Family practice最新文献

{"title":"Excessive polypharmacy and complicated medication regimen are associated with Physicians' perceived burden in home healthcare: a multicenter cross-sectional study.","authors":"Shoichi Masumoto, Gen Nakayama, Yu Sun, Mitsuaki Ishii, Sayaka Nin, Takashi Inaba, Natsuki Kajikawa, Shuhei Hamada, Noriyuki Kimura, Kazushi Maruo, Jun Hamano","doi":"10.1093/fampra/cmag079","DOIUrl":"https://doi.org/10.1093/fampra/cmag079","url":null,"abstract":"<p><strong>Background: </strong>Polypharmacy and complex medication regimens are common in home healthcare; however, their impact on physicians' perceived burden remains unclear. This study examined the associations of polypharmacy and medication regimen complexity with physicians' perceived burden in home healthcare.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at seven home care support clinics and hospitals in Japan. Physicians completed a self-administered questionnaire for patients aged ≥18 years who were receiving home healthcare. Linear mixed-effects models were used to examine the association between the number of medications (categorized into three levels), medication regimen complexity index-Japanese (MRCI-J) scores (categorized into quartiles), and physicians' perceived burden (assessed using a 0-100 mm visual analog scale), with physicians treated as a random effect.</p><p><strong>Results: </strong>Data were collected from 506 patients, of whom 503 were included in the analyses. The mean patient age was 82.4 years, and the median number of medications was six. The mean score for the physicians' perceived burden was 33.6 mm. Excessive polypharmacy and the highest MRCI-J quartile were significantly associated with greater physician burden even after adjustment for covariates (regression coefficient = 8.20, 95% confidence interval (CI): 4.07-12.33; regression coefficient = 7.84, 95% CI: 3.61-12.07, respectively).</p><p><strong>Conclusions: </strong>In home healthcare, excessive polypharmacy and complex medication regimens were significantly associated with increased physician burden. These findings underscore the potential benefits of optimizing pharmacotherapy through interprofessional collaboration with community pharmacists to reduce physician workload. Further research is required to identify effective interventions for mitigating this burden. Clinical trial registration: UMIN000056282.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192384","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":"Feasibility of measuring walking speed in a diabetes clinic in primary care.","authors":"Richard Baskerville, Fiona Reid, Joanna Dawes, Patrick Esser, Pippa Oakeshott","doi":"10.1093/fampra/cmag067","DOIUrl":"https://doi.org/10.1093/fampra/cmag067","url":null,"abstract":"<p><strong>Background: </strong>Usual walking speed may predict cardiovascular disease in type 2 diabetes, but it is not routinely assessed in UK primary care.</p><p><strong>Objective: </strong>To examine the feasibility of three methods of assessing walking speed in patients with diabetes in general practice: timed walking, accelerometry, and treadmill walking.</p><p><strong>Methods: </strong>We approached consecutive mobile patients attending a general practice diabetes clinic. Consenting participants performed a timed 28-m walk (4 × 7 m) at their usual pace in the surgery corridor while wearing an accelerometer, followed by a 3-minute treadmill walk. Measures were repeated after 6 months. Differences in walking speeds between methods and between timepoints were assessed by Bland-Altman limits of agreement.</p><p><strong>Results: </strong>Recruitment rate was 91% (30/33). Mean age of participants was 59.6 years (range 37-75), mean body mass index was 30.6 kg/m2 (21.0-46.4), and 17% had a history of cardiovascular disease. Average duration of diabetes was 10 years (range 1-40). Twenty-five participants (83%) repeated assessments at 6-month follow-up.Average (SD) walking speed on the timed walk was similar to both accelerometer and treadmill: 1.12 (0.13), 1.15 (0.16), and 1.01 (0.39) m/s, respectively. Bland-Altman analysis showed good agreement for repeat tests and, on average, between methods. Limits of agreement between timed walk and treadmill were wide. Feedback from seven participants and three practice staff indicated acceptability of all tests, but treadmill testing took longer and least feasible.</p><p><strong>Conclusions: </strong>Timed walk was the most feasible and acceptable to patients and staff. Results were similar on average to accelerometry and treadmill.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106097","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":"Implementation of an evidence-based app to improve healthcare for female urinary incontinence: identification of implementation strategies using the consolidated framework for implementation research-expert recommendations for implementation change matching tool.","authors":"Anke C Lambooij, Henk van der Worp, Esther van Noort, Marco H Blanker, Anne M M Loohuis","doi":"10.1093/fampra/cmag082","DOIUrl":"https://doi.org/10.1093/fampra/cmag082","url":null,"abstract":"<p><strong>Background: </strong>Female urinary incontinence (UI) affects one in three women and is frequently managed suboptimally. The app-based treatment URinControl demonstrated cost-effectiveness. However, implementation in Dutch primary care is limited. This study aimed to identify key barriers to implementation and develop strategies to support the uptake of URinControl in primary care settings.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey among Dutch general practitioners (GPs), community pharmacists, and supporting personnel working in general practice or local pharmacies. Barriers were identified using the Consolidated Framework for Implementation Research (CFIR). Potential implementation strategies were selected using the CFIR-Expert Recommendations for Implementing Change (ERIC) matching tool.</p><p><strong>Results: </strong>A total of 174 healthcare professionals completed the questionnaire. Key barriers from both GP and pharmacy perspectives included doubts about the relative advantage of the app, limited knowledge of urinary incontinence and the app, organizational constraints, and limited digital skills among patients. In pharmacies, additional barriers included limited opportunity to discuss UI and concerns about financing. Based on these findings, five implementation strategies were developed.</p><p><strong>Interpretation: </strong>Effective implementation of an evidence-based digital app for urinary incontinence in primary care requires improved awareness, knowledge, and support for healthcare professionals, as well as better structural integration of digital health tools into routine practice. Broader policy and societal shifts toward acceptance of eHealth are also needed. We also translated barriers into five tailored, theory-informed strategies addressing clinician education, patient engagement, workflow integration, financing, and collaboration between general practice and community pharmacy settings across the Netherlands in routine care implementation.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192371","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":"Moving from a clinical trial to routine care: a qualitative analysis of primary care physicians' experiences with interventions to promote shared decision making for colorectal cancer screening in older adults.","authors":"Lotan Kraun, Emily Chen, Lauren Leavitt, Kathrene Valentine, Steven J Atlas, Kathleen M Fairfield, Paul K J Han, Brittney Mancini, James M Richter, Lydia Siegel, Leigh Simmons, Karen Sepucha","doi":"10.1093/fampra/cmag075","DOIUrl":"https://doi.org/10.1093/fampra/cmag075","url":null,"abstract":"<p><strong>Background: </strong>The Promoting Informed Decisions About Colorectal Cancer Screening in Older Adults (PRIMED) cluster randomized trial found that 2-hour online training combined with a pre-visit reminder for primary care physicians (PCPs) increased shared decision making (SDM) among patients aged 76-85 years who were due for colorectal cancer screening (CRC) screening discussions. However, the best way to translate findings from the clinical trial setting into routine primary care remains unclear.</p><p><strong>Objective: </strong>To explore PCPs' experiences with the PRIMED SDM training and reminders, and to identify barriers, facilitators, and recommendations for implementation in routine primary care.</p><p><strong>Methods: </strong>A qualitative study using semi-structured interviews was conducted. 59 PCPs from 35 primary care practices affiliated with five hospitals in Massachusetts and Maine who participated in the PRIMED trial were invited to be interviewed. Interviews were conducted between April and July 2021, transcribed verbatim, and analyzed by two independent researchers using a Framework Analysis-informed approach.</p><p><strong>Results: </strong>Of 59 PCPs, 43 participated. Themes included: (i) Training and Reminders Supported SDM; (ii) Real-World Constraints Challenged SDM Implementation, but PCPs Made Efforts to Adapt despite challenges such as time pressures, competing priorities, and the COVID-19 pandemic; and (iii) Scaling and Sustaining SDM Requires a System-Level Approach, such as automated reminders, patient decision aids, concise training, and interprofessional SDM.</p><p><strong>Conclusions: </strong>Overall, PCPs perceived the SDM training and reminders as supporting a more nuanced and individualized approach to CRC screening conversations with older adults. To enable broader scale-up in primary care, these interventions should minimize burden on PCPs by streamlining integration into existing workflows.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106300","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":"An innovative hybrid cognitive behavioral therapy for insomnia approach to insomnia treatment: a retrospective chart review study.","authors":"Brittney Jones, Christine E Smith-Mason, Lisa Medalie, Alyssa M Minnick, David Gozal","doi":"10.1093/fampra/cmag080","DOIUrl":"https://doi.org/10.1093/fampra/cmag080","url":null,"abstract":"<p><strong>Background: </strong>Insomnia is a common and significant concern within family medicine; however, there is limited access to qualified sleep specialists trained in the first-line treatment: cognitive behavioral treatment for insomnia (CBT-I). Technology advancements allowed for \"app delivery\" of CBT-I, but platforms do not customize treatment. To our knowledge, DrLullaby was the first to offer a hybrid approach, to improve behavioral sleep medicine access, through \"tech-enabled services,\" including telehealth sessions alongside our sleep data portal. We hypothesized that this approach would yield improved sleep outcomes.</p><p><strong>Method: </strong>A retrospective chart review of patients who engaged in hybrid CBT-I treatment (n = 155) was performed. The sample was split into two groups based on treatment protocol: (G1) hybrid CBT-I, non-sleep medication tapering (n = 113) and (G2) sleep medication tapering (n = 42). CBT-I-trained clinicians provided virtual insomnia treatment and assigned lessons in the sleep data portal for support between sessions. Self-reported sleep log and medication tapering (for G2) data were analyzed pre-and-post treatment using one-way repeated-measures ANOVA.</p><p><strong>Results: </strong>Sleep metrics significantly improved from baseline to posttreatment for the hybrid CBT-I group, including total sleep time, sleep onset latency, wake after sleep onset, and sleep efficiency (Ps < 0.001). Almost 67% of patients in the sleep medication tapering group completely discontinued their sleep medication(s).</p><p><strong>Conclusions: </strong>DrLullaby's hybrid approach resulted in a significant reduction of insomnia symptoms and sleep medication dosage. Virtual delivery of tech-enabled CBT-I, alongside sleep medication tapering, may be a viable referral option for family medicine clinicians who otherwise lack access to the first-line insomnia treatment.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180375","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":"Information theory and diagnostic reasoning in primary care: a framework for navigating uncertainty.","authors":"Brian H Willis","doi":"10.1093/fampra/cmag083","DOIUrl":"10.1093/fampra/cmag083","url":null,"abstract":"<p><p>This is an overview of how information theory offers a rigorous and intuitive framework for understanding diagnostic reasoning in primary care. Primary care clinicians frequently encounter patients early in their illness trajectory, when symptoms are vague, evolving, or non-specific, creating high diagnostic uncertainty. Information theory, through its core concepts of entropy, information content, and information gain, provides a structured way to quantify this uncertainty and understand how it changes as new clinical information is gathered. Entropy reflects the uncertainty associated with the breadth of the differential diagnosis; information content captures how surprising or discriminating a finding is; and information gain describes how much a particular question, sign, or test reduces uncertainty. Applied to the consultation, these principles explain why rare but specific features are disproportionately informative, why sequences of low-yield tests may add little value, and how targeted history-taking can outperform broad investigation. The framework complements Bayesian reasoning, hypothetico-deductive approaches, and intuitive pattern recognition by clarifying the informational value that underpins each. Through clinical examples, the paper illustrates how information theory sharpens diagnostic strategy, supports efficient use of investigations, and helps clinicians navigate uncertainty with greater clarity and safety. Ultimately, it positions diagnosis as a scientific process of uncertainty reduction central to primary care practice.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192359","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":"Entry into long-term care disrupts primary care continuity-but only at entry: a national cohort study of transitional and post-entry continuity in facility- and home-based care in Australia.","authors":"Johannes Schwabe, Brian W Pulling, Gillian E Caughey, Maria Crotty, Helena Williams, Andrew Kellie, Gillian Harvey, David Roder, Krystal-Lee Nixon, Janet K Sluggett, Monica Cations, Tiffany K Gill, Jyoti Khadka, Megan Corlis, Carolyn Dawkins, Marilyn von Thien, Maria C Inacio","doi":"10.1093/fampra/cmag065","DOIUrl":"10.1093/fampra/cmag065","url":null,"abstract":"<p><strong>Background: </strong>Continuity of primary care is central to older adults' health and wellbeing, but entry into long-term care can disrupt established care relationships.</p><p><strong>Objectives: </strong>This study aimed to characterize how continuity of care evolves across the transition into long-term care and the post-entry period, comparing facility-based and home-based care, with analyses stratified by metropolitan and non-metropolitan location.</p><p><strong>Methods: </strong>A national cohort study of Australians aged ≥65 who entered long-term care in 2019 and had at least three primary care visits within 6 months was conducted. Transitional continuity was defined by whether individuals continued seeing their pre-entry provider. Post-entry continuity was measured using the Usual Provider Index. Cohort differences were examined using regression models.</p><p><strong>Results: </strong>Among 69 081 entrants (home-based = 27 915; facility-based = 41 166), 72% of those entering facilities changed to a new provider, compared with 10% in home-based long-term care, p < .001. In facility-based long-term care, switching to a new provider was more common in metropolitan areas than in non-metropolitan areas. Post-entry continuity was high in both settings, with 78%-80% of visits delivered by a usual provider.</p><p><strong>Conclusions: </strong>Entry into facility-based long-term care substantially disrupts established primary care relationships, but continuity is rapidly re-established after entry. The greater disruption observed in metropolitan areas suggests that factors beyond relocation, such as primary care availability and delivery models, shape transitional continuity. These findings identify long-term care entry as a key intervention point while indicating that post-entry care models effectively consolidate continuity.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192352","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":"Tribals in transition: decoding health-seeking for modern epidemics: a mixed-method study.","authors":"Remya Mary John, Neeraj Agarwal, Gomathi Ramaswamy, Govindrao N Kusneniwar, Madhu Latha Karra, Vishakha Jain","doi":"10.1093/fampra/cmag073","DOIUrl":"10.1093/fampra/cmag073","url":null,"abstract":"<p><strong>Background: </strong>Geographic isolation, limited access to healthcare, and socioeconomic disparities are challenges to the tribal population. The study aimed to explore the health-seeking behaviours, facilitators, and barriers to non-communicable disease (NCD) care among tribal communities in rural Telangana.</p><p><strong>Methodology: </strong>This explanatory mixed-methods study was conducted among tribal communities of Bommalaramaram, India. Quantitative data were collected using a pretested, semi-structured questionnaire, and focused group discussions were conducted to collect qualitative data.</p><p><strong>Results: </strong>The mean (SD) age of participants was 52.5 (14.8) years, and about 206 (51.5%) were females. Only 8 (2%) participants were aware of the ideal age for NCD screening. Most participants preferred informal health care providers (47%), followed by private facilities (45%), and only 8% preferred a government health care facility. About 15% of participants have never been screened for NCDs. Facilitators for NCD care included awareness of NCDs and risk factors, positive attitudes, accessible healthcare, supportive government programmes, family support, fear of premature death, medication adherence, regular follow-ups, dietary changes, and positive healthcare experiences. Barriers included mistrust and dissatisfaction with public health services, perceived system deficiencies, low risk perception before diagnosis, poor medication adherence, distance to facilities, transportation, and financial constraints, neglect of the elderly, lack of awareness about government services, and changes in agricultural practices and food quality.</p><p><strong>Conclusion: </strong>Regular screening for NCD and the continuum of care should be strengthened for tribal people. A system for monitoring and evaluating the effectiveness of NCD interventions in tribal areas can be set up to ensure that programmes are meeting their needs.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910948","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 the Psychosocial Index in primary care: clinimetric assessment of allostatic overload and biological correlates.","authors":"Kübra Nur Seven, Hakan Demirci, Emre Yalçıntaş, Ersin Budak","doi":"10.1093/fampra/cmag077","DOIUrl":"10.1093/fampra/cmag077","url":null,"abstract":"<p><strong>Background: </strong>The Psychosocial Index (PSI) is a clinimetric instrument designed to integrate heterogeneous psychosocial information in medical practice. We examined whether PSI-informed assessment of allostatic overload (AO) identifies a clinically and biologically distinct subgroup in primary care.</p><p><strong>Methods: </strong>This cross-sectional study included 430 adults aged 18-65 years recruited from a primary care centre in Türkiye. The full 55-item PSI was administered. AO status was determined by multidisciplinary consensus using participant interviews, PSI information, and observer ratings, without access to laboratory results. Sociodemographic, clinical, psychosocial, and biochemical characteristics were compared between AO-positive and AO-negative participants. Cortisol and dehydroepiandrosterone sulphate (DHEA-S) were evaluated using multivariate analysis of covariance and follow-up adjusted analyses.</p><p><strong>Results: </strong>Overall, 265 participants (61.6%) were classified as AO positive. They had greater stress, psychological distress, sleep disturbance, and abnormal illness behaviour, together with lower well-being and quality of life. Biochemical data were available for 307 participants. After adjustment for age, sex, marital status, education, chronic disease, psychiatric diagnosis, and diastolic blood pressure, cortisol was 31% higher in AO-positive participants (geometric mean ratio 1.31, 95% confidence interval 1.17-1.47; P < .001). The adjusted DHEA-S difference was not statistically significant (P = .058), while C-reactive protein and metabolic parameters were similar between groups.</p><p><strong>Conclusions: </strong>PSI-informed clinimetric assessment identified a primary care subgroup with a coherent psychosocial profile and higher adjusted morning cortisol. These findings provide preliminary support for the clinical utility and biological correspondence of PSI-based AO assessment.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918761","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":"Artificial intelligence and spiritual health in primary care: lowering barriers without losing connection.","authors":"I O Whitehead","doi":"10.1093/fampra/cmag056","DOIUrl":"https://doi.org/10.1093/fampra/cmag056","url":null,"abstract":"","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677696","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}