BJGP Open最新文献

{"title":"Exploring the equity of distribution of general medical services funding allocations in Wales: a time-series analysis.","authors":"Jonny Currie, Kathrin Thomas, Anne M Cunningham, Kerry Bailey, Haroon Ahmed, Daniel Farewell, Sally Lewis","doi":"10.3399/BJGPO.2024.0080","DOIUrl":"10.3399/BJGPO.2024.0080","url":null,"abstract":"<p><strong>Background: </strong>Good access to quality primary care in high-income countries can improve population health. Access to primary care is, however, often not equal among socioeconomic groups; our analysis sought to explore whether funding, a determinant of service supply, is equitably distributed among GP practices in Wales.</p><p><strong>Aim: </strong>To explore the relationship between funding and deprivation among GP practices in Wales, to understand the equity of current funding policies.</p><p><strong>Design & setting: </strong>A time-series analysis was undertaken in the primary care setting in Wales.</p><p><strong>Method: </strong>We obtained funding data for general practices in Wales between 2014 and 2022, and explored the equity of distribution using the percentage of practice patients living in the 20% most deprived small areas in Wales. We generated a linear regression model exploring the relationship between practice funding and deprivation, with an interaction term with time in years.</p><p><strong>Results: </strong>Practice funding rose for all practices between 2014 and 2022. Practice deprivation and time in years were both associated with practice funding, with increases in practice deprivation associated with reduced funding allocations, and time being associated with a small increase in funding over the study period. Over the period of analysis of 2014-2022, for every 10% increase in patients living in the most deprived lower layer super output areas, funding per patient decreased on average by 1%.</p><p><strong>Conclusion: </strong>General practices in Wales in more deprived areas receive discernibly less funding per patient than those in less deprived areas. Given the potential and likelihood primary care can affect population health outcomes, this underinvestment may be contributing to existing health inequalities and requires urgent further analysis and action.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collecting sociodemographic data in primary care: qualitative interviews in community health centres.","authors":"Rachel Thelen, Sara Bhatti, Jennifer Rayner, Agnes Grudniewicz","doi":"10.3399/BJGPO.2024.0095","DOIUrl":"10.3399/BJGPO.2024.0095","url":null,"abstract":"<p><strong>Background: </strong>Many primary care organisations do not routinely collect sociodemographic data (SDD), such as race, sex, or income, despite the importance of these data in addressing health disparities.</p><p><strong>Aim: </strong>To understand the experiences of primary care providers and staff in collecting SDD.</p><p><strong>Design & setting: </strong>A qualitative interview study with 33 primary care and interprofessional team members from eight Ontario community health centres (CHCs).</p><p><strong>Method: </strong>Semi-structured virtual interviews were conducted between July and August 2021. The interviews were recorded and transcribed verbatim. Content analysis of the transcripts was undertaken.</p><p><strong>Results: </strong>Participants reported using both formal methods of SDD collection, and informal methods of SDD collection that were more organic, varied, and conducted over time. Participants discussed sometimes feeling uncomfortable collecting SDD formally, as well as associated burden and limited resources to support collection. Client-provider rapport was noted as facilitating data collection and participants suggested more training, streamlined data collection, and better communication about purpose and use of data.</p><p><strong>Conclusion: </strong>SDD can be collected informally or formally, but there are limitations to informally collected data and barriers to the adoption of formal processes.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalised care planning for older people with frailty: a review of factors influencing implementation.","authors":"Anne Heaven, Marilyn Foster, Robbie Foy, Rebecca Hawkins, Claire Hulme, Sara Humphrey, Jane Smith, Andrew Paul Clegg","doi":"10.3399/BJGPO.2024.0163","DOIUrl":"10.3399/BJGPO.2024.0163","url":null,"abstract":"<p><strong>Background: </strong>Frailty increases vulnerability to major health changes because of seemingly small health problems. It affects around 10% of people aged >65 years. Older adults with frailty frequently have multiple long-term conditions, personal challenges, and social problems. Personalised care planning (PCP) based on 'goal setting' and 'action planning' is a promising way to address the needs of older adults living with frailty.</p><p><strong>Aim: </strong>To identify and explore factors that influence the implementation of PCP-style interventions for older adults.</p><p><strong>Design & setting: </strong>We conducted a scoping review and identified a small number of interventions that explicitly employed goal setting and action planning.</p><p><strong>Method: </strong>We used a range of sources to identify relevant material. We included all interventions inclusive of patients aged ≥65 years and reported in English. We excluded end-of-life care interventions, group education, and/or those that did not involve one-to-one engagement. We explored all related articles that described, examined, or discussed implementation. We constructed a thematic framework in NVivo (version 11). Findings were narratively synthesised.</p><p><strong>Results: </strong>We identified 18 potentially relevant PCP-style interventions and 13 of these met the inclusion criteria. Within these, were seven main categories of potentially modifiable influences relevant to older adults with frailty related to the following: primary care engagement; delivery staff characteristics; training; patient engagement; collaborative working; organisation and management; and systems.</p><p><strong>Conclusion: </strong>Many modifiable factors can influence the implementation of PCP. We identified several influences that have informed the development and implementation of a novel intervention PeRsOnaliSed care Planning for oldER people with frailty (PROSPER).</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vulnerable older people's views on proactive care planning: a qualitative interview study in primary care.","authors":"Lisa Kastbom, Anna Olaison, Annette Sverker, Anna Segernäs","doi":"10.3399/BJGPO.2024.0167","DOIUrl":"10.3399/BJGPO.2024.0167","url":null,"abstract":"<p><strong>Background: </strong>Patients in old age often have complex care needs owing to multimorbidity and polypharmacy. This qualitative study is part of a larger ongoing Swedish intervention trial Secure And Focused primary care for older pEople (SAFE), including shorter care agreements based on person-centred patient goals.</p><p><strong>Aim: </strong>To explore, in a primary care setting, the views of older and vulnerable patients on a more systematic, proactive approach to care planning, including establishing and documenting care agreements based on person-centred goals.</p><p><strong>Design & setting: </strong>Individual semi-structured interviews with patients (<i>n</i> = 25) aged >75 years from 12 intervention primary healthcare centres in two counties in Sweden.</p><p><strong>Method: </strong>Interviews were conducted between June and October 2023. They were digitally recorded and transcribed verbatim. Latent qualitative content analysis was used.</p><p><strong>Results: </strong>The following three categories, with 10 sub-categories, were found: I would like to live in the present, so why plan ahead? Let me decide versus they know best; and Care agreements usually went unnoticed. The latent theme - The ambivalence of care planning in the fourth age - was created to give a deeper meaning to the content of the categories.</p><p><strong>Conclusion: </strong>This study emphasises that older, vulnerable persons have varying attitudes towards participation in proactive care planning. This ambivalence may originate from the individual's desire to have their autonomy respected and express future care preferences on the one hand, and to avoid or postpone end-of-life conversations and care planning on the other hand. Patients also expressed a desire to be more actively involved in care planning. Although care agreements have the potential to increase patient involvement in proactive care planning, they often went unnoticed. The conversation itself was essential.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescription patterns of anxiolytics in remote consultation versus in-person consultation: a cross-sectional study in French general practice.","authors":"Flora Descans, Vincent Tarazona, David De Bandt","doi":"10.3399/BJGPO.2024.0176","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0176","url":null,"abstract":"<p><strong>Background: </strong>Teleconsultation is a new mode of medical consultation in France, poorly evaluated, and anxiolytics are among the drug classes at risk of over-medication.</p><p><strong>Aim: </strong>This study analyses the prescription patterns of anxiolytics in remote consultation (RC) versus in-person consultation (IPC) in general practice.</p><p><strong>Design & setting: </strong>This is a retrospective cross-sectional study in French general practice in 2021.</p><p><strong>Method: </strong>Consultations at volunteer general practice offices were analysed. The mode of consultation was extracted. For each consultation with an anxiolytic prescription, the prescribed daily dose (PDD), the age, gender, initiation or renewal of treatments, and the length time before the next consultation were recorded. Chi square was performed to compare the correlation between the mode of consultation and the drug prescription. Then, for consultation with anxiolytic prescription, multivariate models were conducted to analyse the PDD and the average time interval before the next consultation adjusted for consultation characteristics.</p><p><strong>Results: </strong>A total of 46 880 consultations were included from 11 general practitioners. The rate of consultations with anxiolytic prescriptions was identical in RC and IPC, but the PDD was higher by 6.17 in RC compared to IPC (95% CI=0.21; 12.12; <i>P</i>=0.04). The average time interval before the next consultation was identical in RC and IPC.</p><p><strong>Discussion: </strong>The rate of consultations with anxiolytic prescriptions is identical in RC and IPC, but the prescribed doses are higher in RC. Given the adverse effects of these treatments, general practitioners should reflect on their prescriptions to avoid over-medication.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns and indications for quetiapine prescribing in Dutch primary care.","authors":"Busra R Cinar, Suzanne A Ligthart, Hugo Ajm de Wit, Arnt Schellekens, Hanneke Hwa Fleuren, Cornelis Kramers, Albert Batalla, Gerard A Kalkman","doi":"10.3399/BJGPO.2024.0219","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0219","url":null,"abstract":"<p><strong>Background: </strong>Quetiapine, an antipsychotic, is registered for schizophrenia, bipolar disorder, and as an add-on therapy for major depressive disorder. Its anxiolytic and sedative effects make it attractive for off-label uses like insomnia, despite cardiovascular and metabolic side effects. The global increase in quetiapine use over the past decade warrants an examination of its prescribing patterns, especially off-label.</p><p><strong>Aim: </strong>This study investigates quetiapine prescribing trends in Dutch primary care, with a focus on off-label use.</p><p><strong>Design & setting: </strong>A retrospective database study using national and regional prescribing data from the Netherlands.</p><p><strong>Method: </strong>National prescribing trends from 2003-2022 were analysed using data from the Drug Information Project database, focusing on the top 10 antipsychotics. Regional data from the Radboudumc Technology Centre Health Database provided detailed quetiapine prescribing patterns from 2012-2021, categorized by daily dose. Indications for quetiapine prescriptions between 2020-2022 were derived from the detailed RTC patient records, including free-text portions, with specific attention for use in sleep problems.</p><p><strong>Results: </strong>Antipsychotic use increased from 1510 to 2061 per 100 000 between 2003-2022, largely due to a 13-fold increase in quetiapine (66 to 870 per 100000). Detailed regional data revealed a 3.3-fold increase in quetiapine use from 2012-2021, particularly at doses<100 mg/day. Among new quetiapine users in 2020-2022 from a subset of practices, 76.6% were for off-label indications, and sleep problems were the primary reason for starting quetiapine in 46.9% of cases.</p><p><strong>Conclusion: </strong>Off-label quetiapine prescribing, particulary for sleep problems, is rising in the Netherlands, despite guideline warnings. Further research on the drivers and long-term effects of this practice is needed.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arab community perceptions and awareness of family medicine: a systematic review.","authors":"Beesan Maraqa, Zaher Nazzal, Therese Zink","doi":"10.3399/BJGPO.2024.0104","DOIUrl":"10.3399/BJGPO.2024.0104","url":null,"abstract":"<p><strong>Background: </strong>Family medicine (FM), often known as general practice, is the foundation of sustainable and universal healthcare worldwide. As a new specialty in the Eastern Mediterranean Region (EMR), it must recruit doctors and gain public acceptability, which has traditionally favoured specialists.</p><p><strong>Aim: </strong>This research examined studies on Arab populations' attitudes towards FM to discover the barriers to creating and embracing this vital specialty.</p><p><strong>Design & setting: </strong>This review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and encompassed peer-reviewed articles from reputable sources such as PsycNet, Web of Science, PubMed, Embase, Scopus, and grey literature.</p><p><strong>Method: </strong>A comprehensive search was conducted across databases for peer-reviewed studies that explored Arabs' awareness, perceptions, and attitudes towards FM and physicians.</p><p><strong>Results: </strong>After a rigorous selection process, 19 studies were deemed suitable for analysis. These studies encompassed diverse participants, including medical students, physicians, patients, and the general public. The overall perception of FM was positive, but it was noted that few had direct exposure to family physicians during their medical education or in the clinical setting.</p><p><strong>Conclusion: </strong>Our review findings suggest the following five recommendations: (1) an education campaign for the general public about the role of FM; (2) increasing training capacity for family physicians; (3) early exposure to family physicians during medical school; (4) developing a process for continually improving the education and quality of family physicians; and (5) further research on the challenges to FM practice in Arab countries to understand the situation better and work toward its improvement.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of utilisation and consequences of CRP point-of-care-testing in primary care practices: qualitative interviews with GPs from Germany.","authors":"Paul Jung, Jutta Bleidorn, Susanne Doepfmer, Christoph Heintze, Markus Krause, Lisa Kuempel, Doreen Kuschick, Lena-Sophie Lehmann, Liliana Rost, Kahina J Toutaoui, Florian Wolf","doi":"10.3399/BJGPO.2024.0076","DOIUrl":"10.3399/BJGPO.2024.0076","url":null,"abstract":"<p><strong>Background: </strong>The use and advantages of point-of-care tests (POCTs) for C-reactive protein (CRP) in general practice, especially for upper respiratory tract infections (uRTIs), have been studied extensively. However, there is limited knowledge about test indications, prerequisites, and integration of these tests into everyday practice.</p><p><strong>Aim: </strong>To investigate the attitudes and experiences of GPs in Germany regarding the use of semi-quantitative C-reactive protein point-of-care tests (CRP-POCTs). The study places special emphasis on implementation in routine care, including testing procedures, feasibility, opportunities, and barriers for specific consultation scenarios, as well as test indications and their impact on GP-patient communication.</p><p><strong>Design & setting: </strong>Qualitative interview study with 10 GPs (May 2023-August 2023) in Germany.</p><p><strong>Method: </strong>Ten German GPs who participated in an observational study on CRP-POCT use in general practices were interviewed using semi-structured interviews. Audio-recordings were transcribed and content analysis was performed.</p><p><strong>Results: </strong>Interviewed GPs stated that CRP-POCTs offer several advantages for various treatment cases. The tests improve diagnostic confidence and certainty of GPs' therapeutic decisions, and offer a broad spectrum of indications and application scenarios. Additionally, the tests have a positive impact on GP-patient communication, and their ease of use enables rapid implementation into existing workflows. On the other hand, CRP-POCTs increase the time required for test performance and patient consultation.</p><p><strong>Conclusion: </strong>Owing to the numerous benefits of semi-quantitative CRP-POCTs, interviewed GPs have a favourable attitude towards their regular integration into everyday practice. Implementation barriers include increased time and personnel expenses for testing and inadequate reimbursement by German statutory health insurance.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do marked discharge summaries with recommendation text boxes enhance patient safety? A nationwide survey.","authors":"Thorbjørn H Mikkelsen, Jesper B Nielsen, Maria M Storsveen, Jens Søndergaard","doi":"10.3399/BJGPO.2024.0037","DOIUrl":"10.3399/BJGPO.2024.0037","url":null,"abstract":"<p><strong>Background: </strong>Danish hospital physicians are required to mark their discharge summaries addressing whether the patient's GP is recommended to follow-up the patient, as well as suggesting follow-up actions.</p><p><strong>Aim: </strong>To investigate whether a new form of discharge summaries may contribute to improving perceived patient safety following transition from hospitals to general practice.</p><p><strong>Design & setting: </strong>A questionnaire sent to a representative sample of GPs in Denmark.</p><p><strong>Method: </strong>A questionnaire was prepared for GPs based on background material, focus group interviews, and discussions with relevant professionals. It was subsequently pilot tested by fellow researchers and GPs, and revised before the presently reported survey.</p><p><strong>Results: </strong>Of 310 participating GPs, 197 (63%) 'totally agree' or 'partly agree' that the marked discharge summaries (MDS) with a recommendation text box contribute to a better handover to general practice, and 223 (72%) 'totally agree' or 'partly agree' that they improve patient safety.</p><p><strong>Conclusion: </strong>The majority of responding GPs believe that the MDS with a recommendation text box enhance patient safety and facilitate the transition of care to general practice following hospital discharge.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mixed methods study of the experience of GP educational supervisors.","authors":"Derek Elliott, Annabel Shepherd, Karena Anne Hanley, Nitin Gambhir","doi":"10.3399/BJGPO.2024.0106","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0106","url":null,"abstract":"<p><strong>Background: </strong>Quality supervision in the clinical learning environment is known to improve future quality of patient care by graduates of that training. Supports required by supervisors are not well documented.</p><p><strong>Aim: </strong>To conduct a needs assessment of educational supervisors (ESs) on the GP training programme.</p><p><strong>Design & setting: </strong>This is a mixed methods study conducted among the trainer population in the West of Scotland Region.</p><p><strong>Method: </strong>The instrument development mixed methods model was used to design a questionnaire for a whole population survey. This collected quantitative and qualitative data which were analysed in a way which triangulated and expanded the data.</p><p><strong>Results: </strong>116 educational supervisors (37%) responded, and cited time pressures, trainee variation, and professional assessment demands as the biggest challenges to providing quality supervision. Less than half of respondents felt they had sufficient time for clinical supervision in the working day. Trainees with additional needs require extra support, a third of ESs do not have sufficient time for pastoral care of their trainee, and the professional assessment burden may have a detrimental effect on the apprenticeship model of GP training. Suggestions for better support are made.</p><p><strong>Conclusion: </strong>With increasing demands on time, an increased trainer workload and an increase in the number of trainees with more variable needs, the willingness of GPs to become ESs may be reaching a tipping point. This research identifies areas for targeting support, but also recommends review of some of the structures of GP training in order to retain quality GP supervision in GP training.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}