Journal of General Internal Medicine最新文献

{"title":"Reframing Micronutrient Deficiencies for Modern times: A Review.","authors":"Azadeh Lankarani-Fard, Maria Romanova, Zhaoping Li","doi":"10.1007/s11606-025-09481-y","DOIUrl":"https://doi.org/10.1007/s11606-025-09481-y","url":null,"abstract":"<p><p>Micronutrient deficiencies are often discounted in as an entity of the past when access to quality nutrition was scarce. However modern-day conditions such as hemodialysis, complex medication interactions, parenteral nutrition, gastrointestinal resections, institutional living, and substance use can place patients at risk. The metabolic demands of critical illness during prolonged hospitalization may provide added stressors. Food insecurity with reliance on inexpensive calorie-rich, nutrient poor diet may lead to deficiency without overt evidence of malnutrition. Moreover, clinical presentation may be subtle and easily attributed to other diagnoses. Increased awareness of current risk factors is essential for detection and treatment.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753095","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":"Correlates of Patient Trust in Doctors: Demographic Factors and Experiences of Medical Care Discrimination.","authors":"Lindsey M Mundy, Suzanne E Judd, Olivio J Clay, Virginia J Howard, Raegan W Durant, Erin E Ballard, Michael Crowe","doi":"10.1007/s11606-025-09474-x","DOIUrl":"https://doi.org/10.1007/s11606-025-09474-x","url":null,"abstract":"<p><strong>Background: </strong>When providing healthcare services to diverse populations of middle-aged and older adults, it is important to understand factors that may influence the amount of trust they have in their doctors, such as demographic factors and previous experiences of discrimination.</p><p><strong>Objective: </strong>We examined correlates of general trust in doctors in a national sample of adults in the USA.</p><p><strong>Design: </strong>The REGARDS longitudinal cohort study included measures of trust in doctors and discrimination at a follow-up visit. Cross-sectional sequential linear regression models, with general trust in doctors as the outcome, first included demographic factors and then added discrimination in a medical care setting.</p><p><strong>Participants: </strong>The baseline REGARDS sample included community-dwelling participants across the contiguous USA who identified as White or Black/African American and were aged 45 or older. Our analytic sample included 8500 participants who completed the second in-home REGARDS visit and were aged 52 years or older.</p><p><strong>Main measures: </strong>Trust was measured by the General Trust in Doctors Scale. Participants also reported whether they had ever experienced discrimination in a medical care setting.</p><p><strong>Key results: </strong>Female sex (b = -1.41, p < 0.05), Black/African American race (b = -0.40, p < 0.05), and having a higher level of education (b = -0.45, p < 0.05) were each independently related to lower trust in doctors. Older age (b = 0.10, p < 0.05) was associated with higher trust. Previous discrimination had a negative association with trust (b = -4.27, p < 0.05) and the relationship between race and trust was reduced to zero (b = 0.28, p = 0.155) with discrimination in the model.</p><p><strong>Conclusions: </strong>Previous discrimination experiences in a medical care setting completely attenuated the relationship between race and trust in doctors, a prominent finding that should be considered when providing healthcare services to diverse populations of adults.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753074","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":"National Norms for Hospital Frailty Risk Score Among Hospitalized Adults in the USA.","authors":"Christine Loyd, Taylor Miller, Shrest Nath, Yue Zhang, Richard E Kennedy","doi":"10.1007/s11606-025-09483-w","DOIUrl":"https://doi.org/10.1007/s11606-025-09483-w","url":null,"abstract":"<p><strong>Background: </strong>Frailty among inpatients increases risk for hospital-associated disability and death. Yet, frailty is not regularly screened in acute care due to the lack of standardized methods, the complexity of frailty, and time and energy required of hospital personnel. Thus, screening with routinely collected data provides an opportunity to assess frailty across inpatient populations.</p><p><strong>Objective: </strong>To calculate normative values for Hospital Frailty Risk Score (HFRS) among adult inpatients in the USA based on age, sex, and race.</p><p><strong>Design: </strong>A retrospective cross-sectional analysis of the 2018 National Inpatient Sample (NIS) database.</p><p><strong>Patients: </strong>US adult inpatients aged 18y + with a focus on patients aged at least 45.</p><p><strong>Main measures: </strong>Hospital Frailty Risk Score (HFRS) is a validated measure that uses ICD-10 codes to calculate frailty risk among hospitalized patients.</p><p><strong>Key results: </strong>Mean HFRS significantly increased with increasing age across sex and race (p < 0.001). Among the oldest age groups 65y + , mean and median normative values were similar between male and female inpatients (mean HFRS range, 6.71-9.62; median HFRS range, 5.40-8.70), and Black inpatients had the highest frailty risk compared to other races (mean HFRS range = 7.56-10.47; median HFRS range = 6.30-9.50). Asian/Pacific Islander inpatients had similar frailty risk to Black inpatients among those 90y + (mean HFRS = 10.48; median HFRS = 9.50).</p><p><strong>Conclusions: </strong>The US national norms for HFRS provide a standardized reference tool for comparing frailty risk among clinical and research inpatient populations to a typical hospitalized adult for their age, sex, and race.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753082","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":"Disparities in Receipt of Chemotherapy at the End of Life among Patients with NSCLC.","authors":"Khushi Kohli, Stephanie Wang, Shriya Garg, Yueao Zhang, Erin Jay G Feliciano, Puneeth Iyengar, Edward Christopher Dee","doi":"10.1007/s11606-025-09479-6","DOIUrl":"https://doi.org/10.1007/s11606-025-09479-6","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753078","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":"Change in Feeding and Swallowing Function in Elderly Patients with Isolated Hospitalization for COVID-19: A Retrospective Cohort Study.","authors":"Kenya Hamazaki, Toru Morikawa, Mari Nezu, Koji Oh, Chihiro Nishio, Takeshi Morimoto","doi":"10.1007/s11606-025-09480-z","DOIUrl":"https://doi.org/10.1007/s11606-025-09480-z","url":null,"abstract":"<p><strong>Background: </strong>Isolation was implemented for elderly patients with coronavirus disease 2019 (COVID-19), which interrupted care including oral intake support.</p><p><strong>Objective: </strong>To assess the changes in feeding and swallowing function measured by the functional oral intake scale (FOIS) and their association with post-discharge mortality in elderly COVID-19 patients.</p><p><strong>Design: </strong>Single-center retrospective cohort study.</p><p><strong>Participants: </strong>We included patients aged ≥ 65 years and admitted for COVID-19 between December 1, 2021 and March 31, 2023. Those with FOIS before onset (pre-FOIS) 1-3 were excluded.</p><p><strong>Main measures: </strong>We measured FOIS (1-7, 1: no oral intake, 7: normal) before onset and at discharge, and assessed mortality for 180 days after onset. The primary outcome was decrease in FOIS during hospitalization; in-hospital mortality was assumed as 4-level decreases in FOIS. The secondary outcome was 180-day mortality. Association of each pre-FOIS (6, 5, 4) relative to pre-FOIS 7 with the primary outcome was estimated as adjusted common odds ratios (ORs) and 95% confidence intervals (CIs). Association of decreases in FOIS with 180-day mortality was assessed with Kaplan-Meier curve.</p><p><strong>Key results: </strong>We included 337 patients whose median age was 81 years, and 56% of them were men. The distribution of pre-FOIS was 7 (190 patients), 6 (89), 5 (40), and 4 (18). The severity of COVID-19 was generally similar among pre-FOIS levels. The pre-FOIS was significantly associated with decreases in FOIS: adjusted common OR 2.23 [95%CI 1.27-3.92] for pre-FOIS 6, 2.96 [1.46-6.05] for pre-FOIS 5, 2.89 [1.14-7.40] for pre-FOIS 4. The degree of decrease in FOIS was significantly associated with 180-day mortality: no decrease, 4.7%; 1-level decrease, 1.2%; 2-level decrease, 27.9%; 3-level decrease, 46.0%.</p><p><strong>Conclusions: </strong>Lower pre-FOIS was associated with further decreases in FOIS in elderly patients who were isolated due to COVID-19, and the degree of decrease was further associated with post-discharge mortality.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753064","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":"Starting Two or More Drugs Concurrently in Primary Care: How Often Is It Done, How Often Is It Needed?","authors":"Tewodros Eguale, Maria Mirica, Alejandra Salazar, John Shilka, William Galanter, John Cashy, Walid Gellad, Jennifer Hale, Bruce L Lambert, Aneesha Fathima Syed Mohamed, Renuka Kandikatla, Lynn A Volk, Adam Wright, Jeffrey A Linder, Gordon D Schiff","doi":"10.1007/s11606-025-09455-0","DOIUrl":"https://doi.org/10.1007/s11606-025-09455-0","url":null,"abstract":"<p><strong>Background: </strong>There is growing awareness of the need for more cautious, conservative prescribing. One conservative prescribing principle urges prescribers, whenever possible, to start only one new medication at a time. Little is known about how often primary care physicians (PCPs) start multiple medications at the same time, and when that is needed.</p><p><strong>Objective: </strong>To describe how frequently PCPs start multiple prescriptions at the same time, evaluate evidence supporting the necessity of initiating multiple prescriptions concurrently, and describe PCP and clinical sites' prescribing variability.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Participants: </strong>PCPs at four sites who wrote prescriptions during January 2017-December 2018.</p><p><strong>Main measures: </strong>Frequency of initiating two or more new prescriptions during the same session.</p><p><strong>Key results: </strong>Across the four sites, 4646 PCPs wrote 7,849,914 new prescriptions. The Veterans Administration (VA) site had the highest percentage of encounters with multiple concurrent new drug starts (27.2%), followed by Northwestern (NW) (19.7%), Brigham and Women's Hospital (BWH) (16.1%), and University of Illinois Chicago (UIC) (14.0%). Within each site, there was wide variation among PCPs in percentage of encounters where they prescribed multiple new medications. Interquartile range varied: 11.0-18.5% (BWH), 15.1-22% (NW), 11.0-15.8% (UIC), and 22.9-31.0% (VA). Reviewing the most frequent combinations, only 0.6% had strong evidence for starting them concurrently. Most were drugs either recommended to be taken together (16.8%) or reasonable to be taken together, but with no evidence supporting starting them simultaneously (71.5%). A smaller percentage of concurrent starts were potentially problematic (10.4%) or contraindicated (0.7%) due to overlapping side effects or drug-drug interactions.</p><p><strong>Conclusions: </strong>PCPs frequently started multiple medications concurrently, often without compelling evidence, with notable variations across prescribers and institutions. Although we could not conduct detailed chart review for each encounter, classification of the most frequent drug pairs concurrently prescribed in our study suggests opportunities to potentially improve prescribing safety.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735748","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":"Barriers to Hepatitis C Treatment Among Los Angeles County Residents.","authors":"Dara Bruce, Riya Shah, Chrysovalantis Stafylis, Cassidy Hernandez-Tamayo, Prabhu Gounder, Jeffrey D Klausner","doi":"10.1007/s11606-025-09477-8","DOIUrl":"https://doi.org/10.1007/s11606-025-09477-8","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742916","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":"Development of a Tool to Measure Potentially Inappropriate Inter-Hospital Transfer (IHT): The POINT Study.","authors":"Stephanie K Mueller, Caitlin Kelly, Stephanie Singleton, Luci K Leykum, James D Harrison, Andrew Auerbach, Jeffrey Schnipper","doi":"10.1007/s11606-024-09221-8","DOIUrl":"https://doi.org/10.1007/s11606-024-09221-8","url":null,"abstract":"<p><strong>Background: </strong>Although inter-hospital transfer (IHT, the transfer of patients between acute care hospitals) aims at matching patients' care needs to appropriate sites of care, IHT practices are variable leaving some patients vulnerable to risks of discontinuity of care without clear benefit. Identifying which patients may not need IHT can help to prevent inappropriate care and improve patient outcomes.</p><p><strong>Study overview: </strong>The POINT Study, \"Identification and Prevention of Potentially Inappropriate Inter-Hospital Transfers,\" is a 5-year study (AHRQ-R01HS028621) that aims to define potentially inappropriate IHT using key stakeholder input, evaluate the incidence and patient safety impact of potentially inappropriate IHT across a nationally representative sample of 18 hospitals, and develop an intervention toolkit to reduce potentially inappropriate IHT. In this paper, we report on the development of a standardized adjudication process to capture potentially inappropriate IHT using results generated from the first 2 years of this project.</p><p><strong>Development of the adjudication tool: </strong>Development of the adjudication tool to measure potentially inappropriate IHT involved a multi-step process, including (1) conducting focus groups of key stakeholders involved in IHT to generate a consensus definition of \"potentially inappropriate IHT;\" (2) translating this definition into an adjudication tool for use during retrospective chart review; and (3) conducting rigorous training among all adjudicators to ensure reliability of the adjudication process.</p><p><strong>Next steps: </strong>Next steps include launching sites to conduct adjudications with a goal of 1800 total transfer case adjudications across the 18 sites. We will support the adjudication process with monthly tracking and case review meetings among other supports. The results of this work will lead to a foundational understanding of the prevalence, risk factors, and patient safety impact of potentially inappropriate IHT.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719655","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":"Availability of Women's Health Clinics, Primary Care Providers, and Women Veterans' Ratings of Care Experiences.","authors":"Danielle E Rose, Melissa M Farmer, Sabine M Oishi, Bevanne A Bean-Mayberry, Ismelda Canelo, Donna L Washington, Elizabeth M Yano","doi":"10.1007/s11606-025-09451-4","DOIUrl":"https://doi.org/10.1007/s11606-025-09451-4","url":null,"abstract":"<p><strong>Background/objective: </strong>VA strives to improve women Veterans' access to comprehensive care. We assessed if availability of specialized clinic arrangements for women or specialized providers (women's health primary care providers) was associated with women Veterans' ratings of primary care experiences.</p><p><strong>Design: </strong>Cross sectional.</p><p><strong>Participants: </strong>We linked patient-level survey data (Survey of Healthcare Experiences of Patients, FY 2017, n=4264) with primary care clinic-level data (Clinical Practice Organizational Survey, primary care module, 2017-2018, n=126) from clinics with ≥300 women Veterans.</p><p><strong>Main measures: </strong>Our dependent variables were derived from top ratings for items rating access, care coordination, comprehensiveness (behavioral health assessed), provider communication, and primary care provider. Our variables of interest were the availability of specialized clinic arrangements such as women's health clinics and specialized providers such as women's health primary care providers.</p><p><strong>Statistical analyses: </strong>We conducted multi-level, multivariate logistic regression predicting women Veterans' optimal ratings of care, controlling for patient-, clinic-, and area-level characteristics.</p><p><strong>Key results: </strong>Women Veterans receiving care at general primary care clinics with no women's health primary care providers had a lower likelihood of rating provider communication as optimal (Adjusted Odds Ratio .60, 95%CI .45-.78) or rating the primary care provider as 9 or 10/10 (Adjusted Odds Ratio .61, 95%CI .42-.86). Women Veterans receiving care at VA sites with a gynecology clinic had a higher likelihood of rating access as optimal (Adjusted Odds Ratio 1.40, 95%CI 1.01-1.94).</p><p><strong>Conclusions: </strong>Our study found that availability of women's health primary care providers in general primary care and availability of gynecology clinics were associated with higher likelihood of women Veterans rating care experiences as optimal. Almost all VA sites have women's health primary care providers available, increasing availability at every site remains an important goal. Relatively few VA community-based outpatient clinics offer gynecology clinics, offering opportunities for improved care experiences among women Veterans.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710148","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":"Relationships Matter: Exploring the Impact of Patients' Familial, Community, and Provider Relationships on Hypertension Management.","authors":"Justin Kramer, Aditi Gupta, Shellie Ellis, Jessica Reed, Andrew McWilliams, Yashashwi Pokharel, Beata Debinski, Brittany Watson, Neil Sparks, Stephanie Daniel, Yhenneko J Taylor","doi":"10.1007/s11606-025-09470-1","DOIUrl":"https://doi.org/10.1007/s11606-025-09470-1","url":null,"abstract":"<p><strong>Background: </strong>Nearly half of US adults have hypertension, with blood pressure (BP) uncontrolled in over two-thirds of cases. Significant disparities exist in BP control, particularly for Southern and rural-dwelling Americans.</p><p><strong>Objective: </strong>To examine the impact of patients' relationships with families, communities, and providers on BP control efforts.</p><p><strong>Design: </strong>Semi-structured interviews explored patient and provider experiences managing hypertension and controlling BP.</p><p><strong>Participants: </strong>Twenty-nine providers and 25 patients with hypertension were recruited from 13 high- and low-performing primary care clinics (assessed via hypertension control rates) and one cardiology clinic across two health systems in North Carolina and Kansas.</p><p><strong>Approach: </strong>A health equity framework-shaped interview guide and codebook development. Inductive and deductive coding methodologies were employed, with thematic analysis used to organize emergent themes.</p><p><strong>Key results: </strong>Patients frequently discussed the prevalence of hypertension within their families, with some detailing feelings of inevitability and/or linking their cardiovascular outcomes to family histories. Cultural expectations were often mentioned, with families' and communities' normative behaviors sometimes creating barriers to hypertension management. Southern and/or rural culture (e.g., diet) may pose unique challenges, as some providers cited patients' resistance to deviate from regional norms. The importance of tailoring hypertension care to patients' unique circumstances was often cited and linked with increased trust and patient activation, with the utilization of culturally appropriate, patient-facing resources being identified as a best practice. While providers in high-performing clinics more consistently discussed approaches to tailoring care and using culturally appropriate materials, providers in low-performing clinics more often referenced time constraints limiting personalized care and having non-inclusive resources.</p><p><strong>Conclusion: </strong>Effective hypertension management may be impacted by patients' relationships, both external (e.g., family, community) and internal (e.g., providers) to healthcare. Future research should explore strategies for tailoring culturally appropriate hypertension care to patients, specifically identifying ways to overcome structural barriers that can hinder clinics' utilization.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676586","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}