Gesundheitswesen最新文献

{"title":"[Health Promotion and Prevention of Non-Communicable Diseases by Public Health Departments in Baden-Württemberg during the COVID-19 Pandemic: Results of an Online Survey].","authors":"Achim Siegel, Daniela Hesmert, Jasmin Mangold, Anika Klein, David Häske, Sofie Wössner, Monika A Rieger, Stefanie Joos, Cornelia Mahler","doi":"10.1055/a-2227-5481","DOIUrl":"10.1055/a-2227-5481","url":null,"abstract":"<p><strong>Objectives: </strong>Disease prevention and health promotion are among the core tasks of German public health services (Öffentlicher Gesundheitsdienst - ÖGD), particularly local public health departments (Gesundheitsämter). Little is known about the extent to which the departments were able to continue activities in the field of health promotion and prevention of non-communicable diseases (HPP-NCDs) during the COVID-19 pandemic. Using the example of public health departments in Baden-Württemberg (BW), we therefore investigated how much staff was available to the departments for HPP-NCDs services, how much staff was actually dedicated to HPP-NCDs during the COVID-19 pandemic, which HPP-NCDs activities were carried out during the pandemic, which were cancelled, and which should be resumed as a priority, according to the public health departments.</p><p><strong>Methods: </strong>We developed a largely standardized online questionnaire for the survey of the 38 public health departments in BW. Per department one questionnaire was to be completed. The survey took place from 9/1/2022 to 11/4/2022. The data of this explorative cross-sectional study were analyzed in a descriptive-statistical manner using SPSS, version 28.</p><p><strong>Results: </strong>Of the 38 departments, 34 participated in the survey (89%). Departments had a mean of 2.44 full HPP-NCDs staff as planned (median 2.00; SD 1.41; range 0.20-5.00). Under pandemic conditions, a mean of 1.23 full HPP-NCDs staff were deployed (median 0.95; SD 1.24; range 0.00-4.50). Respondents gave examples of 61 HPP-NCDs activities that were conducted under pandemic conditions, and they described 69 HPP-NCDs activities that had to be cancelled. Of the latter, respondents felt that 40 should be resumed as a matter of highest priority. Analysis of the priority activities to be resumed reveals characteristic differences: e. g., resumption of structural prevention activities was viewed more frequently as a matter of hightest priority than resumption of behavioral prevention activities.</p><p><strong>Conclusions: </strong>During the pandemic, local public health departments in BW deployed, on average, actually only half of their full staff allocated as planned to HPP-NCDs. Comparing different categories of HPP-NCDs activities (cancelled during the pandemic) in terms of the relative frequency with which their resumption is viewed as matter of highest priority, characteristic differences can be observed. It remains an open question which conclusions can be drawn from such differences.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11248641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140102652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 Data Quality/Completeness In Covid-19 Cases: Why A Digital Integrated Data Collection Is Also Necessary For Pandemic Control].","authors":"Benedikt Mj Lampl, Bernhard Edenharter, Michael Leitzmann, Bernd Salzberger","doi":"10.1055/a-2234-6894","DOIUrl":"10.1055/a-2234-6894","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological data on the corona pandemic collected in the public health sector in Germany have been less useful in estimating vaccine effectiveness and clinical outcomes compared to other countries.</p><p><strong>Methods: </strong>In this retrospective observational study, we examined the completeness of selected own data collected during the pandemic. Information on the important parameters of hospitalization, vaccination status and risk factors for severe course and death over different periods were considered and evaluated descriptively. The data are discussed in the extended context of required digital strategies in Germany.</p><p><strong>Results: </strong>From January 1, 2022 to June 30, 2022, we found 126,920 administrative procedures related to COVID-19. With regard to the data on hospitalization, in 19,749 cases, it was stated \"No\", in 1,990 cases \"Yes\" and in 105,181 cases (83+%) \"Not collected\" or \"Not ascertainable\". Concerning vaccinations, only a small proportion of procedures contained information on the type of vaccine (11.1+%), number of vaccinations (4.4+%) and date of the last vaccination (2.1+%). The completeness of data on chronic conditions/risk factors in COVID-19-related deaths decreased over four consecutive periods between 2020 and 2022 as case numbers increased.</p><p><strong>Conclusion: </strong>Future strategies taking into account meaningfulness and completeness of data must comprise modern technical solutions with digital data collection on infections without putting the principle of data protection at risk.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[On the Effectiveness of Digital Workplace Health Promotion in Times of Home Office: A Systematic Review].","authors":"Sebastian Schmidt, Claudia Andersch-Rupprecht, Thore Dengler, Eckhard Nagel","doi":"10.1055/a-2143-7457","DOIUrl":"10.1055/a-2143-7457","url":null,"abstract":"<p><strong>Background: </strong>In the face of an increasingly aging, multimorbid, chronically ill workforce, company health promotion (BGF) is an important instrument for promoting and maintaining the health of employees in the workplace. Due to digitization and the increasing possibilities of working from home, digital offers for workplace health promotion (dBGF) are being used increasingly in organizations. The portfolio of offers ranges from fitness trackers, online platforms, and health apps to so-called wearables, so that a broad, individual selection is possible for both organizations and employees.</p><p><strong>The aim of the study: </strong>The aim of the study was to identify and analyze randomized controlled trials (RCT) with regard to the health-promoting effectiveness of dBGF.</p><p><strong>Material and methods: </strong>A systematic literature search was carried out in relevant specialist databases (PubMed, Livivo, Cochrane Library). The identified studies were selected, evaluated and then descriptively presented by several people systematically and independently.</p><p><strong>Results: </strong>17 relevant contributions could be identified and analyzed. Above all, measures to promote physical activity and programs to improve mental health were identified in the RCT studies that were carried out. The results of the studies carried out indicate that dBGF can promote health in a variety of ways and support organizations in providing a health-promoting working environment.</p><p><strong>Discussion: </strong>The effectiveness of dBGF could be proven on the basis of the studies identified, whereby the effects are undoubtedly influenced and determined by the employees, above all by their health competence. In order to ensure the long-term effectiveness of dBGF, it will be necessary in the future to increase the interest and motivation of employees with regard to personal health promotion and illness prevention.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11248646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ein After Action Review auf kommunaler Ebene im ÖGD: Lessons learned in der Corona - Einheit des Gesundheitsamtes Düsseldorf nach dem Ende der Covid-19-Pandemie, März 2023.","authors":"Hannah Höglund-Braun, Anne Lisa Quartey, Maya Ganter, Lutz Ehlkes, Steffen Geis, Max Skorning, Sybille Rehmet, Anna Kühne","doi":"10.1055/a-2329-7058","DOIUrl":"https://doi.org/10.1055/a-2329-7058","url":null,"abstract":"","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Postpartum Care by Midwives: Socioeconomic Status has a Strong Influence on the Amount of Care Received An Analysis with Routine Data from BARMER Health Insurance].","authors":"Dagmar Hertle, Danny Wende, Friederike Zu Sayn-Wittgenstein","doi":"10.1055/a-2144-5180","DOIUrl":"10.1055/a-2144-5180","url":null,"abstract":"<p><strong>Background: </strong>Socio-economic situation is associated with inequalities in access to health care and health-related resources. This also applies to pregnancy, birth and the postpartum period. Compared to other European countries, Germany has very good care options for the postpartum period. It has an unique system of postpartum care, which comprises home visits by midwives for 12 weeks after birth and beyond in problem cases and thus has structurally good care options. So far, however, there are hardly any studies based on routine data that show which mothers receive homevisits in postpartum care and to what extent.</p><p><strong>Method: </strong>The study population comprised 199,978 women insured with BARMER who gave birth to at least one child in the years 2017-2020. Some women were pregnant several times in this period of time. The services billed by freelance midwives for outreach midwifery care in the puerperium were considered for 227,088 births, taking into account the socioeconomic situation of the mothers.</p><p><strong>Results: </strong>According to the definition of the German Institute for Economic Research, 26% of the mothers belonged to a low income group, 46% to a medium income group and 29% to a high income group. Similar to what was shown for midwifery care during pregnancy, large differences were also found with regard to postpartum care: While 90.5% of the women with a high income received home visits, only 83.5% of women with a medium income did so, and only 67.9% of women with a low income. The groups did not differ with regard to other characteristics such as rate of caesarean section, preterm births, twins, age or concomitant diseases to an extent that could explain the differences in care. Women who had received midwifery services in pregnancy were much more likely to receive home visits by a midwife in the postpartum period. Furthermore, there was a correlation with the density of midwives in the respective region.</p><p><strong>Conclusions: </strong>The results suggest that access to home-based postpartum care by freelance midwives is significantly limited for low-income women. In contrast to antenatal care, women in the postpartum period cannot switch to other service providers, as outreach postpartum care is a reserved activity of midwives. Women with low incomes thus receive less midwifery care, although they have a higher need for support (Eickhorst et al. 2016).</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11077544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138886253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Redirection of patients from the emergency department to ambulatory care: a feasibility study].","authors":"Lea Koech, Sarah Ströhl, Michael Lauerer, Sarah Oslislo, Michael Bayeff-Filloff, Reno Thoß, Eckhardt Nagel, Sebastian Carnarius, Dominik Stillfried","doi":"10.1055/a-2206-1738","DOIUrl":"10.1055/a-2206-1738","url":null,"abstract":"<p><strong>Background: </strong>§ 120 para. 3b SGB V mandates the Federal Joint Committee to define guidelines for the initial assessment of self-referred walk-in patients as well as for the redirection of patients who can be treated by office-based physicians. A corresponding streaming and redirection process was tested in a feasibility study at the RoMed Clinic Rosenheim.</p><p><strong>Materials and methods: </strong>For the duration of the study, triage nurses of the emergency department (ED) first assessed self-referred walk-in patients with the Manchester Triage System (MTS). Patients in categories green and blue who did not obviously need the ED's resources were additionally assessed by health professionals of the Association of Statutory Health Insurance Physicians of Bavaria using the software Structured Initial Medical Assessment in Germany (SmED). Patients with a recommendation for non-hospital medical treatment were streamed to the out-of-hours practice on campus or were redirected to a physician office after video consultation with an office-based physician. Patient pathways were documented and a qualitative survey using semistructured guided interviews of all stakeholder groups was carried out.</p><p><strong>Results: </strong>1,091 self-referred walk-in patients were included. Direct streaming to the ED occurred in 525 cases,13 refused to participate. Based on SmED, 24 additional patients were referred to the ED, 514 patients were streamed to the out-of-hours practice, 23 received a video consultation and five left the ED. After video consultation, eight patients were redirected to a physician's office, 10 were discharged, and five referred to the ED of which one did not want an office-based physician. No returnees from practices to the ED were identified. Generally, the redirection process was evaluated positively in the interviews (n=18). In particular, potential for technical improvement was identified.</p><p><strong>Conclusion: </strong>Overall, the results indicate the feasibility of the redirection process and high acceptance levels. Using SmED in addition to MTS appeared useful before redirection but not necessary for streaming on campus. Redirection to physician offices can help reduce strain on the ED when the out-of-hours practice is not operating. In addition to arranging acute care appointments, video consultations offer an additional potential to treat patients. In a follow-up study, a broader range of patients should be included and appropriateness of redirection decisions should be evaluated.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11077551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Interface Communication and Information Transfer in Medical Care for People with Intellectual Disabilities: Qualitative Expert Interviews].","authors":"Anne Mainz, Sven Meister, Helmut Budroni, Martina Hasseler, Peter Schmidt, Jörg Stockmann, Andreas G Schulte, Christine Kersting, Achim Mortsiefer, Alexandra Schmidt","doi":"10.1055/a-2167-2245","DOIUrl":"10.1055/a-2167-2245","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to investigate the experiences, barriers, and solutions in communication during the provision of care for people with intellectual developmental disabilities in Germany. As there are approximately 350,000 people living with intellectual or developmental disabilities in Germany, who rely on assistance when communicating with healthcare providers, this study was conducted to examine the communication challenges and potential solutions in this population. The analysis especially focused on the potentials of digital applications facilitating information transfer.</p><p><strong>Methods: </strong>Thirteen expert interviews were conducted using a structured interview guide with caregivers and medical providers to people with intellectual developmental disabilities. The interviews were analyzed using an inductive and deductive content analysis approach, according to Meuser and Nagel.</p><p><strong>Results: </strong>The results revealed that the provision of care for people with intellectual developmental disabilities was characterized by time constraints and uncertainty when caregivers lack experience in caring for this population. Additionally, information transfer increased in complexity due to an overload of individual information provided by caregivers verbally or paper-based as well due to the passive role of patients who were usually not actively involved in the communication process. With regard to the potential for integrating digital applications for information transfer, a controversy between opportunity and risk emerged.</p><p><strong>Conclusion: </strong>The findings demonstrate that there is a need to implement training programs for professionals to enable them to offer improved health care for people with intellectual developmental disabilities. It is essential that caregivers are given sufficient time to communicate with patients, and that digital applications are utilized to support information transfer. Moreover, other research shows that digital applications offer new possibilities to communicate with people with intellectual developmental disabilities, such as the use of simplified or pictorial language. By addressing these communication challenges, healthcare professionals may be able to provide more effective and efficient care to this population. However, this requires further research, which addresses the controversial results regarding digital applications outlined in this paper.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11077553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138886252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysing the Need for Long-Term Care: Potential of Data from Long-Term Care Assessments of the Bavarian Medical Service for Public Health Research and Practice].","authors":"Johanna Schütz, Marie-Christin Redlich, Florian Fischer","doi":"10.1055/a-2189-2064","DOIUrl":"10.1055/a-2189-2064","url":null,"abstract":"<p><strong>Background: </strong>Despite demographic changes, there is still no systematic and comparable differentiation of nursing care reporting on a small-scale level in Germany, where outpatient long-term care is depicted. This article presents findings of care assessment data of the Medical Service of Bavaria and draws conclusions for future reporting on nursing.</p><p><strong>Methods: </strong>For the analysis, anonymised initial long-term care assessments of the Bavarian Medical Service of 2019 were evaluated exemplarily using descriptive methods. The study describes the characteristics of persons with a care level recommendation, the distribution of care level categories, medical diagnoses and degree of independence in the areas of life.</p><p><strong>Results: </strong>The persons assessed were on average 80 years old. At the time of the initial assessment, the largest proportion of persons with an assigned care level lived in an outpatient setting. Care level (PG) 1 (slight impairment of independence or abilities) was assigned to 35.1% of the insured, PG 2 (considerable impairment) to 43.1%, PG 3 (severe impairment) to 16.6%, PG 4 and 5 (most severe impairment) were each rarely assigned at the time of the initial assessment (3.9% and 1.4%, respectively). Medical diagnoses were dominated by gait and mobility disorders, unspecified dementia, heart failure and senility. In particular, there were impairments in the areas of 'mobility' and 'organisation of everyday life and social contacts'.</p><p><strong>Conclusions: </strong>The data available from the German Medical Service may be highly relevant to health research and policy and may provide a basis for planning interventions in long-term care.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Improving Postgraduate Medical Training In Germany: A Proposal].","authors":"Norbert Donner-Banzhoff, Ferdinand Michael Gerlach","doi":"10.1055/a-2189-2209","DOIUrl":"10.1055/a-2189-2209","url":null,"abstract":"<p><p>Postgraduate (vocational, residency) training in Germany is regulated by the Physicians' Chamber in each federal state. Although training requirements are specified in detail by regulatory documents, young doctors are left on their own to find training posts and suitable learning experiences. There are no programmes in place to support trainees nor to identify the need of the health care system regarding the composition of its medical workforce. Hospitals and practices pay salaries to physicians in training from funding obtained for services they provide. We propose a systematic and continuing process of identifying gaps in the workforce. Disciplines with a lack of qualified doctors will be supported by additional funds directed to practices and hospitals. Regional rotation schemes will coordinate and improve the quality of training. Apart from an administrative overhead, this system of regulation will not need additional resources because a limited part of current budgets will be explicitly channelled into salaries for trainees in specialties for which there is a higher need than into others.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11077550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Control and care structures at transplant centers for patients with ethyltoxic cirrhosis while waiting for a liver transplant: A qualitative survey of practitioners.]","authors":"Annette Binder, Julia Fenchel, Immanuel Lang, Anil Batra","doi":"10.1055/a-2106-9717","DOIUrl":"10.1055/a-2106-9717","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to record the current care and control structures in place for patients with ethyltoxic liver cirrhosis while being prepared for a liver transplant (LTX) at German transplant centers. In addition, it was also intended to analyze the associated barriers as well as the view of the practitioners on ways to improve care of this patient group.</p><p><strong>Methods: </strong>In an exploratory descriptive qualitative design, 11 interviews with practitioners from 10 of the 22 German LTX centers were conducted and analyzed using qualitative content analysis.</p><p><strong>Results: </strong>There were considerable differences in the care and control structures in place at the LTX centers. Addiction therapy counseling or treatment were not integrated into the treatment concept at all centers. Structural barriers arose from insufficient funding and staffing. Practitioners recommended expansion of treatment options as well as standardizing treatment concepts.</p><p><strong>Discussion: </strong>The results of our study point to a need for action both in the area of the structures of the individual LTX centers and overall at the system level. Taking into account current standards of addiction medicine, our results could serve as a basis for the development of treatment concepts and recommendations for optimizing standard care before LTX.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11077546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9778225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}