Journal of Family Medicine and Primary Care最新文献

{"title":"BCG-induced trained immunity on clinical outcomes in moderate to severe COVID-19 patients at a tertiary care center: A comparative study based on interferon-gamma release assays status.","authors":"Akhil Dhanesh Goel, Neetha Thayil Ramankutty, Neha Mantri, Nitesh Kumar, Aditya Kundu, Ravi Shekhar Gadepalli, Ankur Sharma, Manoj Kumar Gupta, Pankaj Bhardwaj, Suman Saurabh, Naveen Dutt, Pradeep Bhatia, Praveen Sharma, M K Garg, Vijay Lakshmi Nag, Sanjeev Misra","doi":"10.4103/jfmpc.jfmpc_1348_25","DOIUrl":"10.4103/jfmpc.jfmpc_1348_25","url":null,"abstract":"<p><strong>Background: </strong>(BCG) Bacillus Calmette-Guérin-induced trained immunity has enhanced non-specific protection against a range of pathogens, boosting the immune system's ability to respond to infections beyond its primary target, tuberculosis. This study explores the effect of indirect immunity by BCG vaccine as ascertained by interferon-gamma release assays (IGRA) values and clinical outcomes in COVID-19 patients.</p><p><strong>Methods: </strong>A purposive sampling of 110 severe and moderate COVID-19 patients admitted to a Tertiary care center, Rajasthan was conducted. QuantiFERON-TB (QFT) tests were applied to measure IGRA levels in the blood sample. Clinical outcomes like the length of hospital stay and in-hospital mortality were studied. Mann-Whitney and Fischer's Exact Tests were used to determine the significance of the association using <i>P-</i>values.</p><p><strong>Results: </strong>A total of 13 out of 110 individuals were found to be IGRA positive. The age difference between the two groups was not significant. Most of the patients, who tested negative on the IGRA test were male (90.2%). There was a significant difference in the duration of hospital stay between the two groups (IGRA positive (2-11 days); IGRA negative (7-16 days); and <i>P</i> = 0.049).</p><p><strong>Conclusion: </strong>BCG-induced trained immunity shortens the duration of hospital stay in COVID-19 affected individuals. More studies on cross-protection offered by BCG vaccines may help understand the potential role of trained immunity in reducing the severity and spread of other viral infections, including COVID-19. This research could have significant implications for public health strategies and the development of novel vaccination approaches to combat infectious diseases more effectively.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 6","pages":"2220-2223"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13465914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholinesterase deficiency and anesthesia management: Clinical challenges and coping strategies.","authors":"Tiantian Liu, Chaofeng Sun, Song Ye, Qinsong Ye, Ding Li","doi":"10.4103/jfmpc.jfmpc_318_26","DOIUrl":"10.4103/jfmpc.jfmpc_318_26","url":null,"abstract":"<p><p>Cholinesterase deficiency is a rare genetic disorder that impairs the activity of acetylcholinesterase and butyrylcholinesterase. It causes severe perioperative risks due to prolonged neuromuscular blockade induced by succinylcholine and ester-based anesthetics, and may lead to life-threatening complications such as respiratory depression and cardiovascular instability, thus requiring personalized anesthesia protocols for affected patients. A comprehensive literature review was conducted to synthesize the pathophysiology, genetic basis, and pharmacokinetic impacts of cholinesterase deficiency on anesthetic drugs, and clinical case analyses were performed to validate perioperative management strategies. Genetic mutations such as BCHE c. 695T>A are the primary etiology, and butyrylcholinesterase deficiency is more prevalent and associated with significant anesthetic adverse events. The use of alternative anesthetic agents including non-depolarizing neuromuscular blockers and amide-type local anesthetics, as well as reversal agents such as sugammadex, can significantly reduce perioperative risks. Multimodal monitoring including train-of-four and neurophysiologic monitoring and preoperative screening further optimize safety. Five clinical cases confirmed the efficacy of tailored strategies in diverse surgical settings. Proactive preoperative screening, cholinesterase-independent anesthetic regimens, and interdisciplinary collaboration are pivotal for mitigating risks in cholinesterase-deficient patients. Emerging advances including CRISPR gene therapy and AI-driven pharmacokinetic models hold great promise for precision anesthesia, while genetic counseling remains essential for long-term patient management.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"1880-1887"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A varying presentation of refractory supra ventricular tachycardia in a newborn: A rare and unusual case report.","authors":"Aditi Rawat, Mahaveer S Lakra, Sagar A R Karotkar, Bhavana Lakhkar, Amar Taksande","doi":"10.4103/jfmpc.jfmpc_948_23","DOIUrl":"10.4103/jfmpc.jfmpc_948_23","url":null,"abstract":"<p><p>Conduction abnormalities in neonates are not common and some arrhythmias may resolve spontaneously, while refractory abnormalities may persist. Some rare arrhythmias may be associated with congestive cardiac failure (CCF) or shock, requiring immediate intervention. Most supraventricular tachycardias (SVT) respond to adenosine and are rarely refractory. If not managed properly, it may result in more complications, prolonged hospital stays, and mortality. Here, we are reporting the case of a 20-day-old baby who presented with poor feeding, respiratory distress, lethargy, and tachycardia. The heart rate was at 248 beats per minute, and the electrocardiogram showed a narrow QRS complex arrhythmia. The baby was diagnosed with arrhythmia with CCF and was loaded with adenosine. The baby did not respond to increasing subsequent adenosine doses, so the baby needed an amiodarone infusion, digoxin therapy, and cardioversion. The baby was successfully managed and discharged on tablet propranolol and syrup digoxin, which were discontinued at subsequent visits. Refractory arrhythmias are not a rare phenomenon and can be seen in neonates too, so any baby, if not responding to conventional treatment and adenosine, must be treated with second-line antiarrhythmic drugs.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"2137-2139"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and determinants of peripheral neuropathy among older Malaysians: Insights from a community-based cross-sectional study: Letter to editor.","authors":"T K Abins","doi":"10.4103/jfmpc.jfmpc_330_26","DOIUrl":"10.4103/jfmpc.jfmpc_330_26","url":null,"abstract":"","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"2171-2172"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learnings from a rural primary care physiotherapy program and its practice registry: A synthesis of clinical patterns, Primary Health Care Team Competencies, and Care Access in Southern Rajasthan, India.","authors":"Colis Anwari, Gaurishankar Jha, Varsha Shridhar, Mayank Khurana, Gargi Goel, Pavitra Mohan, Ramakrishna Prasad","doi":"10.4103/jfmpc.jfmpc_1738_25","DOIUrl":"10.4103/jfmpc.jfmpc_1738_25","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In 2022, the Basic Healthcare Services (BHS) primary care physiotherapy program was embedded at three rural primary clinics in southern Rajasthan. The intent was to address critical rehabilitation needs in underserved rural communities, strengthen primary care teams, and improve functional outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose of the study: &lt;/strong&gt;The aim of the paper is to share systematic insights from our practice on the burden of musculoskeletal, neurological, and respiratory conditions in a rural, underserved population, while also documenting the role and outcomes of community-based physiotherapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Basic procedures: &lt;/strong&gt;BHS operates in deeply underserved tribal regions of southern Rajasthan through a network of rural primary care centers (AMRIT Clinics). Within this model, physiotherapy services are designed to emphasize accessibility, continuity, and collaboration, with care provided across clinic, community, and home settings. To systematically document service delivery and outcomes, a prospective clinical registry was maintained from July 2022 to July 2024 in two phases across three rural clinics-Manpur, Ghated, and Bedawal. Service delivery challenges were analyzed using the three-delays framework, which considers barriers in recognizing the need for care, reaching care, and receiving adequate care. This approach highlights both obstacles to rehabilitation access and the solutions emerging from a community-anchored physiotherapy model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main findings: &lt;/strong&gt;Between June 2024 and July 2025, over 1000 physiotherapy encounters were documented. The program served a diverse age range from children under 10 years to elders over 70, with the majority being working-age adults between 20 and 50 years (45%) and older adults &gt;50 years (50%). Patients predominantly presented with musculoskeletal disorders (~70%), followed by respiratory sequelae such as post-tuberculosis lung disease and chronic obstructive pulmonary disease (~15%), and neurological impairments (~10%). Autoimmune conditions, particularly rheumatoid arthritis, were most prevalent among women aged 20-50 years. Seventy six percent of patients were new and 24% were follow-up visits. Occupational analysis indicated that 32% of patients were unemployed and reported disability or functional limitations. The program employed a holistic, low-cost approach integrating pain relief, mobility enhancement, and progressive strengthening tailored to individual needs. Evidence-based interventions-including hot packs, strengthening exercises, breathing routines, and functional rehabilitation-were the most common modalities used.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Analysis of 2 years of registry data from a rural physiotherapy program offers a snapshot of the clinical scope, utilization patterns, and major syndromes encountered in primary care. Three key insights emerge: physiotherapy functions as a core component rather than an ancillary","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"1945-1952"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' attitudes towards homosexuality and affecting factors: A cross-sectional descriptive study.","authors":"Meryem Türkan Işık, Rana Can Özdemir, Havva Kırtıloğlu","doi":"10.4103/jfmpc.jfmpc_2237_25","DOIUrl":"10.4103/jfmpc.jfmpc_2237_25","url":null,"abstract":"<p><strong>Aim: </strong>This study was aimed at assessing the attitudes of professional nurses providing healthcare services in hospitals towards homosexuals from an ethical aspect by determining the influencing factors and the problems they experience during the provision of healthcare services.</p><p><strong>Methods: </strong>This descriptive cross-sectional study was conducted between May and September 2022 with 206 nurses working in a public hospital. Data were collected using the 'Nurse Information Form' and 'The Hudson-Ricketts Index of Homophobia'. 'The Independent Sample-t test', 'Mann-Whitney U', 'ANOVA' and 'Kruskal-Wallis H' test were used to compare three or more independent groups.</p><p><strong>Results: </strong>Among participating nurses, 50.5% perceived homosexuality as a disease, 68.4% reported no difficulty communicating with homosexual individuals, 71.4% believed that homosexuality is not something to be ashamed of, and 80.1% stated that they lacked adequate knowledge about homosexuality. The mean total <i>Hudson-Ricketts Index of Homophobia</i> (HRIH) score was 99.90 ± 26.21.</p><p><strong>Conclusion: </strong>The findings indicate that nurses' prejudices contribute to negative discrimination. Enhancing societal acceptance of sexual diversity and fostering tolerant attitudes are essential to reducing prejudice. Comprehensive integration of sexual and gender minority health care into nursing education curricula is therefore imperative.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"1987-1993"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for irritable bowel syndrome and its associated factors among patients with type 2 diabetes mellitus attending outpatient clinics in Jeddah, Saudi Arabia: A cross-sectional study.","authors":"Sarah Mohamed Hussein, Sara Okasha, Noura Omair, Fatima Bakarshoom, Lamiaa Marghalani, Amina Rajab","doi":"10.4103/jfmpc.jfmpc_126_26","DOIUrl":"10.4103/jfmpc.jfmpc_126_26","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is a major public health problem in Saudi Arabia. Irritable bowel syndrome (IBS) is considered as the most often diagnosed gastrointestinal disease. So, this study aims to screen the prevalence of IBS and its associated factors among patients with T2DM.</p><p><strong>Materials and methods: </strong>This cross-sectional study was performed in the outpatient clinics of a private hospital in Jeddah, Saudi Arabia, among 245 patients with T2DM enrolled in the study by a convenient sampling technique. Data was collected by a structured interview questionnaire. This questionnaire was composed of personal data, diabetes history, IBS screening questions, family history, and other clinical symptoms.</p><p><strong>Results: </strong>Among 245 patients with T2DM, 37.14% were classified as probably having IBS, while 1.22% were likely to have IBS. The mean IBS score was 11.17 ± 6.48. Female gender, younger age, unmarried status, family history of IBS or celiac diseases, rectal bleeding, and nocturnal gastrointestinal symptoms that wake up the patient were significantly associated with IBS likelihood (<i>P</i> < 0.05). Logistic regression identified younger age (OR = 0.97, 95% CI: 0.95-1.00), family history of celiac disease (OR = 2.83, 95% CI: 1.35-5.97), rectal bleeding (OR = 4.15, 95% CI: 1.13-15.19), and nocturnal symptoms (OR = 3.56, 95% CI: 1.69-7.47) as independent predictors of IBS.</p><p><strong>Conclusion: </strong>Probability of having IBS is common among patients with T2DM. Younger age, family history of celiac disease, rectal bleeding, and nocturnal symptoms were significant independent predictors of IBS likelihood. These findings emphasize the need for targeted gastrointestinal assessment in diabetic patients to ensure timely diagnosis and appropriate management.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"2113-2122"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safeguarding healers: Methodological and implementation considerations in crowdsourced research on violence against healthcare workers.","authors":"Suman Ray, Abinash Ray, Akash Nagar","doi":"10.4103/jfmpc.jfmpc_146_26","DOIUrl":"10.4103/jfmpc.jfmpc_146_26","url":null,"abstract":"","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"2173-2174"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acupuncture for post-stroke spastic hemiplegia: A dual-dimensional evidence synthesis combining bibliometric and meta-analysis.","authors":"Junbing Liu, Rong Chen, Qimi Huang, Hui Cheng, Lu Cai, Fang Liu","doi":"10.4103/jfmpc.jfmpc_1889_25","DOIUrl":"https://doi.org/10.4103/jfmpc.jfmpc_1889_25","url":null,"abstract":"<p><p>This study systematically evaluates acupuncture for post-stroke spastic hemiplegia using a dual-dimensional approach: bibliometric analysis and meta-analysis. Databases (PubMed, Web of Science, Embase, CNKI, Wanfang, VIP) were searched from inception to December 31, 2024. Bibliometric tools (VOSviewer, CiteSpace) were used to analyze research trends, collaborations, and keyword clusters. Meta-analysis was performed using R, RevMan, and Stata. Forty-five RCTs were included. Bibliometric findings show a shift from early research on \"acupoint specificity\" to recent hotspots including \"neural mechanisms\" and \"multimodal efficacy evaluation.\" Meta-analysis shows that acupuncture significantly improves muscle tone (Ashworth: MD = -0.64), upper-limb motor function (FMA: MD = 6.75), lower-limb motor function (FMA: MD = 3.46), and activities of daily living (Barthel index: MD = 10.87). Electroacupuncture shows superior effects, and treatment duration ≥4 weeks is more effective. China leads in research output. Acupuncture, especially electroacupuncture combined with conventional rehabilitation, is effective for post-stroke spastic hemiplegia.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"1873-1879"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family medicine: Primary care practice model at a tertiary care centre.","authors":"Santosh Kumar, Nilanjon Roy, Kanchan Gupta, Ekta D Pathak","doi":"10.4103/jfmpc.jfmpc_250_26","DOIUrl":"10.4103/jfmpc.jfmpc_250_26","url":null,"abstract":"<p><p>Tertiary care hospitals in India face an increasing patient load, much of which comprises conditions amenable to primary care management. Fragmented, specialist-centric health-seeking behaviour contributes to overcrowding, inefficient resource use, and poor continuity of care. Family medicine, as a comprehensive primary care discipline, offers a potential solution by integrating preventive, promotive, and curative services across the life course. To describe the conceptualisation, implementation, and functioning of a Family Medicine-led primary care practice model embedded within a tertiary care institution. A Family Medicine Outpatient Department (OPD) was established at AIIMS Rishikesh with a primary care orientation to serve as the first point of contact for patients presenting with common, chronic, and preventive health needs. The model was designed around the core principles of comprehensive, continuous, and coordinated care, with structured patient entry points, systematic baseline assessment, and a bidirectional referral mechanism linking family medicine with specialty departments. The practice also incorporated family- and community-oriented approaches through linkage with primary health centres and outreach services. More than 20,000 patients accessed the Family Medicine OPD, receiving longitudinal, family-centred care. The model enabled early risk identification, appropriate gatekeeping, and rational specialist referrals, with patients returning to family medicine for ongoing follow-up after specialised interventions. This approach improved continuity of care, reduced unnecessary specialist consultations, and optimised utilisation of tertiary care resources, while addressing biopsychosocial determinants of health. Embedding a Family Medicine-led primary care model within a tertiary care hospital is feasible and effective in addressing the dual challenges of overcrowding and fragmented care. This model demonstrates the potential of family medicine to function as a care continuum bridge between community-based primary care and tertiary services and offers a scalable framework for strengthening India's healthcare delivery system.</p>","PeriodicalId":15856,"journal":{"name":"Journal of Family Medicine and Primary Care","volume":"15 5","pages":"2179-2182"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}