Atencion Primaria最新文献

{"title":"Association between dietary patterns and glycemic control in type II diabetes mellitus patients","authors":"","doi":"10.1016/j.aprim.2024.103075","DOIUrl":"10.1016/j.aprim.2024.103075","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the association between dietary patterns and glycemic control among patients with type II diabetes mellitus (T2DM).</p></div><div><h3>Design</h3><p>A cross-sectional study.</p></div><div><h3>Site</h3><p>The 2015–2018 National Health and Nutrition Examination Survey (NHANES).</p></div><div><h3>Participants</h3><p>A total of 1646 T2DM patients were included, of whom 854 were hyperglycemia.</p></div><div><h3>Methods</h3><p>Main dietary patterns were identified using the sparse principal components analysis (SPCA). Logistic regression analysis was applied to investigate the association between each dietary pattern and the risk of hyperglycemia with odds ratios (OR) and 95% confidence intervals (CI). SPCA analysis yielded five significant principal components (PC), which represented five main dietary patterns.</p></div><div><h3>Results</h3><p>PC1, characterized by a high intake of sweets, red meat and processed meat, was associated with higher odds of hyperglycemia in patients who underwent hyperglycemic drug or insulin treatments (OR: 1.71, 95% CI: 1.10–2.64). PC5, characterized by high in red meat, while low in coffee, sweets, and high-fat dairy consumption. The relationship between the PC5 and hyperglycemia was marginal significance (OR: 0.63, 95% CI: 0.38–1.02). PC2 was characterized by a high consumption of green vegetables, other vegetables, and whole grains, and low intake of potatoes and processed meat. In patients with the hyperglycemic drug and insulin free, higher PC2 levels were related to lower odds of hyperglycemia (OR: 0.45, 95% CI: 0.21–0.96).</p></div><div><h3>Conclusions</h3><p>High intake of sweets, red meat, and processed meat might be detrimental to glycemic control in patients with drug-treated T2DM. High in red meat, while low in coffee, sweets, and high-fat dairy consumption may be beneficial to glycemic control. In addition, high consumption of green vegetables, other vegetables, and whole grains, and low intake of potatoes and processed meat may be good for glycemic control in patients without drug-treated T2DM.</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724002178/pdfft?md5=9858548819b14dfc94ddac9a388e57cd&pid=1-s2.0-S0212656724002178-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238232","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":"Desnutrición y obesidad en mayores autónomos y determinantes de salud relacionados con ambos trastornos nutricionales","authors":"","doi":"10.1016/j.aprim.2024.103078","DOIUrl":"10.1016/j.aprim.2024.103078","url":null,"abstract":"<div><h3>Objective</h3><p>Evaluate the nutritional status in older adults in the community, to determine malnutrition, obesity and their risks and to identify determinants related to both clinical situations.</p></div><div><h3>Design</h3><p>Cross-sectional study.</p></div><div><h3>Site</h3><p><em>3 Primary</em> care health centers in La Rioja in urban, semiurban and rural areas.</p></div><div><h3>Participants</h3><p>409 people ≥ 65 years old who came to receive consultation, with 3 abandonments.</p></div><div><h3>Interventions</h3><p>Nutritional assessment by tools screening and anthropometric measurements.</p></div><div><h3>Main measurement</h3><p>The MNA SF® was used to determine the prevalence of malnutrition and the BMI for obesity. Sociodemographic, socioeconomic, health-disease variables, lifestyle habits, metabolic status, and anthropometric measurements were included. Binary logistic regression was performed to predict dichotomous dependent variables.</p></div><div><h3>Results</h3><p>The prevalence of malnutrition and its risk (DR) were 18.7% and obesity and its risk were 66,5%. The multivariate model for malnutrition and DR includes polypharmacy, dyslipidemia, sedentary lifestyle, and having mental pathology (OR<!--> <!-->=<!--> <!-->3.09, 2.01, 2.12, 1.72, respectively). On the other hand, the probability of presenting obesity is associated with cardiovascular risk, age, excessive-moderate alcohol consumption, hypertension and low adherence to the Mediterranean diet (OR<!--> <!-->=<!--> <!-->2.73, 4.27, 2.03, 1.97, 1.81 respectively).</p></div><div><h3>Conclusion</h3><p>This results stand out that the study population has a poor nutritional status, detecting a risk of malnutrition, obesity and overweight. The identified predictors related to lifestyle habits, presence of diseases, psychosocial problems, metabolic alterations, etc. They can guide the selection of those people who would benefit from screening to detect and approach the risk of malnutrition early.</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724002208/pdfft?md5=8f4adbcef442477f04c3d079196a9b8a&pid=1-s2.0-S0212656724002208-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239694","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":"Prevalence and determinants of home delivery among pregnant women in Somaliland: Insights from SLDHS 2020 data","authors":"","doi":"10.1016/j.aprim.2024.103082","DOIUrl":"10.1016/j.aprim.2024.103082","url":null,"abstract":"<div><h3>Objective</h3><p>This cross-sectional study aimed to identify the determinants of home deliveries among women in Somaliland, with the objective of informing targeted interventions to improve maternal and child health outcomes.</p></div><div><h3>Design</h3><p>A cross-sectional study design was employed, utilizing data from a nationally representative sample of 3250 women in Somaliland. A multivariate logistic regression analysis was conducted to examine the factors influencing the likelihood of home delivery.</p></div><div><h3>Site</h3><p>The study was conducted in Somaliland, a region where home delivery remains prevalent.</p></div><div><h3>Participants</h3><p>The study included 3250 women of reproductive age in Somaliland who had given birth.</p></div><div><h3>Interventions</h3><p>No specific interventions were administered as part of this study. The focus was on understanding the factors associated with home deliveries.</p></div><div><h3>Main measurements</h3><p>Sociodemographic, economic, and regional factors were examined as potential determinants of home deliveries. Education levels of women and their husbands, maternal age at first marriage and first birth, and household wealth were among the main measurements analyzed.</p></div><div><h3>Results</h3><p>The analysis revealed that higher education levels were associated with a decreased likelihood of home delivery. Women with secondary (OR: 0.42, 95% CI: 0.32–0.55) or higher (OR: 0.21, 95% CI: 0.12–0.37) education were less likely to deliver at home than those with no education. Similarly, women whose husbands had a secondary (OR: 0.55, 95% CI: 0.41–0.73) or higher (OR: 0.43, 95% CI: 0.28–0.66) education were less likely to deliver at home. Increased maternal age at first marriage (OR: 1.04, 95% CI: 1.02–1.06) and first birth (OR: 1.03, 95% CI: 1.01–1.05) were significant predictors of home delivery. Lower household wealth was also associated with a higher likelihood of home delivery. Significant regional variations were observed, with certain regions showing higher rates of home deliveries compared to others.</p></div><div><h3>Conclusions</h3><p>The findings highlight the importance of targeted interventions to address sociodemographic and regional disparities in the utilization of institutional delivery services in Somaliland. Strategies should focus on improving access to and quality of maternal healthcare services, empowering women's decision-making, and engaging men to address gender norms within households.</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724002245/pdfft?md5=91d09d723014c175fdad37840e31fafa&pid=1-s2.0-S0212656724002245-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233915","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":"Manejo en atención primaria de las infecciones de transmisión sexual (III). Hepatitis víricas e infección por el VIH","authors":"","doi":"10.1016/j.aprim.2024.103048","DOIUrl":"10.1016/j.aprim.2024.103048","url":null,"abstract":"<div><p>Routinely obtaining a sexual history is a necessary first step to identify which patients have specific sexual behaviours that may put them at risk and use appropriate protective measures, especially in vulnerable populations. However, late diagnosis of HIV infection remains very high. Combination prevention strategies based on condom promotion, harm reduction programs for people who inject drugs plus PrEP and HIV PEP are the best options to prevent new infections. Screening for STIs (including hepatotropic viruses) and early diagnosis and treatment are essential for the person since it improves the prognosis and complications and also for the community because it breaks the chain of transmission. People living with HIV who have an undetectable viral load do not transmit the virus sexually (undetectable=untransmittable).</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724001902/pdfft?md5=b04dd3a5f7129cd70621fcccf58af7d8&pid=1-s2.0-S0212656724001902-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172964","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":"Impacto del seguimiento al alta de Enfermería en Atención Primaria sobre los reingresos hospitalarios tempranos. Estudio observacional longitudinal","authors":"","doi":"10.1016/j.aprim.2024.103083","DOIUrl":"10.1016/j.aprim.2024.103083","url":null,"abstract":"<div><h3>Aim</h3><p>To determine the proportion of people who undergo discharge follow-up when indicated.</p></div><div><h3>Design</h3><p>Retrospective longitudinal observational study, with an analytical approach.</p></div><div><h3>Population</h3><p>persons discharged from the Hospital Universitario de la Princesa of any age and sex, with any reason for admission and with an indication for discharge follow-up in Primary Care. Users who did not have an assigned Autonomous Personal Identification Code (CIPA) were excluded. Random sample (n<!--> <!-->=<!--> <!-->289).</p></div><div><h3>Variables</h3><p>Discharge follow-up and readmissions (&lt;30 days). Sociodemographic, clinical and discharge follow-up variables were included from the electronic medical records of Primary and Hospital Care. A descriptive analysis of the sociodemographic and clinical characteristics of the study population was conducted. To analyze the association between discharge follow-up and readmissions, a logistic regression model was used.</p></div><div><h3>Results</h3><p>Age 72.4 years (RIQ 60-87). 55.2% of the population were women. Follow-up was conducted in 61.2% of those indicated. According to the logistic regression model performed between early readmission and discharge follow-up, adjusted for all other factors, the group with discharge follow-up had a 66% lower likelihood of hospital readmission (OR 0.34, 95% <span>C</span>I (0.18-0.67)).</p></div><div><h3>Conclusions</h3><p>These findings suggest that nursing discharge follow-up conducted in primary care reduces the risk of early readmission.</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724002257/pdfft?md5=13c6a5c4aefa72e40d2b74a00fb9e6c8&pid=1-s2.0-S0212656724002257-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172043","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":"Comparación de un hemoglobinómetro portátil (Verio Q Red) con los resultados del laboratorio clínico en la práctica clínica habitual","authors":"","doi":"10.1016/j.aprim.2024.103080","DOIUrl":"10.1016/j.aprim.2024.103080","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the concordance between a hemoglobinometer with capillary blood sample and the clinical laboratory with a venous blood sample.</p></div><div><h3>Design</h3><p>Cross-sectional concordance study.</p></div><div><h3>Location</h3><p>Care Centre Primary Bufalà-Canyet Primary and Care Centre Primary Dalt la Vila Primary Care Center, Badalona, Barcelona.</p></div><div><h3>Participants</h3><p>Random selection of participants who attended routine blood tests. Over 18<!--> <!-->years old. No abandonment or loss was obtained.</p></div><div><h3>Main interventions and measurements</h3><p>Sex, age, and reason for the blood test were collected from the medical history. Venous blood is drawn, and simultaneously, capillary blood is collected.</p></div><div><h3>Results</h3><p>120 individuals are included, with an average age of 58.9<!--> <!-->years. The Bland-Almant graph showed differences within the confidence intervals for hemoglobin and hematocrit. The mean differences between the values of the Verio Q Red hemoglobinometer and those of the clinical laboratory were −0.42<!--> <!-->mg/dl for hemoglobin and −1.25% for hematocrit. The intraclass correlation coefficient showed excellent correlation for hemoglobin and hematocrit between the Verio Q Red hemoglobinometer and the clinical laboratory. Pearson's correlation for hemoglobin was 0.737 and for hematocrit 0.787.</p></div><div><h3>Conclusions</h3><p>The Verio Q hemoglobinometer is a valid tool for the early diagnosis of anemias and can be very useful in primary care consultations.</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724002221/pdfft?md5=2145bcd59571a4d2a58341635066ed51&pid=1-s2.0-S0212656724002221-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172040","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":"Scientific research in family medicine in Latin America: A bibliometric analysis","authors":"","doi":"10.1016/j.aprim.2024.103090","DOIUrl":"10.1016/j.aprim.2024.103090","url":null,"abstract":"","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724002324/pdfft?md5=c074415143a1415e1d12e208ccd76383&pid=1-s2.0-S0212656724002324-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172495","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":"The methodology of health education programs in schools—Qualitative study","authors":"","doi":"10.1016/j.aprim.2024.103091","DOIUrl":"10.1016/j.aprim.2024.103091","url":null,"abstract":"<div><h3>Objective</h3><p>To assess strengths and weaknesses of the methodology of health education programs, carried out in the period 2010–2020, in schools in Serbia.</p></div><div><h3>Design</h3><p>Qualitative study, a thematic analysis approach.</p></div><div><h3>Site</h3><p>Representatives of Public Health institutions, Serbian biggest nongovernmental organization, Youth organization, Ministry of education and municipality.</p></div><div><h3>Participants</h3><p>Nine professionals working in the field of Public Health and Health education.</p></div><div><h3>Method</h3><p>Focus group gathered nine health and non-health professionals in 2022 year. Focus group was recorded, transcribed verbatim, coded and analyzed by three research team members. A coding template evolved through the analysis, providing the expansion of key concepts. Themes were, one by one, extracted, encoded, classified as the smallest units and interpretive, thematic analysis was applied.</p></div><div><h3>Results</h3><p>Although the Focus group in our study identified among other advantages, support of Health sector to Educational sector as crucial, it emphasized as well following weaknesses: Analyzed health education programs were implemented insufficiently as a separate process in schools, did not have the image of programs shared and integrated into community; Health education needs of schoolchildren, parents, and teachers should be examined prior the education implementation; Well-educated interdisciplinary educators have to be strengthened and supported; Parents participation is necessity; Standards and good practice guidelines are needed, and those developed through Health Promoting Schools program could be practiced.</p></div><div><h3>Conclusion</h3><p>It is necessary to support cross-curricular competence, where health education should be integrated into all school subjects, and should go far beyond the school, grow into a culture of community life, which will interconnect all stakeholders in strong Public Health network.</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724002336/pdfft?md5=af3e09fb3d75f05a764163cee372cf34&pid=1-s2.0-S0212656724002336-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168607","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":"Satisfacción laboral y violencia en la relación clínica en Fisioterapia en España","authors":"","doi":"10.1016/j.aprim.2024.103076","DOIUrl":"10.1016/j.aprim.2024.103076","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the job satisfaction (JS) of physiotherapists in Spain and their relationship with occupational violence, as with other socio-demographic, health, and occupational factors.</p></div><div><h3>Design</h3><p>A cross-sectional study was conducted.</p><p>Setting Primary, community, and hospital attention level at public and private care in Spain.</p></div><div><h3>Participants</h3><p>Physiotherapists in Spain who have been working for at least 3<!--> <!-->months during the last year, and with complete answer to the required variables (n<!--> <!-->=<!--> <!-->2,590).</p></div><div><h3>Main measurements</h3><p>Information was collected through a questionnaire distributed online. A descriptive quantitative analysis and 3 logistic regression models were performed. In the first model, sociodemographic and violence variables were included as independent variables, in the second, health-related variables, and in the third, occupational variables.</p></div><div><h3>Results</h3><p>The average JS of physiotherapists is 7.26 points, being 8 or more in 46.8% of the cases, with a higher percentage in men”. Referring not having suffered psychological violence was related to a higher probability of having JS, even controlling for the rest of the variables studied (OR¹ <!-->=<!--> <!-->0.485; OR² <!-->=<!--> <!-->0.611; OR³ <!-->=<!--> <!-->0.697, respectively for each model).</p><p>Variables related to health (state of health, symptoms, consumption of tobacco/alcohol/other substances) and to the work environment (working day, work area, autonomy, relationship with superiors/colleagues) were statistically significantly related to JS.</p></div><div><h3>Conclusions</h3><p>Almost 47% of the respondents had very high JS values. Certain areas of work as well as positive health factors have been linked to very high JS. Psychological violence is the form of violence that, independently of the other factors analysed, leads to lower JS.</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S021265672400218X/pdfft?md5=4a3bfc7a91388bbac749dce06b3ba8da&pid=1-s2.0-S021265672400218X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142167436","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":"De la evidencia a la práctica: la Ciencia de la Diseminación e Implementación en atención primaria y comunitaria","authors":"","doi":"10.1016/j.aprim.2024.103077","DOIUrl":"10.1016/j.aprim.2024.103077","url":null,"abstract":"<div><p>Dissemination and Implementation Science focuses on bridging the gap between scientific research and its practical application in the real world. By identifying and promoting effective strategies, the Science of Dissemination and Implementation disseminates and implements evidence-based interventions in healthcare settings, taking into account the needs, barriers, context, resources, and end users. This special article introduces and debates the most recent advances in this field, highlighting key approaches, theoretical frameworks, as well as specific challenges and opportunities applied to primary and community care. Additionally, concrete examples tailored to the Spanish context are presented. Given the nascent state of the use of the Dissemination and Implementation Science in Spain, the authors recommend strategically adopting this approach and its principles in primary and community care to expedite the adoption of effective interventions that promote health.</p></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0212656724002191/pdfft?md5=9505a31d5cf5df2cc06e0317cf20d52a&pid=1-s2.0-S0212656724002191-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142167438","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}