Primary health care research & development最新文献

{"title":"Healthy ageing in long-term care? Lessons learned from the COVID-19 pandemic: a position paper.","authors":"Frode F Jacobsen, Stinne Glasdam, Heidi Haukelien, Maria E T C van den Muijsenbergh, Gudmund Ågotnes","doi":"10.1017/S1463423624000598","DOIUrl":"https://doi.org/10.1017/S1463423624000598","url":null,"abstract":"<p><strong>Aim: </strong>This position paper focuses on healthy ageing for the frailest and institutionalized older adults in the context of the recent pandemic. The paper aims to identify and discuss hindering and promoting factors for healthy ageing in this context, taking both health safety and a meaningful social life into account, in a pandemic situation and beyond.</p><p><strong>Background: </strong>The recent COVID-19 pandemic has highlighted the vulnerability of frail older adults residing in long-term care institutions. This is a segment of the older population that does not seem to align well with the recent policy trend of healthy and active ageing. The need for healthy ageing in this population has been voiced by professionals and interest organizations alike, alluding to inadequate support systems during the pandemic, conditioned by both previous and newly emerging contextual factors. Supporting healthy ageing in older adults in nursing homes and other residential care settings calls for attending to meaningful social life as well as to disease control.</p><p><strong>Methods: </strong>Findings and early conclusions leading up to the position paper were presented with peer discussions involving healthcare professionals and researchers at two joint EFPC PRIMORE workshops 2021 and 2022, as well as other international research seminars on long-term care. The following aspects of long-term care and COVID-19 were systematically discussed in those events, with reference to relevant research literature: 1. Long-term care policies, 2. pre-COVID state of long-term care facilities and vulnerability to the pandemic, 3. factors influencing the extent of spread of infection in long-term care facilities, and 4. the challenge of balancing between strict measures for infection control and maintaining a meaningful social life for residents and their significant others.</p><p><strong>Findings: </strong>A policy shift towards ageing at home and supporting the healthiest of older adults seems to have had unwarranted effects both for frail older adults, their significant others, and professional care staff attending to their needs. Resulting insufficient investment in primary health care staff and in the built environment for frail older adults in nursing homes were detrimental both for the older adults living in nursing homes, their significant others, and staff. More investment in staff and in physical surroundings might improve the quality of care and the social life of older adults in nursing homes in a non-pandemic situation and be a resource for primary health care staff ensuring both protection from health hazards and a meaningful social life for frail older adults in a pandemic or epidemic situation. As for investing in the physical surroundings, smaller nursing homes are advantageous, with singular resident rooms and for developing out-and indoor spaces for socializing and for meeting with families and other visitors. Regarding investment in staf","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e66"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752606","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":"Early structured communication between general practitioner, sick-listed patient, and employer: Results and lessons learned from a pragmatic trial in the Capacity Note project.","authors":"Paula Nordling, Chioma Nwaru, Lena Nordeman, Ingmarie Skoglund, Maria E H Larsson, Cecilia Björkelund, Gunnel Hensing","doi":"10.1017/S1463423624000574","DOIUrl":"https://doi.org/10.1017/S1463423624000574","url":null,"abstract":"<p><strong>Background and objective: </strong>Early and collaborative interventions are desirable to prevent long-term sick leave and promote sustainable return-to-work (RTW). The aim of this study was to evaluate if the use of the Capacity Note - a brief intervention promoting early and structured communication between general practitioners (GPs), patients, and employers - had an impact on length of sick leave in patients with common mental disorders (CMDs) in primary healthcare.</p><p><strong>Method: </strong>In a pragmatic trial, GPs at eight primary healthcare centres were randomized to provide the intervention or control and recruited eligible patients: employed women and men, 18-64 years, who visited a GP due to CMD and became or were (<4 months) full- or part-time sick-listed. Patients in the intervention group (n=28) used the Capacity Note in addition to usual care. Patients in the control group (n=28) received usual care. Outcomes of interest were time until full RTW, sick leave status at end of follow-up (17 months), number of sick leave episodes during follow-up, and number of sick leave days at 6, 12, and 17 months of follow-up.</p><p><strong>Results: </strong>The proportion of patients with full RTW at the end of follow-up was 79.2% in the intervention group and 84.6% in the control group. Time until full RTW was 102 and 90 days (median) in intervention and control group, respectively. We found no statistically significant differences between the groups for any of the outcomes.</p><p><strong>Discussion: </strong>Despite efforts to increase the number of participants, the study ended up with a small sample. This prohibited us from drawing any final conclusions about the effect of the intervention. Obstacles to recruitment of patients and use of the intervention are discussed.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e64"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741425","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 impact of COVID-19 on referrals among general practitioners and specialists in Shanghai, China.","authors":"Zhongqing Xu, Jingchun Fan, Dandan Shi, Jingjing Ding, Jun Zhou, Xianzhen Feng, Brett D Hambly, Kun Tao, Shisan Bao","doi":"10.1017/S1463423624000525","DOIUrl":"https://doi.org/10.1017/S1463423624000525","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has impacted patient's visits to general practitioners (GPs). However, it is unclear what the impact of COVID-19 has been on the interaction among the local primary care clinics, the GP Department within the hospital and specialists.</p><p><strong>Methods: </strong>The interaction among GPs referring to hospital-based specialists and specialists to local doctors was determined, comparing pre-pandemic 2019 and 2020 during the pandemic.</p><p><strong>Results: </strong>Reduced referrals from GPs to specialists were consistent with the reduction in specialist referrals back to the local doctors, which dropped by approximately 50% in 2020, particularly in the two most common chronic conditions (hypertension and diabetes mellitus).</p><p><strong>Discussion: </strong>Reduced referral of patients from local clinics to Tongren Hospital is probably due to the extensive online training provided to the local GPs to become more competent in handling local patients via telehealth. Our data provide some insight to assist in combatting the pandemic of COVID-19, offering objective evidence of the impact of COVID-19 on patient management by GPs.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e63"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677739","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 unrevealed links: periodontal health, human milk composition, and infant gut microbiome dynamics.","authors":"Rana Badewy, Michael Glogauer, Kristin L Connor, Michael Sgro, Jim Yuan Lai, Richard P Bazinet, Howard C Tenenbaum, Amir Azarpazhooh","doi":"10.1017/S1463423624000215","DOIUrl":"https://doi.org/10.1017/S1463423624000215","url":null,"abstract":"<p><strong>Aim: </strong>This review aims to identify the mechanistic relationships related to periodontal diseases and its possible association with changes in human milk composition and the composition and function of infants' gut microbiome.</p><p><strong>Background: </strong>Maternal health conditions, especially inflammatory, are associated with altered human milk composition. It is <i>not</i> known whether maternal oral inflammatory diseases, including periodontal diseases, deleteriously affect human milk composition.</p><p><strong>Methods: </strong>A narrative review was conducted according to SANRA, the Scale for the Assessment of Narrative Review Articles, guidelines. PubMed, Google Scholar, and Cochrane database of systematic reviews were searched from September 2019 up to December 2023 using keywords such as breast/human milk, maternal health/infections, and periodontal diseases. Reference lists of relevant articles were also screened. Our primary outcome of interest was human milk composition (i.e., any changes in macronutrients, immunological components, etc.). Secondary outcomes included changes in human milk microbiome and subsequent changes in the infant gut microbiome. Outcomes were synthesized using a narrative approach where the existing evidence and current literature were summarized. No risk of bias assessment of the studies was performed in this review.</p><p><strong>Findings: </strong>The search yielded no studies investigating the relationship between periodontal diseases in nursing mothers and changes in human milk composition. However, a dose-response relationship exists between the severity of periodontal diseases and the risk of adverse pregnancy outcomes such as preterm birth. Mastitis and diabetes affected milk lipids. Immunoglobulin A (sIgA) was increased in mastitis, whereas reduced concentrations were reported in diabetes. Potential biological pathways through which periodontal diseases can negatively affect human milk composition include the systemic dissemination of inflammatory cytokines like IL-6, PGE2, and tumor necrosis factor (TNF)-β that can be up-regulated by bacterial by-products. This biological plausibility needs to be investigated, given the potentially negative impact on the quality of human milk that could be caused by periodontal inflammation.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e62"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633505","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":"Primary healthcare as a strategy for eliminating hepatitis C: the METRIC toolkit.","authors":"Ricardo Baptista-Leite, Henrique Lopes, Diogo Franco, Timo Clemens, Helmut Brand","doi":"10.1017/S1463423624000355","DOIUrl":"10.1017/S1463423624000355","url":null,"abstract":"<p><strong>Aim: </strong>This paper presents the development of the METRIC toolkit, aimed at enhancing primary healthcare interventions in the context of hepatitis C control, thus contributing to the World Health Organization's global strategy to achieve the elimination of the disease by 2030.</p><p><strong>Background: </strong>At the global level, most people living with hepatitis C are unaware of their condition. As such, the eradication of hepatitis C necessitates comprehensive strategies within primary healthcare settings, as it provides an opportunity to reach the general population, facilitates the identification of potential patients who may be unfamiliar with hepatitis C, and guides them toward adequate care. Herein, we propose the METRIC toolkit as a means to optimize the efficiency and efficacy of healthcare services dedicated to hepatitis C control.</p><p><strong>Methods: </strong>The development of the METRIC toolkit was guided by a thorough review of pertinent literature, focusing on primary healthcare interventions in hepatitis C control. Key components were identified, encompassing systematic problem identification, solution formulation, outcome evaluation, and feedback integration.</p><p><strong>Findings: </strong>The METRIC toolkit represents a valuable resource for strengthening primary healthcare interventions in hepatitis C control. By fostering a culture of continuous improvement and data-driven decision-making, this framework holds promise in advancing the global agenda towards hepatitis C elimination. However, its successful application requires careful consideration of contextual factors and ongoing adaptation to local needs and circumstances.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e61"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592069","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":"The current state of primary healthcare in Pakistan: a way forward for low-to-middle income countries.","authors":"Syed Hassan Ahmed, Maha Zahid, Summaiyya Waseem, Amna Zafar, Taha Gul Shaikh, Taha Sabri, Ainan Arshad","doi":"10.1017/S1463423624000549","DOIUrl":"10.1017/S1463423624000549","url":null,"abstract":"<p><strong>Background: </strong>Primary healthcare (PHC) plays a crucial role in improving health outcomes and reducing healthcare burden, especially in low-to-middle-income countries (LMICs). However, PHC has not received adequate attention in Pakistan despite its recognized importance. This study aims to examine the current state of PHC in Pakistan, identifying factors compromising its quality and effectiveness.</p><p><strong>Methods: </strong>To find relevant data, the authors conducted a thorough literature search on PubMed, Google Scholar, and Cochrane Library from inception till 2 July 2022, without any language restriction. The following keywords were employed during the literature search, separated by Boolean operators AND, OR: \"Primary Healthcare\", \"PHC\", \"Healthcare primary\", \"Primary Health\", and \"Pakistan\".</p><p><strong>Results: </strong>Pakistan's PHC infrastructure shows promise, with a considerable number of healthcare facilities in place. However, various factors hinder its effectiveness and compromise the quality of care provided. Insufficient investment, resource constraints, inadequate training of healthcare providers, lack of oversight, and limited access to essential medicines and equipment are some of the key challenges observed. Improving PHC in Pakistan is vital for addressing the population's healthcare needs, particularly in rural areas. Adequate investment, enhanced training programs, improved oversight mechanisms, and increased availability of essential resources are necessary to strengthen the PHC system. By prioritizing PHC and addressing the identified challenges, Pakistan can enhance healthcare access, reduce healthcare burden, and improve overall health outcomes for its population.</p><p><strong>Conclusion: </strong>It is high time LMICs like Pakistan recognize PHC as the most economically feasible pathway toward accomplishing healthcare targets and adopt adequate measures to elevate its standards.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e59"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549433","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":"Ecological system theory and school-age obesity in Thailand: a participation action research for implications to practice.","authors":"Pennapa R Suwannawong, Naruemon Auemaneekul, Arpaporn Powwattana, Rewadee Chongsuwat","doi":"10.1017/S1463423624000501","DOIUrl":"10.1017/S1463423624000501","url":null,"abstract":"<p><strong>Objective: </strong>Developing an appropriate context-based school-age obesity prevention programme, understanding the root causes of obesity in real-life situations is vital. The objectives of this study were to explore the risk factors of school-age obesity based on Ecological System Theory (EST) and develop mutual problem-solving guidelines for school-age obesity prevention.</p><p><strong>Methods: </strong>Participation Action Research (PAR) was used as the study design. The data collection employed focus group discussions, in-depth interviews, participant's observations, together with the procedures of Appreciation, Influence, and Control (AIC) with 55 school key informants.</p><p><strong>Results: </strong>Risk factors supported by EST at all level included high-calorie intake; sedentary lifestyles; perceptions of 'Chubby are cute'; indulgent parenting, including limited exercise area in school. PAR process guarantees the sustained context-based prevention guidelines.</p><p><strong>Conclusions: </strong>The results could be used as a policy-driven for school-based participation and environmental support in order to promote health-promoting school.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e60"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549432","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":"Clinical psychologists' perceptions of telephone consultation for low-income patients during the COVID-19 pandemic: an interview study.","authors":"Ségolène Payan, Pablo G Barbosa Bergami, Xanthie Vlachopoulou, Pascale Baligand, Jean-Christophe Peronnet, Marion Robin, Aziz Essadek","doi":"10.1017/S1463423624000495","DOIUrl":"10.1017/S1463423624000495","url":null,"abstract":"<p><strong>Aims: </strong>We will examine the processes of change in psychological practice that have been altered by the lockdown.</p><p><strong>Background: </strong>During the COVID-19 pandemic, low-income populations, notably residents of social homes or shelters, were shown to be particularly susceptible to contagion. During lockdown, telephone-based psychological consultations became the norm.</p><p><strong>Methods: </strong>In this qualitative research, we carried out semi-structured interviews with 10 psychologists working in social homes or shelters. Interviews were transcribed verbatim. Data were studied using consensus qualitative research.</p><p><strong>Findings: </strong>During lockdown, participants felt that isolation increased while medical and social support decreased. Psychologists had to adapt their work methods and work more closely with on-site staffs. After lockdown, there was an increase in mental health issues. Participants perceived that telephone consulting seemed to facilitate access to psychological help. Although psychologists have quickly adapted, a decrease in the quality of clinical work was a general assessment. Results stress the necessity to train French psychologists in telemental health practices.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e58"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549431","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":"Pursuing the efficient operation of the primary healthcare hospitals in Thailand through efficiency assessment using the data envelopment analysis method.","authors":"Siripattra Juthamanee, Aimutcha Wattanaburanon, Yuvadee Rodjarkpai, Saowanee Thongnopakun, Winai Puttakul","doi":"10.1017/S1463423624000513","DOIUrl":"10.1017/S1463423624000513","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to assess the operational efficiency of Sub-District or Tambon Health Promoting Hospitals (THPHs) in Thailand's Eastern Economic Corridor (EEC) and to propose management guidelines for future improvements.</p><p><strong>Background: </strong>The current state of Thailand's public health demonstrates that government policy has prioritized equal access to public health services in all areas. This increases the need for primary public health services, yet resources are limited and cannot be increased to meet the growing demand. The only effective way to address this issue is to develop the efficiency of public health operations.</p><p><strong>Methods: </strong>The sample consisted of 104 THPHs in Chachoengsao, a province in Thailand's EEC. Data for five input and seven output variables were collected between September 18 and November 15, 2023. An online survey was conducted to gather the required data for fiscal year 2022. Data envelopment analysis was used to measure the efficiency of THPHs.</p><p><strong>Findings: </strong>The average efficiency index of the 104 THPHs was 0.9066, with about 60% having an efficiency index of 1.00. When classified by size, it was found that the efficiency levels of the THPHs grew with size, considering that the average efficiency index of the small, medium, and large THPHs was 0.8642, 0.9140, and 0.9417, respectively. The proportion of efficient THPHs also increased with size, at 58.14%, 60.00%, and 66.67%, respectively. Regarding efficiency improvement targets, small THPHs had the highest output targets (28.40%), followed by medium THPHs (15.31%) and large THPHs (9.91%). For the inefficient THPHs, some management guidelines were made to improve their future performances.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e57"},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523812","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":"A model proposal for qualitative data analysis, interpretation, and reporting: contextuality, reflectivity, and narrativity.","authors":"Mehmet Ali Gülpınar","doi":"10.1017/S1463423624000562","DOIUrl":"10.1017/S1463423624000562","url":null,"abstract":"<p><strong>Rationale: </strong>From education to healthcare and management processes, it is important to address the experience in health within its own complexity, context, and uniqueness. At this point, qualitative studies come to the fore and this increases the need for practical guides and models for qualitative studies. Qualitative studies have a paradigm that is different from quantitative research and its paradigm ontologically, epistemologically, and methodologically. These differences are reflected in the design of the research as well as the analysis, interpretation, and reporting of qualitative data. From such a point of view, this paper first briefly outlines the design process of qualitative studies and then proposes a model for the analysis, interpretation, and reporting of qualitative data.</p><p><strong>Conceptual/theoretical framework: </strong>The three core concepts of the model are 'contextuality', 'reflectivity', and 'narrativity'. Such a conceptual/theoretical framework transforms qualitative data analysis, interpretation, and reporting processes into processes that are carried out with a reflective approach within their specific contexts.</p><p><strong>Model: </strong>Taking this into account, by considering a contextual, reflective, and narrative approach, two frameworks, namely, the 'Contextual (Multiple) Reading and Analysis Framework' consisting of three stages and seven steps, and the 'Contextual Understanding, Interpretation and Reporting Framework' consisting of four stages, were developed. This provides a practical guide to contextual and reflective data analysis, interpretation, and reporting for the use of those conducting qualitative studies.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e55"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514326","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}