Family practice最新文献

{"title":"Implementing the screening for poverty and related social determinants and intervening to improve knowledge of and links to resources (SPARK) in primary care clinics across Canada.","authors":"Leanne Kosowan, Joseph J O'Rourke, Dana Howse, Lane Williams, Itunuoluwa Adekoya, Abigail Zita Seshie, Alannah Delahunty-Pike, Mélanie Ann Smithman, Alan Katz, Eunice Abaga, Alexander Zsager, Jane Cooney, Marjeiry Robinson, Dorothy Mary Senior, Kris Aubrey-Bassler, Emily Gard Marshall, Cory Neudorf, Nazeem Muhajarine, Isabelle Fortuna, Archna Gupta, Andrew D Pinto","doi":"10.1093/fampra/cmaf109","DOIUrl":"10.1093/fampra/cmaf109","url":null,"abstract":"<p><strong>Background: </strong>Routine systematic collection of social determinants data can inform improvements to health service delivery and system and policy planning.</p><p><strong>Objective: </strong>This cohort study reports on the implementation of the SPARK tool to collect and integrate demographic and social needs data in primary care.</p><p><strong>Methods: </strong>The 20-question SPARK tool was implemented from September 2022 to October 2023 at five primary care clinics. Implementation was evaluated using the following outcomes: acceptability, appropriateness, adoption, feasibility, fidelity, cost, penetration, and sustainability. Data included: clinic checklists (n = 5), training evaluations (n = 33), SPARK tool responses (n = 2063), patient surveys (n = 1368), and provider and staff surveys (n = 36). Survey responses were analyzed using frequency (%) and mean (SD). Open-ended responses were analyzed to identify key themes.</p><p><strong>Results: </strong>There was strong acceptability and adoption of the tool. Collection methods contributed to variation in perceived relevance, compatibility and barriers. Among patients, 90.5% indicated the tool was clear and easy to complete, and 84.5% had a positive experience. A minority of patients (7.8%) indicated difficulty answering ≥1 question on SPARK. Among clinic staff and providers, 96.7% reported the tool was useful, and 81.8% had a positive experience. Clinics highlighted concerns with resource allocation and suggested adjustments to collection, integration, and personnel to support implementation.</p><p><strong>Conclusions: </strong>The SPARK tool is acceptable and feasible for adoption in primary care clinics. This study provides practical insight into implementing demographic and social needs data collection, including adaptations to clinic workflows, enhanced integration platforms, and supports that ensure the sustainability of social needs screening in primary care.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766756","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":"Identifying patient and provider determinants of primary care experiences and outcomes for persons with chronic conditions: a multilevel analysis of a nation-wide survey in Norway.","authors":"Øyvind Bjertnæs, Mieke Rijken, Ian Porter, Rebecka M Norman, Ingeborg S Sjetne, Hilde H Iversen, Guri Rørtveit, Jose M Valderas","doi":"10.1093/fampra/cmag017","DOIUrl":"10.1093/fampra/cmag017","url":null,"abstract":"<p><strong>Background: </strong>We aimed to: (i) examine to what extent care experiences and perceived outcomes among persons with chronic conditions depend on the GPs they are registered with and (ii) map the associations between patient and GP-level determinants of patient-reported experience and outcome measures.</p><p><strong>Methods: </strong>Cross-sectional general practice nested survey of patients (n = 6691). We estimated the amount of variation at the GP level and conducted multilevel regression analyses to test hypothesized associations between potential predictors (mostly registry-based) and the six Patient-Reported Experience Measures and five Patient-Reported Outcome Measures as dependent variables.</p><p><strong>Results: </strong>The ICC for four of six PREMs varied from 0.035 to 0.091, while the ICCs for the PROMs varied from 0.014 to 0.022. The main predictors of patients' care experiences were health literacy (P < 0.001 for all measures) and the number of years on the GP list (P < 0.001 for five of six measures). The main predictors for patient-reported outcomes were the number of chronic conditions (P < 0.001 for all), income (P < 0.001 for all indicators for low income compared to high), health literacy (P < 0.001 for all) and the number of consultations in the last 24 months (P < 0.001 for all), and the number of years on the GP list was also significantly associated with all PROMs.</p><p><strong>Conclusions: </strong>Most PREMs demonstrated substantial variation between GPs, warranting GP-level initiatives to improve care experiences for persons with chronic conditions. Health literacy and continuity of care were important determinants of patient-reported experiences and outcomes, demonstrating the importance of these factors for health system performance.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638338","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":"Measuring the relationship between outpatient family physician visit regularity and acute care utilization during the end of life: a population-level retrospective cohort study.","authors":"Shuaib Hafid, Aaron Jones, Anastasia Gayowsky, Aria Wills, Sarina R Isenberg, Michelle Howard","doi":"10.1093/fampra/cmag014","DOIUrl":"10.1093/fampra/cmag014","url":null,"abstract":"<p><strong>Background: </strong>Family physicians (FP) are critical in providing outpatient end-of-life (EOL) care, yet most continuity measures do not consider temporal changes in visits. The relative variance index (RVI), which measures visit interval variation, has not been applied to the EOL context.</p><p><strong>Aim: </strong>To measure the association between outpatient FP visit regularity & acute care use in the last month of life.</p><p><strong>Design: </strong>Retrospective cohort study using linked population-level health administrative data. FP visit regularity was measured using the RVI, calculated from outpatient visits during the last two years of life (excluding the last month). Outcomes included hospitalizations, emergency department (ED) visits in the last month of life & acute care setting deaths.</p><p><strong>Setting: </strong>Adults with cardiorespiratory conditions who died in Ontario, Canada, between 2017 & 2019.</p><p><strong>Results: </strong>Patients' (N = 151 030) median age at 2-years before death was 80, 55% were male, & had a median of 9 FP outpatient visits in the last two years of life. Higher FP RVI scores were associated with increased hospitalizations (IRR [95% CI]: 1.07 [1.05,1.10]), ED visits (1.06 [1.03, 1.08]) & acute care deaths (OR [95% CI]: 1.30 [1.26, 1.35]). Sensitivity analyses identified that RVI scores varied across different look-back periods, while sensitivity model performances remained stable when adjusting for specialist visit regularity.</p><p><strong>Conclusions: </strong>Higher outpatient FP visit regularity was associated with increased EOL acute care use, despite low visit regularity during the last two years of life. However, the RVI's sensitivity to observation period lengths limits its utility as an EOL care-quality indicator.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638356","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":"Primary healthcare practitioners' views and experiences of providing postpartum contraception counselling and care: a rapid review.","authors":"Jenna Perkins, Sian Stuckey, Danielle Mazza, Jessica R Botfield","doi":"10.1093/fampra/cmag022","DOIUrl":"10.1093/fampra/cmag022","url":null,"abstract":"<p><strong>Background: </strong>Primary healthcare practitioners play a pivotal role in postpartum care. Many countries encourage women to attend a postnatal check after birth, providing an ideal opportunity for contraceptive care. However, contraception is often not discussed, increasing the risk of unintended pregnancy and short interpregnancy intervals.</p><p><strong>Objective: </strong>To explore primary healthcare practitioners' views and experiences of providing postpartum contraceptive counselling and care to better understand the gaps, needs, and opportunities.</p><p><strong>Methods: </strong>A rapid review was conducted of English language peer-reviewed primary research studies from high-income countries focussing on primary healthcare practitioners' views and experiences of providing postpartum contraceptive counselling and care. Studies were retrieved from five databases, supplemented by Google Scholar and citation searching. Key characteristics were extracted, and thematic analysis identified key themes.</p><p><strong>Results: </strong>Altogether, 2255 references were identified, with eight studies included. Four themes were constructed: (1) varied knowledge and attitudes regarding postpartum contraception, including views on of long-acting reversible contraception (LARC), safety concerns, and optimal counselling timing; (2) structural and logistical barriers to contraception provision in primary healthcare, including lack of LARC availability, time constraints, and funding issues; (3) limited contraception education and training for practitioners in LARC provision, with practitioners lacking skills or motivation to upskill; and (4) gaps in postpartum contraception resources and guidelines needed to promote postpartum contraceptive care.</p><p><strong>Conclusion: </strong>Improving postpartum contraceptive counselling requires embedding comprehensive contraceptive training in healthcare education, developing standardized guidelines for postpartum appointments, and addressing barriers such as time constraints, lack of resources and funding to support effective contraception care for postpartum women.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766792","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":"Dimensions of patient-perceived service quality in primary care: a web-based cross-sectional survey of adults aged 50-59 with hypertension or diabetes in South Korea.","authors":"Dong-Wook Yang, Youran Noh, Kyung-Bok Son","doi":"10.1093/fampra/cmag032","DOIUrl":"10.1093/fampra/cmag032","url":null,"abstract":"<p><strong>Background: </strong>Although service quality is a key determinant of patient outcomes in primary care, theoretical evaluation tools may not fully reflect the actual structure of patients' perceptions. This study aimed to explore and validate the underlying structure of primary care service quality as perceived by patients with hypertension or diabetes in South Korea.</p><p><strong>Methods: </strong>We conducted a nationwide, cross-sectional web-based survey with 300 South Korean patients in their 50s who had been diagnosed with hypertension or diabetes and were currently receiving treatment. The psychometric properties of primary care service quality were evaluated using exploratory factor analysis and internal consistency testing. Multiple linear regression analysis was conducted to examine the associations between the identified dimensions and overall satisfaction and intention to reuse services.</p><p><strong>Results: </strong>Factor analysis revealed a simplified two-dimensional structure of service quality: \"Care Excellence,\" which encompassed health outcomes, patient-centeredness, professionalism, and the physical environment; and \"Cost,\" which reflected the cost and convenience of services. Multiple regression analysis showed that both factors significantly predicted patient satisfaction (β = 0.70 and β = 0.18, respectively). However, only \"Care Excellence\" (β = 0.70) emerged as a significant predictor of the intention to reuse services.</p><p><strong>Conclusions: </strong>Primary care service quality exhibits a two-dimensional structure, with each factor exerting a unique level of impact on patient satisfaction and service reuse. To enhance service quality, particular emphasis should be placed on improving \"Care Excellence,\" highlighting the need for an integrated and holistic approach to strengthening the clinical aspects of primary care valued by patients.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148028391","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 scope of practice of nurses and allied health professionals in primary care in Ontario, Canada: a scoping review.","authors":"Sisira Sarma, Tianyue Zhong, Rose Anne Devlin, Jennifer Rayner","doi":"10.1093/fampra/cmag027","DOIUrl":"10.1093/fampra/cmag027","url":null,"abstract":"<p><strong>Background: </strong>Primary care is essential for health care systems to promote health, prevent disease, and manage chronic conditions. However, a shortage of primary care physicians challenges the delivery of high-quality primary care services to the population, especially for those living with multimorbidity. To address this challenge, interprofessional primary teams consisting of primary care physicians, nurses, and allied health professionals (AHPs) have been rolled out in many jurisdictions. This approach allows physicians to focus on complex patient care, where less complex care can be delegated to nurses and AHPs.</p><p><strong>Methods: </strong>We conducted a scoping review of the literature on the scope of practice of nurses and AHPs in interprofessional primary care teams in Ontario, Canada.</p><p><strong>Results: </strong>Nurse practitioners and registered nurses are heavily involved in providing direct patient care, whereas registered practical nurses are less involved. Pharmacists focus on medication management and patient education, dieticians focus on dietary assessments and nutrition education, and social workers focus on counselling and psychosocial assessments. Pharmacists and nurse practitioners often face challenges in defining their independent roles. Some physicians struggle with teamwork, whereas others appreciate multidisciplinary approaches.</p><p><strong>Conclusions: </strong>Effective integration of nurses and AHPs in a primary care setting would enable physicians to delegate several tasks and address primary care physician shortages in various jurisdictions. Clarifying the professional roles of AHPs in primary care would enhance interprofessional team functioning, helping to increase both the quality and quantity of primary care.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148041660","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":"Correction to: Assessment of self-management questionnaire in diabetes mellitus (ASQ-DM-EX)-the validation of novel lived experience inventory.","authors":"","doi":"10.1093/fampra/cmag028","DOIUrl":"10.1093/fampra/cmag028","url":null,"abstract":"","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835763","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":"Insomnia as a risk factor for the development of depression and anxiety in primary care: a matched population-based cohort study.","authors":"Maria C N Meijer, Rutger A Middelburg, Ingrid A Arnold, Jeanine Kamphuis, Dennis O Mook-Kanamori, Mattijs E Numans, Niels H Chavannes, Robert A Schoevers, Jens H van Dalfsen","doi":"10.1093/fampra/cmag019","DOIUrl":"10.1093/fampra/cmag019","url":null,"abstract":"<p><strong>Background: </strong>While insomnia, depression and anxiety disorders are most frequently diagnosed and treated in primary care, the longitudinal relationship between these phenomena remains elusive in this setting. The present study aimed to quantify the association of registered insomnia with subsequent depression or anxiety in primary care.</p><p><strong>Methods: </strong>A matched population-based cohort study was conducted using International Classification of Primary Care (ICPC) and Anatomical Therapeutic Classification (ATC) codes extracted from medical records of 84 Dutch general practices. Patients without documented psychological or social problems, aged 18 to 65 years, with a registered insomnia diagnosis (ICPC: P06) or prescribed sleep medication (ATC: N05CD, N05CF, N05CH) were matched 1:1 to healthy controls on sex, year of birth, and general practice. Controls could be used more than once. The primary outcome measure was depression (ICPC: P03, P76, P76.02) or anxiety (ICPC: P01, P74, P74.01, P74.02) registration up to five years after the insomnia diagnosis.</p><p><strong>Results: </strong>Patients with insomnia between 1 January 2010 and 1 January 2015 (n = 1535) and the control group (n = 1502) were followed for five years after the insomnia diagnosis. Patients with insomnia had a higher risk of depression or anxiety (odds ratio (OR) = 1.53, 95% confidence interval (CI) [1.18-1.98]).</p><p><strong>Conclusions: </strong>Patients with an insomnia diagnosis in primary care were at higher risk to develop depression or anxiety compared to healthy controls. This finding identifies insomnia as a potential marker for early detection and prevention of depression and anxiety in primary care.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13093215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722347","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":"Evaluation of the effectiveness of an algorithm to predict COPD exacerbations in primary care: an interrupted time series analysis.","authors":"Francesco Lapi, Ettore Marconi, Piergiuseppe De Rosa, Marco Gorini, Stefania Marcoli, Gerardo Medea, Iacopo Cricelli","doi":"10.1093/fampra/cmag021","DOIUrl":"10.1093/fampra/cmag021","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of the Clinical Exacerbation Score for Health Search (CEX-HScore) on the frequency of registered chronic obstructive pulmonary disease (COPD) exacerbations and referrals to specialists in Italian primary care using an interrupted time series (ITS) analysis.</p><p><strong>Methods: </strong>Using data from an Italian federated network of general practitioners (GPs), we conducted an ITS analysis on GP-level (aggregated) indicators to assess changes in registration of moderate-to-severe COPD exacerbations and pulmonologist referrals before (up to January 2023) and after (up to June 2024) the implementation of CEX-HScore as a decision support system in GPs software.</p><p><strong>Results: </strong>The launch of the CEX-HScore on 1 January 2024 did not yield statistically significant increases in indicators quantifying monthly referral rates or coded exacerbations in the general COPD population. Instead, among incident COPD cases, a significant increase of 45% per month (P < .001) in the proportion of coded exacerbations out of total exacerbations was observed postintervention.</p><p><strong>Conclusion: </strong>These findings suggest that the implementation of CEX-HScore may enhance the coding accuracy of COPD exacerbations in newly diagnosed patients. Further data points are needed to robustly evaluate its long-term effectiveness on broader clinical outcomes.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766840","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":"Continuity of care and patient-reported experiences in Norwegian general practice: are they linked, and does the measurement of continuity matter?","authors":"Rebecka Maria Norman, Øyvind Bjertnæs, Katrine Damgaard Skyrud, Rortveit Guri, Steinar Hunskaar","doi":"10.1093/fampra/cmag025","DOIUrl":"10.1093/fampra/cmag025","url":null,"abstract":"<p><strong>Background: </strong>Continuity of care has been associated with improved health and healthcare outcomes. Continuity can be measured using registry-based and patient-reported measures, but how these measures relate to patient-reported experiences is less well understood. The main aim was to assess the association between continuity of care and patient-reported experiences in Norwegian general practice, using registry-based and self-reported measures. A secondary aim was to compare the two continuity measures and examine their agreement.</p><p><strong>Methods: </strong>A cross-sectional study was conducted combining data from a national survey of patient-reported experiences with individual-level registry data on general practitioner (GP) consultations. Continuity of care was measured using a self-reported indicator of normally seeing one's own GP and a registry-based Usual Provider of Care (UPC) index. Associations with patient-reported experience scale scores were analysed using adjusted linear regression. Agreement between registry-based and self-reported continuity were examined by comparing their distributions and associations within the same study sample.</p><p><strong>Results: </strong>Both registry-based and self-reported continuity were positively associated with higher patient-reported experience scores across all scales (P < 0.001), with stronger associations for self-reported continuity. Associations were stronger among patients with long-term conditions. Agreement between registry-based and self-reported continuity was moderate and asymmetrical: most patients with high registry-based continuity reported seeing their own GP, whereas patients with low registry-based continuity were almost equally likely to report seeing their own GP or other GPs.</p><p><strong>Conclusions: </strong>The findings underline the importance of continuity of care in general practice. Registry-based and self-reported continuity measures capture related but non-interchangeable aspects of continuity and provide complementary information.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13168889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147928052","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}