/10.1093/ageing/afaf018","url":null,"abstract":"Background The Netherlands introduced abrupt, large-scale, long-term care (LTC) reforms in 2015 that promoted ageing-in-place. However, there has been no comprehensive population-level study evaluating how these reforms have impacted nursing home (NH) utilisation. This study examines the association between the 2015 reforms with national monthly rates of NH admissions and survival time amongst newly admitted older adults. Methods We analysed population data from Statistics Netherlands (2011–2019), conducting an interrupted time-series analysis to compare monthly NH admission rates before and after the 2015 reforms amongst adults aged 65 and older (N = 402 350). A Cox proportional hazards model was used to assess the reform’s impact on mortality risk amongst newly admitted residents. Results The adjusted NH admission rate before the reform was 88.80 per 100 000 older adults (95% CI (confidence interval): 82.36–95.83), compared to 69.82 per 100 000 after the reform (95% CI: 65.91–73.78), indicating a significant reduction (incident rate ratio: 0.80, 95% CI: 0.74–0.86). Over a 3-year follow-up, the average survival time for those admitted after the reform was 608 days (95% CI: 608.72–610.74), compared to 622.52 days (95% CI: 620.59–624.45) for those admitted before the reform. The reform was associated with a slightly increased mortality risk (hazard ratio: 1.05, 95% CI: 1.02–1.07). Conclusions The 2015 Dutch LTC reform is associated with a reduction in national NH admissions and a decrease in average survival time of 2 weeks.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"41 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deprescribing in cognitively vulnerable older people: development and validation of STOPPCog criteria","authors":"Siobhan McGettigan, Denis Curtin, Denis O’Mahony","doi":"10.1093/ageing/afaf014","DOIUrl":"https://doi.org/10.1093/ageing/afaf014","url":null,"abstract":"Objective To validate STOPPCog, a list of explicit criteria for potentially inappropriate medication use in cognitively vulnerable older adults. Design A Delphi consensus survey of an expert panel comprising academic geriatricians, old age psychiatrists, general practitioners, and clinical pharmacists. Setting Ireland. Subjects Nine panellists. Methods STOPPCog criteria were initially created by the authors based on clinical experience and literature appraisal. Criteria were organised according to drug/drug class. Using Delphi consensus methodology, panellists ranked their agreement with each criterion on a 5-point Likert scale and provided written feedback. Criteria with a median value of 1 or 2 (strongly agree/agree) and a 25th centile value of ≤2 were included in the final list. Results All panellists completed two Delphi consensus validation rounds. Twenty-five criteria were proposed initially, twenty were accepted. One criterion was rejected (multi-vitamin supplements), and four criteria were rephrased (two of these were combined to one criterion for greater clarity). The final list comprised 23 criteria that are arranged in six subgroups i.e. (i) drugs with anticholinergic properties taken daily; (ii) drugs with sedative properties taken daily; (iii) drugs that may exacerbate psychotic symptoms in patients with alpha-synuclein pathology; (iv) drugs used for chronic pain; (v) drugs without proven efficacy for dementia taken daily; (vi) drugs that are of no proven benefit in advanced stage dementia i.e. clinical dementia rating of 3.0 where palliation may be appropriate. Conclusion STOPPCog comprises 23 criteria relating to medications that are potentially inappropriate in cognitively vulnerable older adults. STOPPCog may assist physicians in deprescribing medications in this patient population.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"80 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of in-hospital medication changes on clinical outcomes in older inpatients: the journey and destination","authors":"Nashwa Masnoon, Sarita Lo, Danijela Gnjidic, Andrew J McLachlan, Fiona M Blyth, Rosemary Burke, Ana W Capuano, Sarah N Hilmer","doi":"10.1093/ageing/afae282","DOIUrl":"https://doi.org/10.1093/ageing/afae282","url":null,"abstract":"Background Medication review is integral in the pharmacological management of older inpatients. Objective To assess the association of in-hospital medication changes with 28-day postdischarge clinical outcomes. Methods Retrospective cohort of 2000 inpatients aged ≥75 years. Medication changes included the number of increases (medications started or dose-increased) and decreases (medications stopped or dose-decreased) for (i) all medications, (ii) Drug Burden Index (DBI)–contributing medications and (iii) Beers Criteria 2015 medications (potentially inappropriate medications, PIMs). Changes also included differences in (i) the number of medications, (ii) the number of PIMs and (iii) DBI score, at discharge versus admission. Associations with clinical outcomes (28-day ED visit, readmission and mortality) were ascertained using logistic regression, adjusted for age, gender and principal diagnosis. For mortality, sensitivity analysis excluded end-of-life patients due to higher death risk. Patients were stratified into : (i) ≤4, (ii) 5–9 and (iii) ≥10 discharge medications. Results The mean age was 86 years (SD = 5.8), with 59.1% female. Medication changes reduced ED visits and readmission risk for patients prescribed five to nine discharge medications, with no associations in patients prescribed ≤4 and ≥ 10 medications. In the five to nine medications group, decreasing PIMs reduced risks of ED visit (adjusted odds ratio, aOR 0.55, 95% CI 0.34–0.91, P = .02) and readmission (aOR 0.62, 95% CI 0.38–0.99, P = .04). Decreasing DBI-contributing medications reduced readmission risk (aOR 0.71, 95% CI 0.51–0.99, P = .04). Differences in PIMs reduced ED visit risk (aOR 0.65, 95% CI 0.43–0.99, P = .04). There were no associations with mortality in sensitivity analyses in all groups. Discussion Medication changes were associated with reduced ED visits and readmission for patients prescribed five to nine discharge medications.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"50 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143077484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of claims-based frailty measurements in older patients with cancer: a retrospective cohort study.","authors":"Hirooka Kayo, Kanno Yusuke, Itoh Sakiko, Sagawa Mieko, Sakano Tomomi, Takahashi Kunihiko, Anzai Tatsuhiko, Fukui Sakiko","doi":"10.1093/ageing/afaf015","DOIUrl":"10.1093/ageing/afaf015","url":null,"abstract":"<p><strong>Background: </strong>Frailty is associated with poor outcomes in older adults with cancer. Several efforts have been made to assess frailty using the administrative claims data based on the number of clinical diagnosis codes, yet the literature reporting on this is scarce. This study aimed to evaluate the impact of frailty measures using administrative databases in Japan.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting and participants: </strong>5176 patients with cancer aged ≥65 years who underwent cancer treatment in hospitals.</p><p><strong>Methods: </strong>The Electronic Frailty Index (eFI) and Veterans Affairs Frailty Index (VA-FI), based on diagnostic codes recorded were calculated. We plotted Kaplan-Meier survival curves and calculated hazard ratios (HR) using Cox regression analyses. The primary outcome was mortality, whereas the composite secondary outcome included a decline in care-need level, admission to a long-term care facility (LTCF) or mortality.</p><p><strong>Results: </strong>The Kaplan-Meier survival curve demonstrated a significant association between the eFI and VA-FI and each research outcome. Compared to the lowest frailty group, the highest frailty group exhibited an HR of 2.59 [95% confidence interval (CI), 1.66-4.06] for eFI and 2.45 (95%CI, 1.02-5.91) for VA-FI in relation to a decline in care-need level, an LTCF admission and mortality. The trend test indicated a significant increase in the rate of each outcome with higher frailty levels.</p><p><strong>Conclusions: </strong>Higher frailty levels are associated with an increased risk of composite outcomes in older adults with cancer. This study suggests the potential application of frailty measurements in oncology care settings.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 2","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who came to the rescue? Sources of informal support to older Europeans before, during and after the COVID-19 pandemic.","authors":"Judite Gonçalves, France Weaver","doi":"10.1093/ageing/afaf034","DOIUrl":"10.1093/ageing/afaf034","url":null,"abstract":"<p><strong>Background/objective: </strong>The COVID-19 pandemic disrupted the provision of informal care in major ways. This study documents the prevalences of informal support with (instrumental) activities of daily living (IADL and ADL) before, during and after the pandemic, distinguishing between children, other relatives and friends/neighbours and focusing on individuals 50 years and older across 27 European countries.</p><p><strong>Methods: </strong>This longitudinal analysis relies on the Survey of Health, Ageing and Retirement in Europe (SHARE)'s Wave 8 (2019), two Corona surveys (2020 and 2021) and Wave 9 (2022). Linear probability models adjusted for individual fixed effects and time-varying confounders were used to estimate prevalences of informal support over time.</p><p><strong>Results: </strong>During the pandemic, the prevalences of informal support with both IADL and ADL from all three groups of caregivers increased significantly (P < 0.01), to return to their pre-pandemic levels by 2022. For example, the adjusted likelihood of IADL help from children increased from 18.5% (2019) to 36.6% (2020) and 42.5% (2021), then dropped back to 19.7% in 2022. Friends and neighbours played a critical role, with the adjusted likelihood of IADL help going from 8.8% (2019) to 29.7% (2020), then down to 18% (2021) and 8.9% (2022).</p><p><strong>Conclusions: </strong>Future emergency and disaster preparedness plans should contemplate the various sources of informal care, including support measures to non-relative caregivers, as those helpers may be able to rapidly respond to unexpected crisis.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 2","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding polypharmacy for people receiving home care services: a scoping review of the evidence.","authors":"Radin Karimi, Anna Robinson-Barella, Vanessa Davey, David R Sinclair, Barbara Hanratty, Adam Todd","doi":"10.1093/ageing/afaf031","DOIUrl":"10.1093/ageing/afaf031","url":null,"abstract":"<p><strong>Background: </strong>Polypharmacy, defined as the concurrent use of five or more medications, is common amongst older adults receiving home care services. The relationship between home care and polypharmacy may be critical to older people's health, but there is little research on this topic.</p><p><strong>Objective: </strong>To understand the extent and type of evidence on individuals receiving home care services and experiencing polypharmacy.</p><p><strong>Methods: </strong>This review followed the Preferred Reporting of Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Three databases (MEDLINE, Embase, CINAHL) were systematically searched (December 2023) to identify studies with adult participants experiencing polypharmacy and receiving home care.</p><p><strong>Results: </strong>Twenty-three studies were included. For individuals receiving home care services, the studies reported on the following: (i) prevalence of polypharmacy, (ii) interventions to reduce inappropriate polypharmacy, (iii) perceived role of home care workers, (iv) assessment of health literacy in individuals experiencing polypharmacy, and (v) factors associated with polypharmacy and potentially inappropriate medications (PIMs). Polypharmacy and PIMs were found to be associated with older age, female sex, increased frailty, living alone, poor economic situation and inaccuracies within medical records. Improved appropriateness of prescribing can be achieved through interprofessional interventions, efficient use of home care workers and improved health literacy.</p><p><strong>Conclusion: </strong>This review highlights research on the extent of polypharmacy in home care and ways to address it. Whilst there are suggestions for enhancing medication quality, key gaps remain in research into the experiences of care staff and recipients in managing medications and polypharmacy, which should be addressed.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 2","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Goals of care discussions and treatment limitation decisions in European acute geriatric units: a one-day cross-sectional study.","authors":"Ruth Piers, Sophie Pautex, Lourdes Rexach Cano, Jean-Claude Leners, Marc Vali Ahmed, Isabelle De Brauwer, Fatma Ö Kayhan Koçak, Dana Hrnciarikova, Marcin Cwynar, Mariana Alves, Erwin H Pilgram, Rozemarijn L van Bruchem-Visser","doi":"10.1093/ageing/afaf026","DOIUrl":"10.1093/ageing/afaf026","url":null,"abstract":"<p><strong>Background: </strong>It is important to pursue goal-concordant care and to prevent non-beneficial interventions in older people.</p><p><strong>Aim: </strong>To describe serious illness communication and decision-making practices in hospitalised older people in Europe.</p><p><strong>Setting/participants: </strong>Data on advance directives, goals of care (GOC) discussions and treatment limitation decisions were collected about patients aged 75-years and older admitted to 23 European acute geriatric units (AGUs).</p><p><strong>Results: </strong>In this cohort of 590 older persons [59.5% aged 85 and above, 59.3% female, median premorbid Clinical Frailty Score (CFS) 6], a formal advance directive was recorded in 3.3% and a pre-hospital treatment limitation in 14.0% with significant differences between European regions (respectively P < 0.001 and P = 0.018).Most prevalent GOC was preservation of function (46.8%). GOC were discussed with patients in 64.0%, with families in 73.0%, within the interprofessional hospital team in 67.0% and with primary care in 13.4%. The GOC and the extent to which it was discussed differed between European regions (both P < 0.001). The prevalence of treatment limitation decisions was 53.7% with a large difference within and between countries (P < 0.001). The odds of having a treatment limitation decision were higher for patients with pre-hospital treatment limitation decisions (OR 39.1), residing in Western versus Southern Europe (OR 4.8), belonging to an older age category (OR 3.2), living with a higher number of severe comorbidities (OR 2.2) and higher premorbid CFS (OR 1.3).</p><p><strong>Conclusions: </strong>There is large variability across European AGUs concerning GOC discussions and treatment limitation decisions. Sharing of information between primary and hospital care about patient preferences is noticeably deficient.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 2","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}