BJGP Open最新文献

{"title":"Correction: Exploring the facilitators and barriers to addressing social media's impact on anxiety within primary care: a qualitative study.","authors":"","doi":"10.3399/BJGPO.2024.9998","DOIUrl":"10.3399/BJGPO.2024.9998","url":null,"abstract":"","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice visitations in primary care to improve performance of cardiovascular risk management: an observational study.","authors":"Geert Hjm Smits, Michiel L Bots, Monika Hollander, Ardine de Wit, Sander van Doorn","doi":"10.3399/BJGPO.2023.0213","DOIUrl":"10.3399/BJGPO.2023.0213","url":null,"abstract":"<p><strong>Background: </strong>Despite programmatic protocolised care and structured support, considerable variation is observed in completeness of registration and achieving targets of cardiovascular risk management (CVRM) between individual GPs in the Netherlands.</p><p><strong>Aim: </strong>To determine whether completeness of registration and achieved targets of cardiovascular risk factors improves with practice visitation.</p><p><strong>Design & setting: </strong>Observational study utilising the care group's database (2016-2019), comparing changes in registration and achieved targets in non-visited practices and visited practices.</p><p><strong>Method: </strong>We compared completeness scores of registration and scores of targets achieved before visitation and 1 year after visitation. Data were analysed on patient level and GP level. Separate analyses were performed among GPs who were ranked in the lower 25% of score distributions.</p><p><strong>Results: </strong>We observed no clinically relevant improvements in completeness of registration and targets achieved in 2017, 2018, and 2019 that could be attributed to visitations in the previous year, both on individual patient level and on aggregated level per general practice. In practices ranked in the lower 25% of the distribution, improvements over time were clinically relevant and larger than the overall changes. Yet, these findings were irrespective of the number of practice visitations.</p><p><strong>Conclusion: </strong>Practice visitations in our setting did not seem to lead to improvements in practice performance, nor in completeness of registration of risk factors or in reaching predefined target goals for cardiovascular risk factors.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-guided DVT diagnosis in primary care: protocol for cohort with qualitative assessment.","authors":"Kerstin Nothnagel, Alastair Hay, Jessica Watson, Jonathan Banks","doi":"10.3399/BJGPO.2024.0165","DOIUrl":"10.3399/BJGPO.2024.0165","url":null,"abstract":"<p><strong>Background: </strong>Deep vein thrombosis (DVT), a formation of blood clots within deep veins, mostly of the proximal lower limb, has an annual incidence of 1-2 per 1000. Patients who are affected by multiple chronic health conditions and who experience limited mobility are at high risk of developing DVT. Traditional DVT diagnosis involves probabilistic assessment in primary care, followed by specialised ultrasound scans (USS), mainly conducted in hospitals. The emergence of point-of-care ultrasound (POCUS), coupled with artificial intelligence (AI) applications, has the potential to expand primary care diagnostic capabilities.</p><p><strong>Aim: </strong>To assess the accuracy and acceptability of AI-guided POCUS for DVT diagnosis when performed by non-specialists in primary care.</p><p><strong>Design & setting: </strong>Diagnostic cross-sectional study coupled with a qualitative evaluation conducted at primary care DVT clinics.</p><p><strong>Method: </strong>First, a diagnostic test accuracy (DTA) study will investigate the accuracy of AI-guided POCUS in 500 individuals with suspected DVT, performed by healthcare assistants (HCAs). The reference standard is the standard of care of USS conducted by sonographers. Second, after receiving both scans, participants will be invited to complete a patient satisfaction survey (PSS). Finally, semi-structured interviews with 20 participants and four HCAs, and three sonographers will explore the acceptability of AI-guided POCUS DVT diagnosis.</p><p><strong>Conclusion: </strong>This study will rigorously evaluate the accuracy and acceptability of AI-guided POCUS DVT diagnosis conducted by non-specialists in primary care.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903165","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":"GP access for inclusion health groups: perspectives and recommendations.","authors":"Aaminah Verity, Victoria Tzortziou Brown","doi":"10.3399/BJGPO.2024.0021","DOIUrl":"10.3399/BJGPO.2024.0021","url":null,"abstract":"<p><strong>Background: </strong>General practice has seen the widespread adoption of remote consulting and triage systems. There is a lack of evidence exploring how inclusion health populations have been impacted by this transformation.</p><p><strong>Aim: </strong>This study aimed to explore the post-pandemic GP access for inclusion health populations, through the lens of those with lived experience, and identify practical recommendations for improving access for this population.</p><p><strong>Design & setting: </strong>A mixed-methods study exploring the direct experience of people from inclusion health groups trying to access GP care in 13 practices in east London.</p><p><strong>Method: </strong>A mystery shopper exercise involving 39 in-person practice visits and 13 phone calls were undertaken. The findings were reflected on by a multidisciplinary stakeholder group, which identified recommendations for improvements.</p><p><strong>Results: </strong>Only 31% of the mystery shopper visits (<i>n</i> = 8) resulted in registration and the offer of an appointment to see a GP for an urgent problem. None of the mystery shoppers was able to book an appointment over the phone but <i>n</i> = 10/13 felt that they would be able to register and make an appointment if they followed the receptionist's instructions. Most mystery shoppers felt respected, listened to, and understood the information provided to them. Just under half of the practices (46%, <i>n</i> = 6) received positive comments on how accessible and supportive their spaces felt. Practice- and system-level recommendations were identified by the stakeholder group.</p><p><strong>Conclusion: </strong>Ongoing GP access issues persist for inclusion health populations. We identified practice- and system-level recommendations for improving access for this vulnerable population.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From statistics to stories: understanding the complex landscape of missed medical appointments. A mixed-methods pilot study.","authors":"Lea Charton, Francis Gatier, Chloe Delacour, Camille Lépine","doi":"10.3399/BJGPO.2024.0007","DOIUrl":"10.3399/BJGPO.2024.0007","url":null,"abstract":"<p><strong>Background: </strong>Research suggests that in both France and the UK, between 5% and 10% of appointments with GPs are unattended. A comprehensive Irish study linked missed appointments with an increased short-term risk of mortality, prompting further investigation into the reasons behind absenteeism.</p><p><strong>Aim: </strong>To delve into the underlying causes of missed appointments, within the context of an urban health centre.</p><p><strong>Design & setting: </strong>Using a mixed-method approach, this study combines qualitative telephone interviews with quantitative analysis of medical records. The study focuses on patients who failed to attend appointments at an urban health centre in France over a 15-day period.</p><p><strong>Method: </strong>The interview guide collected data on circumstances leading to missed appointments and explored patients' social determinants of health. Additionally, quantitative data, including patients' socioeconomic backgrounds, were extracted from medical records.</p><p><strong>Results: </strong>Among 53 missed appointments (4.9% of all scheduled), 22 patients were interviewed. State health coverage (SHC) beneficiaries (68.2% of the sample) cited socioeconomic instability, including precarious work hours, social isolation, and multiple commitments, as reasons for non-attendance. For non-SHC beneficiaries, forgetting the appointment or failing to cancel it after self-resolution of the health issue was one of the main causes. Remarkably, 36.4% disclosed that they had experienced domestic violence. During the qualitative interview, patients were offered the opportunity to reschedule appointments, and a retrospective analysis by physicians found that over a quarter of the missed appointments were classified as 'capital appointments', meaning their absence could have significantly harmed the patient's health.</p><p><strong>Conclusion: </strong>The findings indicate that missed appointments can highlight social inequality, emphasising the need to align health care with patients' temporal realities. The identification of patients who have experienced violence and the use of missed appointments as triggers for follow-up calls seem to be promising strategies to enhance care and mitigate health inequalities.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of the FebriDx point-of-care test for lower respiratory tract infections in primary care: a qualitative interview study.","authors":"Jill Rutter, Christopher R Wilcox, Nour Odeh, Ingrid Muller, Tristan W Clark, Paul Little, Firoza Davies, John McGavin, Nick Francis","doi":"10.3399/BJGPO.2024.0024","DOIUrl":"10.3399/BJGPO.2024.0024","url":null,"abstract":"<p><strong>Background: </strong>FebriDx is a single-use, analyser-free, point-of-care test with markers for bacterial (C-reactive protein [CRP]) and viral (myxovirus resistance protein A [MxA]) infection, measured on a finger-prick blood sample.</p><p><strong>Aim: </strong>As part of a larger feasibility study, we explored the views of healthcare professionals (HCPs) and patients on the use of FebriDx to safely reduce antibiotic prescriptions for lower respiratory tract infections (LRTIs) in primary care.</p><p><strong>Design & setting: </strong>Remote semi-structured qualitative interviews were conducted in South England.</p><p><strong>Method: </strong>In total, 22 individuals (12 patients who underwent FebriDx testing and 10 HCPs from general practices that conducted testing) participated in interviews, which were analysed thematically.</p><p><strong>Results: </strong>Patients and HCPs expressed positive views about use of the test. They felt FebriDx was a useful tool to inform prescribing decisions and provided a visual aid to support shared decision making and appropriate antibiotic use. Most felt it would be feasible to integrate use into routine primary care consultations. Some practical difficulties with blood collection and interpreting results, which impacted on usability, were identified. Some patients' reactions to negative test results suggested the need for better communication alongside use of the test.</p><p><strong>Conclusion: </strong>FebriDx was perceived as a useful tool to guide antibiotic prescribing and support shared decision making. Initial practical problems with testing and communicating results are potential barriers to use. Training and practice on using the test and effective communication are likely to be important elements in ensuring patient understanding and satisfaction, and successful adoption.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hammering nails with a screwdriver: how GPs perceive video consultations.","authors":"Magnus Repstad Wanderås, Eirik Abildsnes, Elin Thygesen, Santiago Gil Martinez","doi":"10.3399/BJGPO.2024.0010","DOIUrl":"10.3399/BJGPO.2024.0010","url":null,"abstract":"<p><strong>Background: </strong>Early in the COVID-19 pandemic, the use of video consultation (VC) expanded considerably, with GPs indicating high satisfaction with it. However, use of VC declined as lockdown measures were eased.</p><p><strong>Aim: </strong>To explore reasons why VC use has declined in Norwegian general practice since the start of the pandemic by investigating GPs' experiences with VC and their attitudes towards it in a post-pandemic setting.</p><p><strong>Design & setting: </strong>Qualitative study using semi-structured interviews with 13 GPs in southern Norway between May 2022 and March 2023.</p><p><strong>Method: </strong>Data analysis was conducted by applying the six steps of Braun and Clarke's reflexive thematic analysis.</p><p><strong>Results: </strong>Although the implementation of VCs was unplanned, most participants were able to use this modality without much problem. Several GPs initially envisioned long-term VC use. However, despite certain positives, VCs were largely sidelined in favour of face-to-face and telephone consultations, owing to their practicality and VC's limited usefulness when considering the extra effort required. Nonetheless, GPs recognised ways of using VC that might exploit its strengths, but they highlighted how its sustained use would require them to replace other consultation modalities. They also identified extrinsic factors that might lead to the increased use of VC, including improved VC technology and patient demand.</p><p><strong>Conclusion: </strong>Although VC is now part of many GPs' consultation toolboxes, its perceived relative lack of usefulness and extra effort compared with other remote consultation modalities mean that most GPs have chosen to abandon it as a routine consultation modality.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311846","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":"Lyme disease in UK primary care: a knowledge, attitude and practice survey.","authors":"Lucy Delaney, Amanda Semper, Neil French, John Sp Tulloch","doi":"10.3399/BJGPO.2024.0092","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0092","url":null,"abstract":"<p><strong>Background: </strong>Lyme disease (LD) cases in the UK most commonly present within the primary care setting. Despite an upward trend of incidence, little is known regarding general practitioner (GP) experience with diagnosis and treatment.</p><p><strong>Aim: </strong>This study aims to describe baseline primary care clinician Knowledge, Attitude and Practice (KAP) in Scotland and England.</p><p><strong>Design & setting: </strong>Online KAP survey on Lyme disease for UK based practising GPs.</p><p><strong>Method: </strong>An online KAP questionnaire was developed for use in UK primary care. The survey was distributed through UK based research networks, professional societies and via social media.</p><p><strong>Results: </strong>191 complete responses were analysed (England <i>n</i>=130, Scotland <i>n</i>=61). The Scotland-based respondent group had more relevant consultations in the previous 3 years. Respondents from Scotland demonstrated a greater awareness that erythema migrans (EM) is pathognomonic for Lyme disease and that serological testing of this patient group is not indicated. Less common cardiac and neurological symptoms were not as well associated with Lyme disease by both respondent groups for the former and England-based respondents for the latter. Prescribing according to the National institute for Health and Care Excellence (NICE) guidance was identified in 70% of Scotland and 42% of England-based GP responses.</p><p><strong>Conclusion: </strong>Targeted resources may improve clinician confidence on exposure risk, symptom recognition, testing limitations and treatment dose and duration. Scotland-based respondents' better survey performance potentially reflects greater clinical exposure and public awareness of the disease, due to high endemicity within the nation.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523272","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":"The prescribing of opioids for chronic noncancer pain in the menopausal and postmenopausal population: a drug utilisation study in the United Kingdom.","authors":"Emma Tillyer, Yogini Jani, Li Wei, Ruth Brauer","doi":"10.3399/BJGPO.2024.0169","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0169","url":null,"abstract":"<p><strong>Background: </strong>Opioid use for chronic noncancer pain (CNCP) is consistently higher in menopausal/postmenopausal women than in younger women or men, elevating their risk of opioid-related adverse health outcomes. Since pain severity increases with hormonal changes accompanying menopause, these women should be a focus of opioid stewardship efforts.</p><p><strong>Aim: </strong>To examine opioid prescribing trends for CNCP in menopausal/postmenopausal women diagnosed with a musculoskeletal condition.</p><p><strong>Design & setting: </strong>Population-based drug utilisation study using IQVIA Medical Research Data UK.</p><p><strong>Method: </strong>Annual opioid prescribing incidence, prevalence, and average duration of use were calculated for a cohort of women aged 50-79 with musculoskeletal conditions newly diagnosed between 2010-2021. Specific results were stratified by age, pain indication, and Townsend score.</p><p><strong>Results: </strong>From 2010 to 2021, incident prescribing rates of opioids increased in women aged 50-54 (161.4 [95% CI 149.7-174.0] per 1000 PYAR in 2010 to 239.6 [95% CI 211.7-271.2] per 1000 PYAR in 2021); these women discontinued opioid use faster (~1 year) than older age groups (~2 years). Overall, opioid prescribing prevalence decreased from 23% in 2010 to 14% in 2021, and average opioid use duration decreased from 3 years to 1 year (2010 - post-2017) in women aged 50-79.</p><p><strong>Conclusion: </strong>The overall observed decrease in prevalence and average duration of opioid use is encouraging. Incident prescriptions are rising in women aged 50-54 and those with fibromyalgia while remaining steady in women aged 55-79. Understanding the impact of menopause/post-menopause on opioid use trends is important for effective opioid stewardship.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476728","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":"Advance care planning before and during the COVID-19 pandemic: an observational cohort study of 73 675 patients' records.","authors":"Philippa G McFarlane, Catey Bunce, Katherine E Sleeman, Martina Orlovic, Jonathan Koffman, John Rosling, Alastair Bearne, Margaret Powell, Julia Riley, Joanne Droney","doi":"10.3399/BJGPO.2023.0145","DOIUrl":"10.3399/BJGPO.2023.0145","url":null,"abstract":"<p><strong>Background: </strong>Advance care planning (ACP) was encouraged by policymakers throughout the COVID-19 pandemic. Little is known about use of ACP during this time.</p><p><strong>Aim: </strong>To compare use of ACP before and during the COVID-19 pandemic.</p><p><strong>Design & setting: </strong>Retrospective, observational cohort study comparing the creation, use, and content of Electronic Palliative Care Coordination System (EPaCCS) records in London. Individuals aged ≥18 years with a Coordinate My Care record, created and published in the pre-pandemic period (1 January 2018-31 December 2019), wave 1 (W1; 20 March 2020-4 July 2020), interwave (IW; 5 July 2020-30 September 2020), and wave 2 (W2; 1 October 2020-5 March 2021).</p><p><strong>Method: </strong>Patient demographics and components of ACP were compared using descriptive and comparative statistics.</p><p><strong>Results: </strong>In total, 73 675 records were included; 35 108 pre-pandemic, 21 235 W1, 6323 IW, and 9925 W2 (<i>n</i> = 1084 records not stratified as created and published in different periods). Most records were created in primary care (55.6% pre-pandemic, 75.5% W1, and 47.7% W2). Compared with the pre-pandemic period, the average weekly number of records created increased by 296.9% W1 (<i>P</i><0.005), 35.1% IW, and 29.1% W2 (<i>P</i><0.005). Patients with records created during the pandemic were younger (60.8% aged ≥80 years W1, 57.5% IW, 59.3% W2, 64.9% pre-pandemic [<i>P</i><0.005]). Patients with records created in W1 had longer estimated prognoses at record creation (73.3% had an estimated prognosis of ≥1 year W1 versus 53.3% pre-pandemic [<i>P</i><0.005]) and were more likely to be 'for resuscitation' (38.2% W1 versus 29.8% pre-pandemic [<i>P</i><0.005]).</p><p><strong>Conclusion: </strong>During the COVID-19 pandemic increased ACP activity was observed, especially in primary care, for younger people and those not imminently dying. Further research is needed to identify training and planning requirements as well as organisational and system changes to support sustained high-quality ACP within primary care.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865231","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}