Scandinavian Journal of Primary Health Care最新文献

{"title":"Worries and information seeking during pregnancy: a cross-sectional study among 1402 expectant Norwegian women active on social media platforms.","authors":"Mari Hegnes Hansen, Hanna Sandbakken Mørkved, Bjarne Austad, Gunnhild Åberge Vie, Linn Okkenhaug Getz, Bente Prytz Mjølstad","doi":"10.1080/02813432.2025.2461036","DOIUrl":"https://doi.org/10.1080/02813432.2025.2461036","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women often navigate extensive information from healthcare professionals, social networks and online sources, which can increase anxiety. Understanding their concerns and preferred information sources is crucial for effective antenatal care.</p><p><strong>Objective: </strong>To explore worries and information-seeking behaviour among pregnant women in Norway using social media.</p><p><strong>Methods: </strong>An anonymous, web-based survey was conducted among 1402 pregnant women in Norway from January to March 2022, distributed via Facebook and Instagram. The survey covered 11 pregnancy worries, eight postpartum worries, information sources and thoughts regarding childbirth.</p><p><strong>Results: </strong>Nearly, all participants had concerns, mainly about foetal anomalies (99%, <i>n</i> = 1381), miscarriage (95%, <i>n</i> = 1332) and childbirth (85%, <i>n</i> = 1195). Postpartum worries included physical changes (90%, <i>n</i> = 1266), breastfeeding (85%, <i>n</i> = 1187) and financial situation (74%, <i>n</i> = 1030). Major worries were more common among first-time mothers and women with financial insecurity. Most women sought information from quality-assured public health websites (74%, <i>n</i> = 1042) and healthcare personnel (56%, <i>n</i> = 775), with only 2% (<i>n</i> = 32) turning to influencers or bloggers.</p><p><strong>Conclusions: </strong>Pregnancy and postpartum worries are widespread among pregnant women using social media, especially among first-time mothers and those with financial insecurity. Most pregnant women prefer quality-assured websites and healthcare personnel for information. Antenatal care could benefit from offering more tailored information and follow-up, particularly for first-time mothers and financially insecure women.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A shared approach to managing urinary tract infections in nursing homes improved perceived care quality, workload, and collaboration - a qualitative study.","authors":"Sif Helene Arnold, Melissa M W Thomsen, Marius Brostrøm Kousgaard, Jette Nygaard Jensen","doi":"10.1080/02813432.2025.2463455","DOIUrl":"https://doi.org/10.1080/02813432.2025.2463455","url":null,"abstract":"<p><strong>Background: </strong>In 2019, around 4.95 million global deaths were linked to bacterial antimicrobial resistance (AMR). Managing urinary tract infections (UTIs) in nursing homes involves prevention, diagnosis, and treatment. This is often complex and cause excessive antibiotic use, increasing AMR. Infection prevention and antimicrobial stewardship (AMS) are complementary strategies for reducing AMR. Studies show that nursing home staff can safely reduce antibiotic prescriptions for UTIs using these strategies and that cross-sectoral collaboration with general practice is important in UTI management. However, the impact of combining infection prevention with AMS and general practice is unknown.</p><p><strong>Objective: </strong>To explore the perceived impact of a new cross-sectorial intervention combining prevention and AMS on UTI management in nursing homes.</p><p><strong>Methods: </strong>The intervention included a 3-h seminar for general practice and nursing home staff, and a reflection sheet to assess residents. We held 9 seminars in the Capital Region of Denmark in 2022 and conducted 15 semi-structured online and phone interviews with participants.</p><p><strong>Results: </strong>Our findings indicate that the intervention clarified workflows, encouraged nursing staff to adhere to agreements, and increased trust and respect between nursing homes and general practice. A reflection sheet was essential in linking planned changes to actual implementation. The sheet helped restructure UTI management, leading to perceived improved patient assessment and fewer UTI-related inquiries to general practice.</p><p><strong>Conclusion: </strong>Our findings suggest that the intervention had a positive impact on experienced care quality, workload, and cross-sector collaboration. However, physical attendance at the seminar limits the large-scale implementation of the intervention.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in use of telemedicine integrated into traditional primary health care - a comparative observational study.","authors":"Pär Eriksson, Maria Randjelovic, Hans Thulesius, Tora Hammar, Stefan Lagrosen, Evalill Nilsson","doi":"10.1080/02813432.2025.2457542","DOIUrl":"https://doi.org/10.1080/02813432.2025.2457542","url":null,"abstract":"<p><p>Telemedicine in primary health care is expected to address many of the issues currently challenging service delivery. However, the impact and effect will depend on who will use the new technology.</p><p><strong>Objective: </strong>The objective of the study was to investigate differences between users and non-users of telemedicine integrated into traditional office-based primary health care.</p><p><strong>Methods: </strong>Quantitative registry-based population study in two regions in the southeast part of Sweden (<i>n</i> = 73,486), comparing users with non-users of telemedicine across the variables sex, age, socioeconomic status (SES), morbidity and health care seeking behaviour (HSB). Two study periods of six months were used (September 2019-February 2020 for Region Östergötland, and September 2021-February 2022 for Region Kalmar County) to collect user data. A reference period of 36 months (September 2016-August 2019) was used, to collect data on HSB.</p><p><strong>Results: </strong>Users were more often women under the age of 60 and had higher morbidity (measured as resource utilisation) than non-users (<i>p</i> < .001). In contrast, no statistically significant differences were seen between the two groups regarding SES, measured as Care Need Index (CNI). Regarding HSB, a proxy measure (health record entries) showed more entries for users than non-users.</p><p><strong>Conclusions: </strong>Our findings suggest that users are more likely to be women and below the age of 60. Likewise, users also tend to have a greater need for health care services compared to non-users, and they seek health care more often compared to non-users. No differences regarding SES were found.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences from Sweden on developing evidence-based care for the primary care population.","authors":"Cecilia Björkelund, Karin Mossberg","doi":"10.1080/02813432.2025.2461047","DOIUrl":"https://doi.org/10.1080/02813432.2025.2461047","url":null,"abstract":"","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"B-phosphatidylethanol testing to identify hazardous alcohol use in primary health care-a game changer and a challenge for general practitioners: a qualitative study.","authors":"Åsa Steensland, Anna Segernäs, Mårten Larsson, Andrea Johansson Capusan, Lisa Kastbom","doi":"10.1080/02813432.2025.2456949","DOIUrl":"https://doi.org/10.1080/02813432.2025.2456949","url":null,"abstract":"<p><strong>Background and aims: </strong>Alcohol use disorder (AUD) and hazardous alcohol use are common but underdiagnosed in primary health care (PHC). This study aimed to explore general practitioners' (GPs') experiences and perceptions of using B-Phosphatidylethanol (PEth), a specific quantitative biomarker for alcohol use, in their clinical work with patient consultations and treatment follow-up in Swedish PHC.</p><p><strong>Design, participants, and setting: </strong>Individual interviews were conducted with GPs and resident GPs (n 20) in Swedish PHC and analysed using qualitative content analysis.</p><p><strong>Findings: </strong>The overarching theme <i>PEth testing in primary health care-a game changer and a challenge</i> illustrated that PEth testing has improved the prerequisites for the GP-patient interaction while making it more complex. Four categories underpinned this theme: <i>Comprehending the context</i>, describing the challenges in the GP-patient interaction when hazardous alcohol use or AUD was suspected; <i>Getting the pieces in place</i>, illustrating the struggle of integrating PEth testing into clinical practice and how it diminished the role of alcohol history taking; <i>The challenges and facilitators of the conversation</i>, comprising both the difficulties in informing about PEth testing and the positive impact on the interaction, and <i>Considerations based on the PEth test results</i>, emphasising the consequences of elevated PEth test results and their influence on physicians' motivation to using PEth.</p><p><strong>Conclusions: </strong>PEth is an important tool in the identification of hazardous alcohol use. Emerging ethical dilemmas regarding patient information on PEth testing and management of medical and medico-legal obligations when test results indicate high alcohol use need to be addressed in future guidelines for clinical management of PEth.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-13"},"PeriodicalIF":1.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive dysfunction in diabetes - the 'forgotten' diabetes complication: a narrative review.","authors":"Åke Sjöholm, Louise Bennet, Peter M Nilsson","doi":"10.1080/02813432.2025.2455136","DOIUrl":"https://doi.org/10.1080/02813432.2025.2455136","url":null,"abstract":"<p><strong>Background: </strong>In addition to peripheral neuropathy of various kinds, diabetes can also cause central neuropathy, which among other things can manifest itself as premature cognitive dysfunction, often linked to vascular dysfunction. Although the link between diabetes and cognitive dysfunction was discovered more than 100 years ago and has important clinical implications, this diabetes complication remains relatively unknown. Recent years have seen research that has clarified cerebral insulin resistance and defective insulin signaling as examples of pathogenic factors behind this cognitive impairment in diabetes.</p><p><strong>Method: </strong>We provide a narrative review of select and contemporary publications with relevance for the interface between diabetes/prediabetes and cognitive function.</p><p><strong>Results: </strong>Recently published studies show that physical activity can reverse insulin resistance in the brain as well as cognitive impairment and pathological appetite regulation. Pharmacological interventions with, for example, nasal insulin, GLP-1 receptor agonists, SGLT-2 inhibitors, or PPAR-γ agonists have also shown promising results.</p><p><strong>Conclusion: </strong>Optimization of lifestyle factors (e.g. physical activity), as well as several pharmaceutical agents already in clinical use against diabetes, have shown promising results in improving cognitive function in diabetic patients. An important task for primary health care, where most patients with type 2 diabetes are diagnosed, treated, and followed, is to increase awareness and early detection of cognitive dysfunction in these patients for optimizing risk factor control.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Coronary Risk Evaluation 2 (SCORE2), arterial stiffness, and subclinical coronary atherosclerosis in a population-based study.","authors":"Susanna Strömberg, Andreas Stomby, Jan Engvall, Carl Johan Östgren","doi":"10.1080/02813432.2025.2456948","DOIUrl":"https://doi.org/10.1080/02813432.2025.2456948","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the association between Systematic Coronary Risk Evaluation 2 (SCORE2) and subclinical damage in two vascular beds: atherosclerosis in the coronary arteries and aortic arterial stiffness, in a large population-based cohort without cardiovascular disease or diabetes.</p><p><strong>Methods: </strong><i>Design:</i> A cross-sectional study based on Swedish CArdio Pulmonary bioImaging Study (SCAPIS) data. <i>Study population:</i> A population-based cohort of 3087 participants aged 50-64.</p><p><strong>Outcome: </strong>Pulse Wave Velocity (PWV) was measured, and aortic arterial stiffness was defined as PWV≥ 10 m/s. Coronary artery calcium score (CACS) was determined by coronary computed tomography and clinically significant coronary calcification was defined as CACS > 100.</p><p><strong>Results: </strong>The prevalence of arterial stiffness was 6.6% in the low-moderate SCORE2 risk group, 31.0% in the high-risk group, and 53.3% in the very high-risk group. The prevalence of coronary calcification was 4.5%, 18.5% 23.0%, respectively. There was a modest overlap between arterial stiffness and coronary calcification in all SCORE2 risk groups. When comparing the high SCORE2 risk group with the low-moderate risk group, the Odds ratio (OR) was 6.4, 95% confidence interval (CI 5.1-8.0) for arterial stiffness and 4.8 (CI 3.7-6.3) for coronary calcification. When comparing the very high SCORE2 risk group to the low-moderate group, the OR was 16.2 (CI 11.3-23.1) for arterial stiffness and 6.4 (CI 4.2-9.7) for coronary calcification.</p><p><strong>Conclusion: </strong>Our study shows that high cardiovascular risk according to SCORE2 is associated with increased arterial stiffness and significant coronary calcification in a population without prevalent cardiovascular disease or diabetes. This knowledge can be useful in primary care, where SCORE2 is frequently used as a risk prediction tool. The modest overlap between arterial stiffness and coronary calcification suggests that CACS and PWV describe different types of vascular damage.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise capacity after long-term physical activity on prescription provided by physiotherapists.","authors":"Daniel Karsberg Zotterman, Åsa Cider, Stefan Lundqvist","doi":"10.1080/02813432.2025.2450376","DOIUrl":"https://doi.org/10.1080/02813432.2025.2450376","url":null,"abstract":"<p><p><b>Background:</b> Research has shown that physical activity on prescription (PAP), used in Swedish healthcare, increases patients' physical activity, but data are lacking regarding the long-term effects of PAP on exercise capacity. Therefor exercise capacity was evaluated in patients with metabolic risk factors, after 4.5 years of PAP treatment provided by physiotherapists in primary healthcare.</p><p><p><b>Method:</b> This study included 98 patients (49% women; mean age, 56 years) with metabolic risk factors, who were still physically inactive after a previous 6-month PAP treatment. The patients received physiotherapist-provided PAP treatment for 4.5 years, including 11 follow-ups and 6 exercise capacity tests.</p><p><p><b>Results:</b> After 4.5 years, 41 patients completed the final exercise capacity test (58% drop-out rate). Compared to baseline, the whole cohort exhibited a significantly increased exercise capacity (9.1 W, <i>p</i> = 0.014) with a small effect size (<i>r</i> = 0.27), with no significant differences associated with age or gender.</p><p><p><b>Conclusion:</b> The increased exercise capacity may indicate positive effects on longevity, and consolidates previous findings that long-term behavior change is possible among physically inactive patients. It also demonstrates the feasibility of continuous exercise capacity testing with physiotherapist support in an ordinary primary care setting. The drop-out rate and lack of control group complicate the interpretation of the effects of PAP treatment on the increased exercise capacity. Further research should strive for an RCT study design.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General practitioners' clinical decision-making in patients that could have cancer: a vignette study comparing the Baltic states with four Nordic countries.","authors":"Alexander Rosendahl, Anet Vanaveski, Liina Pilv-Toom, Jānis Blumfelds, Vija Siliņa, Mette Brekke, Tuomas Koskela, Aurimas Rapalavičius, Hans Thulesius, Peter Vedsted, Michael Harris","doi":"10.1080/02813432.2025.2451653","DOIUrl":"https://doi.org/10.1080/02813432.2025.2451653","url":null,"abstract":"<p><strong>Objective: </strong>Relative one-year cancer survival rates in the Baltic states are lower than the European mean; in the Nordic countries they are higher than the mean. This study investigated the likelihood of General Practitioners (GPs) investigating or referring patients with a low but significant risk of cancer in these two regions, and how this was affected by GP demographics.</p><p><strong>Design: </strong>A survey of GPs using clinical vignettes.</p><p><strong>Setting: </strong>General Practice in Denmark, Estonia, Finland, Latvia, Lithuania, Norway, and Sweden.</p><p><strong>Subjects: </strong>General Practitioners.</p><p><strong>Outcome measures: </strong>A regional comparison of GPs' stated immediate diagnostic actions (whether or not they would perform a key diagnostic test and/or refer to a specialist) for patients with a low but significant risk of cancer (between 1.2 and 3.6%).</p><p><strong>Results: </strong>Of the 427 GPs that completed the questionnaire, those in the Baltic states, and GPs that were more experienced, were more likely to arrange a key diagnostic test and/or refer their patient to a specialist than those in Nordic Countries or who were less experienced (<i>p</i> < 0.001 for both measures). Neither GP sex nor practice location within a country showed a significant association with these measures.</p><p><strong>Conclusion: </strong>While relative one-year cancer survival rates are lower in the Baltic states than in four Nordic countries, we found no evidence that this is due to their GPs' reluctance to take immediate diagnostic action, as GPs in the Baltic states were more likely to investigate and/or refer at the first consultation. Research on patient and secondary care factors is needed to explain the survival differences.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life, lifestyle habits and chronic pain in individuals with knee pain - a 2-year follow-up study.","authors":"Charlotte Sylwander, Emma Haglund, Ingrid Larsson, Maria L E Andersson","doi":"10.1080/02813432.2025.2452916","DOIUrl":"10.1080/02813432.2025.2452916","url":null,"abstract":"<p><strong>Introduction: </strong>Knee pain increases the risk of developing chronic widespread pain (CWP) and knee osteoarthritis (KOA). The prevalence of CWP and KOA has increased, and there is a need for early prevention. Therefore, the aim was to examine the associations of health-related quality of life (HRQoL) and lifestyle habits with chronic pain at a two-year follow-up in individuals with knee pain.</p><p><strong>Methods: </strong>A two-year longitudinal cohort study including 251 individuals aged 30-60 years reporting knee pain at baseline. HRQoL was measured via the Short-Form General Health Survey (SF-36), and lifestyle habits included questions on overweight, physical activity, diet, alcohol and tobacco use. Pain was assessed with a pain mannequin. Differences in health status and lifestyle habits over time in groups with unchanged no chronic pain (NCP), transitioned to less and more pain, and unchanged CWP were analysed using Wilcoxon's, McNemar's and Friedman's tests. Multinominal regression analysis was performed to study associations with reporting chronic pain at follow-up.</p><p><strong>Results: </strong>Reporting better HRQoL across various SF-36 concepts and normal weight at baseline was associated with reporting NCP after two years. A few changes were made regarding HRQoL and lifestyle habits over the course of two years, but an increase in general health was associated with transitioning to less pain.</p><p><strong>Conclusions: </strong>During primary care visits for knee pain with a combination of overweight or lower HRQoL, individuals should receive comprehensive attention to prevent the development of CWP. Future studies should investigate the associations further.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}