Scandinavian Journal of Primary Health Care最新文献

{"title":"Health screening and its association with emergency department visits and related costs among home-dwelling older adults.","authors":"Jonna-Carita Kanninen, Hannu Kautiainen, Anu Holm","doi":"10.1080/02813432.2024.2423233","DOIUrl":"10.1080/02813432.2024.2423233","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate the effectiveness of the health screening procedure for home-dwelling older adults in reducing emergency department visits and associated costs.</p><p><strong>Methods: </strong>Data were derived from health screenings from 2020 to 2021 for 75-year-old home-dwelling residents of Western Finland. The study compared emergency department visits and associated costs between older adults who participated in the health screening (intervention group) and those who did not (non-intervention group). For each older adult, three non-intervention controls were matched according to age, sex, health screening year and wellbeing service county. Emergency department visits and International Classification of Diseases (ICD)-10 codes from one year before to two years after health screening were analyzed.</p><p><strong>Results: </strong>In the non-intervention group, a 19% increase in emergency visit rates was seen (457-564 per 1000 person-years), while the intervention group showed a 67% decrease (165-23). Annual costs for the non-intervention group increased from 148 euros (€) to €183, a mean ratio increase of 1.24 per person-year (range 1.08-1.40). In contrast, the intervention group's costs decreased from €53 to €8, a mean reduction ratio of 0.15 per person-year (range 0.10-0.71). The intervention group had lower frequency of visits for respiratory and circulatory diseases but higher for digestive and metabolic diseases, unlike the non-intervention group.</p><p><strong>Conclusions: </strong>The implementation of the health screening is an effective strategy for reducing both the frequency of emergency department visits and associated costs in home-dwelling older adults in good condition.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"209-218"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic treatment recommendations for acute respiratory tract infections in Scandinavian general practices-time for harmonization?","authors":"Malene Plejdrup Hansen, Sigurd Høye, Katarina Hedin","doi":"10.1080/02813432.2024.2422441","DOIUrl":"10.1080/02813432.2024.2422441","url":null,"abstract":"<p><strong>Introduction: </strong>During recent years, the world-including Scandinavia-has experienced significant challenges with shortages of antibiotics. In Scandinavia, phenoxymethylpenicillin is recommended as first-line antibiotic treatment for most acute respiratory tract infections (ARTIs). However, the Scandinavian countries each constitute rather small markets for phenoxymethylpenicillin. The aim of this discussion paper is to enlighten the differences in Scandinavian ARTI antibiotic treatment recommendations. This information is fundamental for exploring the potential of harmonizing treatment recommendations in Denmark, Norway and Sweden-to help ensure sufficient future supply of phenoxymethylpenicillin.</p><p><strong>Methods: </strong>Information from national ARTI antibiotic treatment recommendations from respectively Denmark, Norway and Sweden has been collated.</p><p><strong>Results: </strong>Several discrepancies exist in recommendations. Adult dosage varies from a minimum of 660 mg x 4 (Denmark) to a maximum of 2000 mg × 3 (Sweden). Within Norway and Sweden, variations in recommended dosage also exist between the different types of ARTIs. A main challenge is that the tablet strengths recommended, and available on the market in the three countries, differs.Also, antibiotic treatment durations vary significantly between countries and infections treated-from five to 10 days of treatment.</p><p><strong>Conclusion: </strong>In the capacity of a well-established network for antibiotic stewardship, we have enlightened the differences in Scandinavian ARTI antibiotic treatment recommendations. This paper is the first step moving forward to scrutinizing the potential for harmonizing recommendations for Denmark, Norway and Sweden-to help ensure continued supply of phenoxymethylpenicillin for use within the Scandinavian countries.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"205-208"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationally competent attitudes and actions: a systematic review of general practice literature.","authors":"Cæcilie Hansen, Ann Dorrit Guassora, Anne Beiter Arreskov, Annette Sofie Davidsen, Gritt Overbeck","doi":"10.1080/02813432.2024.2417169","DOIUrl":"10.1080/02813432.2024.2417169","url":null,"abstract":"<p><strong>Objective: </strong>To explore core elements from Teachers' Relational Competence in general practice literature regarding building relationships in consultations, specifying actions doctors take to create and maintain relationship quality with patients. This systematic literature review aims to map and propose a similar framework for the doctor-patient relationship.</p><p><strong>Background: </strong>The doctor-patient relationship, a well-researched yet complex field, often lacks clear descriptions. In recent definitions of patient-centred medicine, the responsibility of this relationship falls on the doctor, though how both relationship and responsibility is enacted needs clarification. Pedagogical literature on the student-teacher relationship provides a framework for relational competence, incorporating the needs and interactions between teacher and student and their alignment with institutional goals.</p><p><strong>Methods: </strong>A systematic review of two databases yielded 1256 hits. After screening, 15 studies were included and assessed. A qualitative synthesis was conducted through iterative and thematic deductive analysis.</p><p><strong>Results: </strong>Four relationally competent attitudes identified were: Attention to emotion, Devotion, Mentalization, and Time-oriented presence. Four relationally competent actions identitfied were: Being open, Attunement, Offering Support, and Using humor. Additionally, Trust and Continued connectedness were found as components of both attitudes and actions.</p><p><strong>Conclusion: </strong>An explanatory framework for professional relational competence for GPs includes concrete actions and specific attitudes before and during consultations. These consist of four key attitudes and four categories of actions with several subgroups of actions. Two additional components to the framework was found.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"181-193"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient perspectives on multidimensional learning and person-centred care: interviews with persons living with type 2 diabetes.","authors":"Alma Dautovic, Eva Brink, Susanne Andersson, Ulla Fredriksson-Larsson","doi":"10.1080/02813432.2024.2423881","DOIUrl":"10.1080/02813432.2024.2423881","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to explore patients' learning and support needs within contemporary diabetes care to help them deal with daily life challenges.</p><p><strong>Design: </strong>A qualitative descriptive design was used following the Consolidated Criteria for Reporting Qualitative Studies. The 15 individual face-to-face interviews were analysed using qualitative content analysis.</p><p><strong>Setting: </strong>Participants were drawn from three healthcare centres in rural and urban regions of West Sweden.</p><p><strong>Participants: </strong>The study involved 15 patients (8 men, 7 women) with T2DM who experienced contemporary diabetes care.</p><p><strong>Results: </strong>Patients expressed a strong desire for access to person-centred, multidimensional learning, with a focus on genuine partnership, tailored education, and emotional engagement. Digital tools were seen as valuable aids in their self-care efforts. Sub-themes were '<i>Desiring genuine partnership and tailored patient education</i>' and '<i>Needing support related to altered perspectives on life and awareness of care standards but with finite care resources</i>'.</p><p><strong>Conclusion: </strong>The findings suggest that integrating person-centred, multidimensional learning strategies into diabetes care could be beneficial, particularly when addressing both practical and emotional needs. Encouraging active patient engagement through flexible digital solutions and providing support for emotional well-being may improve the overall patient experience. However, further research and practical application are needed to fully understand how these strategies could be effectively implemented to support patients with T2DM in managing their daily health challenges.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"230-240"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Shades of grey': a focus group study on diagnostic uncertainty among general practitioners using point-of-care ultrasound.","authors":"Hans-Christian Myklestul, Holgeir Skjeie, Mette Brekke, Trygve Skonnord","doi":"10.1080/02813432.2024.2423242","DOIUrl":"10.1080/02813432.2024.2423242","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (POCUS) has long been a diagnostic tool in family medicine, although most Norwegian general practitioners (GPs) who use POCUS, scans infrequently. The broad scope of family medicine, the relatively low prevalence of illnesses and infrequent use of POCUS imply that GPs may experience diagnostic uncertainty regularly.</p><p><strong>Aim: </strong>To explore how GPs perceived and managed diagnostic uncertainty when using POCUS.</p><p><strong>Design and setting: </strong>A qualitative focus group study among Norwegian GPs using POCUS.</p><p><strong>Methods: </strong>Four focus group discussions were conducted. Total number of participants were 21. The interview guide was piloted, the focus group discussions were audio-recorded and transcribed, and Systematic Text Condensation, a thematic cross-case analysis, was used to analyse the data.</p><p><strong>Results: </strong>Diagnostic uncertainty using POCUS was considered as aligning to the general clinical uncertainties in family medicine, but there were also POCUS-specific uncertainties in clinical decision-making. We generated six themes: emotional, cognitive, and ethical uncertainty using POCUS, communicating uncertainty to patients, interaction with specialists when using POCUS, and coping strategies of participants. POCUS results were the only results the participants sometimes withheld when communicating with other specialists. POCUS itself stimulated a renewed interest in family medicine. Scanning enough patients was the recommended coping strategy.</p><p><strong>Conclusion: </strong>POCUS-using GPs experienced diagnostic uncertainty when using POCUS that aligned with other diagnostic uncertainties they experienced in everyday practice. However, they did not treat the results like other findings, as the GPs at times withheld their POCUS findings when interacting with secondary care specialists. This requires further investigation.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"219-229"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142580953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to support researchers in the primary care setting?","authors":"Frida Gyllenberg, Niko Wasenius, Merja K Laine","doi":"10.1080/02813432.2024.2429688","DOIUrl":"10.1080/02813432.2024.2429688","url":null,"abstract":"","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intervention description of pharmacist-facilitated medication reviews in Nordic primary care settings: a scoping review.","authors":"Karl-Erik Bø, Kjell H Halvorsen, Elin C Lehnbom","doi":"10.1080/02813432.2024.2439909","DOIUrl":"10.1080/02813432.2024.2439909","url":null,"abstract":"<p><strong>Background: </strong>Multicomponent interventions are increasingly utilized to tackle the complexity of aging and co-morbid patients. However, descriptions of interventions are generally poor, making it difficult for healthcare providers to implement successful programs.</p><p><strong>Objectives: </strong>This study aimed to explore the completeness of intervention description of pharmacist-facilitated medication reviews (MRs) in Nordic primary care settings.</p><p><strong>Methods: </strong>We performed a scoping review of studies reporting on pharmacist-facilitated MRs in Nordic primary care settings. Medline, Embase, CINAHL and Web of Science were searched on 24 January 2024. We used Arksey and O'Mally's framework for scoping studies and applied an adapted version of the Template for Intervention Description and Replication (TIDieR) checklist to evaluate intervention reporting. The Pharmaceutical Care Network Europe (PCNE) classification of MR levels was used to identify the components of different MRs.</p><p><strong>Results: </strong>Sixteen studies were included in this scoping review. The studies were conducted in Sweden (<i>n</i> = 7), Norway (<i>n</i> = 6), Finland (<i>n</i> = 2) and Denmark (<i>n</i> = 1). Information on the participating pharmacists' expertise, qualifications and training was fully reported in only two studies. Twelve studies did not provide any information related to intervention cost, dose or duration, making it challenging to estimate the economic impact of the intervention. Only one study made an evaluation of intervention fidelity. Conversely, 15 studies lacked information on this topic which can lead to inaccurate conclusions about the program's effectiveness.</p><p><strong>Conclusion: </strong>The studies included in this scoping review do not provide sufficient MR information for intervention replication. We recommend that pharmacy trials use reporting checklists to increase the replicability and transferability of effective interventions.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"241-253"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The in- and outpatient health care use of patients with COPD before and after initiation of home care: a registry study from Norway.","authors":"Tron Anders Moger, Jon Helgheim Holte, Olav Amundsen, Silje Bjørnsen Haavaag, Øystein Døhl, Line Kildal Bragstad, Ragnhild Hellesø, Nina Køpke Vøllestad, Trond Tjerbo","doi":"10.1080/02813432.2024.2404056","DOIUrl":"10.1080/02813432.2024.2404056","url":null,"abstract":"<p><strong>Objective: </strong>Chronic obstructive pulmonary disease (COPD) is a common condition associated with age, multimorbidity and frequently involves the use of health care across levels. Understanding the factors associated with the initiation of long-term care is important when planning the future need for services. We describe healthcare use before and after the reception of any home care. We further studied the associations between healthcare use and first registered home care service and from first registered home care service to nursing home admission or death.</p><p><strong>Design and subjects: </strong>Patients residing in Oslo or Trondheim at the time of first contact with a COPD primary diagnosis, 2009-2018. Patient data were linked across national and municipal registries, covering healthcare and sociodemographics. The sample consisted of 16,738 individuals.</p><p><strong>Results: </strong>There was a marked increase in inpatient and outpatient hospital contacts in the years prior to and after the reception of any home care. Adjusted for comorbidities and sociodemographics, high numbers of GP consultations, and inpatient and outpatient hospital contacts for respiratory diagnoses were associated with a significantly higher likelihood of receiving home care the next year (hazard odds ratios > 1.3). Following the reception of home care, the type of home care service received (e.g. home nursing or short-term rehabilitation/treatment) was more important than outpatient services in predicting next-year nursing home admission or death.</p><p><strong>Conclusion: </strong>Including data on prior outpatient care when predicting future need for home care is beneficial. A high frequency (top 10%) of yearly GP, in- or outpatient hospital contacts can imply that the patient may be in need of home care in the near future.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"100-110"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing visual and automated urine dipstick analysis in a general practice population.","authors":"S M L Cox, P Hoitinga, G J Oudhuis, R M Hopstaken, P H M Savelkoul, J W L Cals, E G P M de Bont","doi":"10.1080/02813432.2024.2392776","DOIUrl":"10.1080/02813432.2024.2392776","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary symptoms constitute the primary reason for female patients to consult their general practitioner. The urinary dipstick test serves as a cornerstone for diagnosing urinary tract infections (UTIs), yet traditional visual interpretation may be subject to variability. Automated devices for dipstick urinalysis are routinely used as alternatives, yet the evidence regarding their accuracy remains limited. Therefore we aimed to compare concordance between visual and automated urinary dipstick interpretation and determine their test characteristics for the prediction of bacteriuria.</p><p><strong>Material and methods: </strong>We conducted a prospective validation study including urine samples originating from adult patients in general practice that were sent to the Maastricht Medical Centre + for urinary culture. Urinary dipstick tests were performed on each sample, which were interpreted visually and automatically. We calculated Cohen's κ and percentage agreement and used 2 × 2 tables to calculate test characteristics.</p><p><strong>Results: </strong>We included 302 urine samples. Visual and automated analysis showed almost perfect agreement (κ = 0.82 and κ = 0.86, respectively) for both nitrite and leukocyte esterase, but moderate agreement for erythrocytes (κ = 0.51). Interpretation of clinically relevant (nitrite and/or leukocyte esterase positive) samples showed almost perfect agreement (κ = 0.88). Urinary dipsticks show similar test characteristics with urinary culture as gold standard, with sensitivities of 0.92 and 0.91 and specificities of 0.37 and 0.41 for visual and automated interpretation respectively.</p><p><strong>Conclusion: </strong>Automated and visual dipstick analysis show near perfect agreement and perform similarly in predicting bacteriuria. However, automated analysis requires maintenance and occasionally measurement errors can occur.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"59-65"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is general practitioner involvement in the initiation of opioids for chronic non-cancer pain associated with opioid dose and concurrent drug use?","authors":"Trond Høibø, Svetlana Skurtveit, Torgeir Gilje Lid","doi":"10.1080/02813432.2024.2404053","DOIUrl":"10.1080/02813432.2024.2404053","url":null,"abstract":"<p><p><i>Objective</i> Is the involvement of the regular general practitioner (GP) in the decision to initiate opioid treatment for chronic non-cancer pain (CNCP) associated with two main risk factors for serious adverse events: increased opioid dose and the concomitant use of prescribed benzodiazepines or benzodiazepine-related medications? <i>Design and setting</i> An anonymous web-based survey was conducted in the county of Rogaland, Norway, during the spring of 2021. <i>Subjects</i> GPs who self-reported applying at least once for reimbursement of opioids prescribed to treat CNCP. They were asked to answer the survey based on the last patient for whom they recalled submitting a reimbursement application. <i>Main outcome measures</i> 1) Total opioid dose in daily oral morphine equivalents (OMEQ). 2) Concurrent use of benzodiazepines and/or benzodiazepine-related drugs. <i>Results</i> The daily opioid dose was lower when the surveyed GPs initiated the opioid treatment (36 OMEQ, <i>n</i> = 25), than when others had initiated the treatment (108 OMEQ, <i>n</i> = 31, <i>p</i> = 0.001). For concurrent use of benzodiazepine or benzodiazepine-related drugs, no significant difference was found (33%, <i>n</i> = 9 with GP involvement <i>vs</i>. 47%, <i>n</i> = 16, <i>p</i> = 0.279 with no GP involvement). <i>Conclusions</i> GP involvement in the initiation of opioid medication for CNCP was associated with a lower opioid dose being prescribed. <i>Implications</i> GP involvement in the initiation of opioid prescriptions may facilitate safer prescribing.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"96-99"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}