Family Medicine and Community Health最新文献

{"title":"Implementation outcomes from delivering 'acute-on-demand telehealth services' in primary care: a retrospective observational study.","authors":"Ngiap Chuan Tan, Shen Yi Dominic Lim, Win Yee Cheong, Yi Ling Eileen Koh, Chun-Yun Gary Kang, Jambay Dorji","doi":"10.1136/fmch-2026-003988","DOIUrl":"10.1136/fmch-2026-003988","url":null,"abstract":"<p><strong>Objectives: </strong>The retrospective component of this mixed method study leveraged implementation science to assess the execution of an acute-on-demand telehealth (AODTH) service pioneered in a Singapore public primary care institution using video consultation (VC) targeting the local multiethnic population.</p><p><strong>Design: </strong>A study was conducted using electronic medical records and AODTH service data from 2023 to 2024. The data were computed to determine the implementation outcomes based on the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework: demographics of users (Reach); conversion to in-patient consultations (Effectiveness); AODTH uptake (Adoption); defaulters, post-VC referral to emergency or specialist outpatient services, medical certification (Implementation); purpose and service utility trend (Maintenance).Descriptive statistics, Pearson's χ² test and regression analyses were executed to report implementation outcomes and associated factors.</p><p><strong>Setting: </strong>Data were obtained from a primary care clinic (polyclinic) in eastern Singapore.</p><p><strong>Participants: </strong>AODTH users aged ≥18 years who used the service between 2023 and 2024 were included. No exclusion criteria were applied.</p><p><strong>Results: </strong>39 811 AODTH VCs were completed by 17 603 unique users, including 44.4% males and Chinese (59%) and Malay (24%) ethnicity. Senior adults aged 65 years and older represented only 2.5% of users and 1.2% of VCs. Monthly VC volumes in 2024 exceeded those in 2023, with some months recording nearly double the consultation numbers and surpassing 2500 VCs in the second half of 2024. Mean default (6.6%) and conversion (2.2%) rates showed a decreasing trend from 2023 to 2024. Referrals to emergency or specialist outpatient services constituted 5.6% of VCs. Acute medical conditions accounted for 82.7% of VCs, chronic disease management 12.4% and other reasons 4.9%, with upper respiratory tract infections comprising almost half of acute cases. Over half (50.9%) of consultations were not prescribed medications, of which 72.3% were issued sick leave. 81.3% of users had two or fewer sick leave issuances, including those with none.</p><p><strong>Conclusion: </strong>Although AODTH outreach to older adults was low, the service was effective for acute medical management with low in-person consultation conversion despite the lack of physical examination. The rising trends of AODTH users and VCs over 2 years reflect gradual service adoption, while low defaulter and referral rates reflect an appropriate implementation framework. Prevalent medical certification is likely the cornerstone to maintain AODTH service as a means for recovery from acute illnesses.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725346","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":"Clinical accountability in fragmented primary care for older adults: a practical framework for minimal multidimensional assessment and targeted testing in community and home-based settings.","authors":"Joomong Park","doi":"10.1136/fmch-2026-004209","DOIUrl":"10.1136/fmch-2026-004209","url":null,"abstract":"<p><p>Fragmented care in older adults often results in duplicated testing, delayed decision-making and unclear clinical responsibility. These challenges are particularly pronounced in community and home-based primary care settings, where multiple providers contribute to care without formal coordination structures. Although comprehensive multidimensional geriatric evaluation is recommended, its complexity limits routine implementation. This article proposes a pragmatic framework integrating assessment of daily functioning, cognitive screening, mood assessment and mobility evaluation with targeted laboratory testing guided by clinical findings. A central principle of this model is clinical accountability, defined as the responsibility of the clinician who performs assessment and interprets findings to integrate diagnostic results into patient management and follow-up. In this framework, accountability refers specifically to responsibility for documenting findings, initiating appropriate follow-up evaluation and ensuring communication of clinically significant results. By linking brief multidimensional assessment, problem-oriented testing and explicit responsibility for follow-up, this practice-informed communication offers a pragmatic, adaptable approach for family physicians and community-based clinicians working in fragmented care environments. It is presented as a practice-informed proposal rather than a validated framework, consensus statement or guideline.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698074","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":"Residency taught me medicine: practice taught me everything else.","authors":"Dominika Jegen","doi":"10.1136/fmch-2026-004247","DOIUrl":"10.1136/fmch-2026-004247","url":null,"abstract":"","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649447","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":"Analysis of the OPTIMUM (Optimising care of Patients via Telemedicine In Monitoring and aUgmenting their control of diabetes Mellitus) tele-monitoring system in primary care as perceived by healthcare professionals using the CFIR framework.","authors":"Cia Sin Lee, Pei Pei Gong, Gerald Choon Huat Koh, Ngiap Chuan Tan","doi":"10.1136/fmch-2026-004076","DOIUrl":"10.1136/fmch-2026-004076","url":null,"abstract":"<p><strong>Objective: </strong>Telemedicine has been increasingly adopted post-COVID-19 to optimise chronic disease management, improving patient outcomes. The multi-component OPTIMUM (Optimising care of Patients via Telemedicine In Monitoring and aUgmenting their control of diabetes Mellitus) tele-monitoring (TM) system yielded favourable health outcomes and was introduced in primary care nationwide in Singapore. This study aims to understand the factors associated with its implementation during the randomised controlled trial (RCT).</p><p><strong>Design: </strong>A qualitative study was conducted using individual semi-structured interviews. Data were transcribed, audited, coded and analysed using thematic analysis. The CFIR (Consolidated Framework for Implementation Research) framework, consisting of five domains (Intervention characteristic, Outer setting, Inner setting, Characteristics of individuals and Process), was adopted as the underpinning framework.</p><p><strong>Setting: </strong>Primary care setting in Singapore.</p><p><strong>Participant: </strong>Healthcare professionals involved in the care provided to patients enrolled in the OPTIMUM RCT.</p><p><strong>Results: </strong>TM facilitated behavioural change in patients, and its robust treatment algorithm allowed continuous monitoring and personalised advice. The associated external factors were manpower, costing and data security. Measures to mitigate internal risks included managing additional healthcare professionals' burden, reducing potential adverse events and addressing medicolegal risks related to TM. While TM enhanced provider satisfaction and the patient-healthcare professional relationship, strategies to enhance user experience and streamline the TM processes are required to improve its acceptance and adoption.</p><p><strong>Conclusion: </strong>The CFIR served as a useful framework to identify factors associated with successful implementation of an intervention in a real-world setting. Understanding these factors enables healthcare leaders to address the challenges before scaling up the intervention in routine clinical services.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 Suppl 4","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608412","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":"Association of radioactive iodine treatment with survivorship symptoms and primary care utilisation in women of reproductive age with thyroid cancer: a retrospective cohort study.","authors":"Priya Devanarayan, Meghan Hartman, Michael Partin","doi":"10.1136/fmch-2026-004118","DOIUrl":"10.1136/fmch-2026-004118","url":null,"abstract":"<p><strong>Objectives: </strong>Radioactive iodine (RAI) is commonly administered after thyroid cancer surgery and is generally considered low risk. Its use in women of reproductive age, however, is increasingly debated. Most research has focused on cancer outcomes, fertility or short-term psychological effects, with limited attention to symptoms relevant to primary care after treatment. Evidence describing post-treatment symptom burden, mental health outcomes and primary care utilisation in this population is limited. This study examines whether RAI treatment after thyroid cancer surgery in women of reproductive age is associated with an increase in disease-related symptom burden, new mental health diagnoses and greater primary care utilisation within the first year following treatment.</p><p><strong>Methods: </strong>This retrospective cohort study used the TriNetX database to compare adult women of reproductive age (18-49) with thyroid cancer who underwent thyroidectomy from 1 January 2000 to 1 January 2024 by RAI treatment status. Propensity score matching was performed to balance baseline demographic and clinical characteristics. Outcomes within 1 year included new diagnoses of fatigue and malaise, generalised anxiety disorder, depressive episodes, sleep disorders, cognitive symptoms, adjustment disorders and primary care utilisation. Standardised mean differences (SMD) compared baseline characteristics and risk differences with 95% CIs and risk ratios (RR) with 95% CIs compared outcomes between cohorts.</p><p><strong>Results: </strong>Before propensity score matching, patients receiving RAI had higher prevalence of obesity (SMD 0.269), hypertension (SMD 0.189), diabetes (SMD 0.127) and mental health conditions (SMD 0.370). After matching, 10 882 patients were analysed. RAI-treated patients experienced significantly higher rates of fatigue and malaise (RR 1.239, 95% CI 1.031 to 1.490; p=0.022), depressive episodes (RR 1.344, 95% CI 1.043 to 1.732; p=0.022), sleep disorders (RR 1.281, 95% CI 1.006 to 1.630; p=0.044) and primary care visits (RR 1.476, 95% CI 1.330 to 1.638; p<0.001).</p><p><strong>Conclusion: </strong>RAI treatment in women of reproductive age may be associated with increased symptom burden and primary care utilisation in the first year following thyroid cancer treatment. These findings underscore the importance of anticipatory guidance, symptom screening, coordinated survivorship care and further research to define optimal survivorship care pathways for this population.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537045","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":"Continuity as infrastructure: protecting patient outcomes, equity and the rural primary care workforce.","authors":"Jesus Ruiz","doi":"10.1136/fmch-2026-003958","DOIUrl":"10.1136/fmch-2026-003958","url":null,"abstract":"","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473535","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":"Pilot of a novel patient-led intervention for postdischarge from hospital management of older patients' care in general practice.","authors":"Rachel Spencer, Naomi Klepacz, Annabelle Louisa Long, Simon Edward Frank Spencer, Hema Mistry, Frances Griffiths, Jeremy Dale","doi":"10.1136/fmch-2026-003981","DOIUrl":"10.1136/fmch-2026-003981","url":null,"abstract":"<p><strong>Objective: </strong>General Practice Management After Transition Events (GP-MATE) is a codesigned patient-held tool to structure a dedicated postdischarge appointment for older patients. This pilot in routine general practice evaluated its feasibility (recruitment, tool use), acceptability (staff/patient views), potential outcomes (error, harm and readmission) and healthcare cost implications.</p><p><strong>Design and setting: </strong>Seven diverse general practices in the West Midlands, England, participated in this 4-year mixed-methods National Institute for Health and Care Research-funded study. A 20-minute GP-MATE appointment was offered to all patients aged >65 recently discharged from the hospital, supported by a paper-based communication tool sent to those who accepted. Three months of free-text electronic health records were reviewed for care use, intervention coverage, error, harm and readmission. Attributable healthcare costs were assessed. Patient/carer surveys and interviews with patients, carers and healthcare professionals explored experiences of delivery and use.</p><p><strong>Participants: </strong>40 patients (mean age 75 years; 53% female) attended GP-MATE appointments, and 29 returned surveys. 17 patient-held GP-MATE forms were retrieved and analysed. Seven patients/carers and nine healthcare professionals were interviewed.</p><p><strong>Results: </strong>Care appeared safe, with tentative signs of being two-thirds less error prone (<i>X</i> ²=3.48 on 1df, p=0.06); no harms were detected. Postdischarge general practice use was high, with 115 admission-related contacts; almost two-thirds of the cohort had already received discharge-related care before GP-MATE. Despite this, GP-MATE appointments addressed persistent gaps in discharge information, leading to meaningful changes in care (mean=2.6 per patient), including new referrals and medication changes. Intervention costs represented just over half of the total mean attributable general practice care costs. Staff and patient/carer experiences indicate acceptability, though some unwell or confused patients struggled to differentiate the GP-MATE intervention from usual care. The perceived benefits were lower for elective or less complex admissions. Practices reported mixed experiences, including administrative difficulties in booking appointments and high non-attendance rates.</p><p><strong>Conclusion: </strong>GP-MATE was feasible to deliver, acceptable to staff and patients/carers and supported postdischarge communication. Larger trials are needed to establish robust evidence of readmission reduction and error/harm reduction, equity and cost-benefit.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413368","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":"Integrating genomic medicine into primary care: a precision health model from Riyadh, Saudi Arabia.","authors":"Khaled Alabduljabbar, Aljoharah Alaskar, Hana Al Alshaykh, Hamad Alzaidan, Salman Alanazi, Mylynda Massart","doi":"10.1136/fmch-2026-004088","DOIUrl":"10.1136/fmch-2026-004088","url":null,"abstract":"<p><strong>Objective: </strong>To describe the design, structure and first-year operational data of the Precision Medicine Clinic (PMC) at King Faisal Specialist Hospital & Research Centre (KFSHRC), a primary-care-embedded genomic medicine service launched in Riyadh, Saudi Arabia, in January 2025.</p><p><strong>Design: </strong>Descriptive service report.</p><p><strong>Setting: </strong>The Precision Medicine Clinic, an embedded subspecialty service within the Department of Family Medicine and Polyclinics at KFSHRC-a publicly funded, single-payer tertiary academic centre in Riyadh, Saudi Arabia.</p><p><strong>Participant: </strong>Adult and paediatric patients evaluated at the PMC during its first calendar year of operation (January-December 2025), referred from primary care for predictive genomic testing, pharmacogenomic testing or genetic counselling.</p><p><strong>Result: </strong>The PMC evaluated 212 patients in 2025. Predictive genomic testing accounted for approximately 57% of evaluations and pharmacogenomics for approximately 43%, indicating a genuinely hybrid first-year caseload rather than one dominated by a single modality. Turnaround time from referral to results delivery was approximately 2-4 months. The predominant care model was two-visit (family-history capture and consent at visit 1; results disclosure at visit 2). Distinguishing features include embedding within a fully operational family-medicine department, a hybrid service scope spanning reactive pharmacogenomics, predictive Centres for Disease Control and Prevention (CDC) tier-1 actionable-gene screening and reproductive carrier screening under a single referral interface, integration with the Saudi Human Genome Program (SHGP) reference catalogue, and operation during the first year without routine medical-geneticist involvement.</p><p><strong>Conclusion: </strong>The PMC-KFSHRC offers a replicable organisational template for integrating genomic medicine into primary care within a publicly funded, single-payer system and a reference architecture for Gulf and emerging-economy health systems pursuing primary-care genomic integration under Vision 2030-aligned digital-health strategies.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399600","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":"Translating evidence into primary care: Singapore's 2025 national osteoporosis guideline and a multilevel framework for assessing guideline impact in mixed health systems.","authors":"M Premikha, Valentina Ricci, Shu Jun Kan, Phyllis Kim","doi":"10.1136/fmch-2025-003802","DOIUrl":"https://doi.org/10.1136/fmch-2025-003802","url":null,"abstract":"<p><strong>Objective: </strong>Osteoporosis is a major contributor to morbidity and mortality worldwide, yet underdiagnosis and undertreatment remain pervasive across diverse health systems, including Singapore's mixed public-private primary care landscape. In 2025, the Agency for Care Effectiveness (ACE), Ministry of Health, Singapore, updated its national clinical guideline 'Osteoporosis: Diagnosis and Management' to address these persistent gaps. This paper describes the development of the guideline and examines its implications for primary care using conceptual frameworks.</p><p><strong>Design: </strong>The guideline was developed using a transparent, GRADE-aligned adaptation process that incorporated 10 high-quality international guidelines, local epidemiological and cost data, and formal RAND-UCLA consensus from a multidisciplinary Expert Group.</p><p><strong>Setting: </strong>Singapore's mixed public-private primary healthcare system.</p><p><strong>Participants: </strong>Oversight was provided by ACE's internal team, with content expertise drawn from a 21-member multidisciplinary expert group (EG), of whom 10 members (47.6%) were practising in public and private primary care settings. The panel included primary care physicians, specialists (ie, endocrinologists, rheumatologists, geriatricians, gynaecologists, orthopaedic surgeons), nurses and pharmacists, ensuring representation across care levels and disciplines.</p><p><strong>Results: </strong>The updated guideline comprises six recommendations spanning risk assessment, lifestyle optimisation, diagnostic thresholds, pharmacologic treatment and referral for complex presentations. Key adaptations include earlier case finding in men, pragmatic vitamin D guidance, locally derived treatment thresholds for osteopenia and selective use of anabolic agents for patients at very high fracture risk. Conceptual analysis using Starfield's 4Cs (comprehensive, continuous, coordinated and first-contact care) and ACE's multilevel impact model, highlighted how the guideline may strengthen primary care functions and influence policy-level, organisational-level, clinician-level and patient-level pathways.</p><p><strong>Conclusion: </strong>Singapore's experience illustrates how mixed health systems can translate global evidence into concise, context-appropriate primary care guidance that supports system redesign and strengthens longitudinal management of chronic disease. Five transferable lessons emerge for similar systems: targeted adaptation of international evidence, pragmatic contextualisation of recommendations to local workflows and resources, strategic use of conditional recommendations, alignment of guideline implementation with broader system reforms and anchoring of chronic disease management in primary care.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382902","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":"Mitigating future pandemics: the need for socio-behavioural data collection systems and proactive community engagement.","authors":"Keenan Duggal, Nina Gobat, Thomas Moran, Thomas Abraham, Daniel Romer, Jim Duggan, Vicky Houssiere, Olivia Tulloch, Wenqing Zhang, Jean-Michel Heraud, Kai Von Harbou","doi":"10.1136/fmch-2026-003962","DOIUrl":"10.1136/fmch-2026-003962","url":null,"abstract":"","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"14 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377389","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}