Primary health care research & development最新文献

{"title":"From screening to prediction: rethinking malnutrition risk in primary care.","authors":"Pratyasha Saha, James Holmes, Charlotte Davies, Alison Smith, Kathryn Richardson, Jane Skinner, Helen Parretti, Alexander MacGregor, Ailsa Welch","doi":"10.1017/S1463423626101704","DOIUrl":"10.1017/S1463423626101704","url":null,"abstract":"<p><p>Despite more than 90% of cases arising in the community, malnutrition is under-recognised in UK primary care. Current screening tools such as the Malnutrition Universal Screening Tool identify malnutrition once it is already established and are inconsistently implemented. As a result, malnutrition is detected late, after functional decline and avoidable harm have already occurred. Our narrative review highlights that existing malnutrition prediction tools were largely developed in hospital populations, show variable accuracy, and have not been validated for community use. Emerging machine-learning models demonstrate feasibility but are similarly limited. We outline the urgent need for automated, data-driven prediction models drawing on routinely collected primary-care data - such as weight trajectories, comorbidities, medications, and biochemistry markers - to identify individuals at future risk of malnutrition. A proactive, electronic health record-embedded approach could shift practice from reactive diagnosis to early intervention, with the potential to improve outcomes and reduce inequalities.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e107"},"PeriodicalIF":1.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042614","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":"Implementing quality improvement for patients with high-risk chronic disease: lessons from the CONQUEST UK COPD programme.","authors":"David M G Halpin, James Gatenby, Katherine Hickman, John Hurst, Amy Couper, Andrew P Dickens, Alexander Evans, Alejandro Adan Coronado, Rachel Pullen, Luís Alves, Mona Bafadhel, Victoria Carter, Michael Crooks, Marc Miravitlles, Tamsin Morris, Hana Müllerová, Mukesh Singh, Jennifer K Quint, Dave Singh, Tom Wilkinson, Tonya Winders, David Price","doi":"10.1017/S1463423626101480","DOIUrl":"10.1017/S1463423626101480","url":null,"abstract":"<p><p>Large-scale quality improvement programmes (QIPs) have diverse factors that may influence their success and can undergo rapid changes throughout their lifecycle. The COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST) programme has recently been implemented in primary care practices in the UK. The CONQUEST programme aims to identify patients with already diagnosed and undiagnosed COPD at high risk of COPD-related adverse outcomes and optimize their management. CONQUEST has been successful in identifying COPD patients who may represent an outsized opportunity to improve patient outcomes and healthcare utilization, whilst focusing on relatively few patients per primary care practice. This paper reviews the steps involved in implementing CONQUEST in the UK, focussing on the challenges encountered, the solutions used to overcome these challenges barriers, and the lessons learned for the implementation of QIPs more widely. Key lessons from this process include that QIPs need to be designed with the flexibility to adapt to multiple and different local contexts, that early monitoring of data across the lifecycle of a QIP allows efficient detection of issues and troubleshooting, and that planning for allocation of limited resources to a QIP is essential for real-world implementation. The problems and solutions described here are applicable to QIPs in a wide variety of high-risk diseases and different healthcare settings.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e106"},"PeriodicalIF":1.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019205","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":"Barriers to good consultations in public primary healthcare clinics.","authors":"Vincent Setlhare, Sphiwe Madiba","doi":"10.1017/S1463423626101789","DOIUrl":"10.1017/S1463423626101789","url":null,"abstract":"<p><strong>Study aim: </strong>To explore the barriers to good consultations in government primary health care (PHC) clinics, in Botswana.</p><p><strong>Background: </strong>Good consultations improve adherence to treatment, treatment outcomes, and health seeking behaviour while bad consultations do the opposite. We explored the barriers to good consultations (doctor patient interactions) in public PHC clinics in Botswana. Knowledge of these barriers may help in crafting strategies to eliminate the barriers and improve health care.</p><p><strong>Methods: </strong>This was a descriptive qualitative study in which patients and doctors were interviewed. A semi structured interview guide was used to collect data, until data saturation. Public PHC clinics and participants were purposively selected to ensure variety in both. The data was analysed for themes, manually and using NVivo software.</p><p><strong>Findings: </strong>Barriers included patients' and doctors' negative behaviours and attitudes, inadequate time to conduct consultations, not having time to do physical examination of patients, and high patient volumes. Other barriers were drug and equipment shortages, lack of privacy, and communication barriers.</p><p><strong>Conclusion: </strong>Barriers to good consultations included health system level, doctor level, and patient level barriers. Thus, corrective interventions will need to target patient, doctor, and health system factors. These interventions should target improving doctors' and patients' behaviours and attitudes during consultations. Health system interventions should be directed at medicine and equipment shortages, as well alleviating the problem of high patient loads per doctor. Addressing communication barriers between patients and doctors should be part of the interventions to improve consultations and healthcare in public PHC clinics.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e103"},"PeriodicalIF":1.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993019","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":"Facilitators and barriers to implementing a digital health-supported, community pharmacy-based prediabetes management program (PRIME program) in Malaysia: a qualitative study of participants' and pharmacists' perspectives.","authors":"Kah Woon Teoh, Choon Ming Ng, Chun Wie Chong, Wing Loong Cheong, Shaun Wen Huey Lee","doi":"10.1017/S1463423626101765","DOIUrl":"10.1017/S1463423626101765","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to evaluate the facilitators and barriers to the implementation, adoption, and participation of these programs.</p><p><strong>Background: </strong>The Prediabetes Intervention, Management, and Evaluation (PRIME) program is an initiative that integrates digital health tools with community pharmacy services to encourage lifestyle behaviour changes among participants with prediabetes. While PRIME demonstrates effectiveness in clinical outcomes, the integration of such programs into community pharmacy services remains limited.</p><p><strong>Methods: </strong>In-depth focus group discussions and one-on-one interviews were conducted with participants and pharmacists who were involved in PRIME. The semi-structured interviews focused on the experiences and perceptions of the implementation of PRIME and its influence on behaviour change. All audio-recorded interviews were transcribed, coded, and analysed using thematic analysis techniques, leading to the development of major themes.</p><p><strong>Findings: </strong>Seven focus groups and twenty interviews were conducted among 37 participants and 10 pharmacists. Five themes were developed: 1) Intrinsic motivations towards better health; 2) Influence of rapport building; 3) Improved convenience to healthcare access; 4) Resource and support; and 5) Innovation with digital health. Key barriers were related to the use of digital health tools (technical difficulties, lacking engaging functionalities) and resources (workload management, availability of prediabetes-specific guidelines). The participants perceived the blended approach of in-person support with technology-assisted interventions in PRIME as an effective way to build healthier lifestyles. While community pharmacy-based prediabetes management programs like PRIME can be effective in driving healthier lifestyles, several barriers hinder their broader adoption. Addressing these barriers could enhance the implementation and uptake of these programs.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e104"},"PeriodicalIF":1.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992980","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":"A hybrid deep learning framework for early autism screening.","authors":"Hüseyin Ünözkan, Hüseyin Ali Sarıkaya","doi":"10.1017/S1463423626101698","DOIUrl":"10.1017/S1463423626101698","url":null,"abstract":"<p><strong>Objectives: </strong>Early diagnosis of autism spectrum disorder (ASD) remains a significant challenge due to the time-consuming and subjective nature of traditional diagnostic methods. This study proposes a reliability-oriented hybrid deep learning framework that provides a low-cost, scalable, non-invasive, and AI-assisted pre-screening tool for early ASD risk indication and referral support.</p><p><strong>Methods: </strong>The proposed system integrates two independent deep learning architectures: (1) a ResNet18 model optimized with 10-fold cross-validation using static periocular image data, and (2) a multi-CNN facial image classification ensemble combining ResNet50, EfficientNet-B0, and DenseNet121 architectures. The periocular pathway uses the fine-tuned ResNet18 fully connected softmax layer as its decision boundary. The facial pathway uses weighted probabilistic averaging, and the two subsystem outputs are subsequently combined through an OR-based reliability fusion rule. Additionally, explainable artificial intelligence (Grad-CAM) was employed to visualize decision-relevant regions.</p><p><strong>Results: </strong>The static periocular ResNet18 model achieved a sensitivity of 90%, while the multi-CNN facial classification ensemble reached a sensitivity of 87.1% and an AUC of 0.948. Under the conditional-independence assumption, OR-based reliability fusion yielded an analytically estimated system-level sensitivity of 0.9871, corresponding to a joint false-negative probability of approximately 1.29%.</p><p><strong>Conclusions: </strong>The developed hybrid model is positioned as an AI-assisted pre-screening and early-referral support tool, not as a replacement for clinical evaluation. By combining reliability-oriented parallel fusion with explainable AI, the system supports clinical transparency and offers a scalable pathway for early ASD risk indication.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e101"},"PeriodicalIF":1.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972044","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":"A qualitative study of provincial managers' perspectives on community health worker (CHW) and outreach team leader (OTL) training in South Africa: practices, systemic challenges, and strategic recommendations for strengthening primary health care.","authors":"Natisha Dukhi, Zainonisa Petersen, Allanise Cloete, Yolande Lisette Shean, Shandir Ramlagan, Adlai Davids, Rindidzani Magobo, Sizulu Moyo","doi":"10.1017/S1463423626101753","DOIUrl":"10.1017/S1463423626101753","url":null,"abstract":"<p><strong>Aim: </strong>This paper explores barriers and facilitators to training of community health workers (CHWs) and outreach team leaders (OTLs) in South Africa, from the perspectives of provincial managers.</p><p><strong>Background: </strong>Ward-based Primary Health Care Outreach Teams (WBPHCOTs), comprised of generalist CHWs, supervised by OTLs (nurses), are a central pillar of South Africa's primary health care system, increasingly playing a critical role in extending services to underserved communities. As their responsibilities expand, effective and well-resourced training is essential; however, training approaches remain uneven across provinces.</p><p><strong>Methods: </strong>Between July and August 2023, a descriptive exploratory qualitative study was conducted among 15 purposively selected provincial managers whose roles involved interfacing/engaging with CHW responsibilities across the country's eight provinces. Telephone interviews were audio-recorded, transcribed verbatim and thematically analysed using Atlas.ti 23.</p><p><strong>Findings: </strong>Three key themes emerged: (i) current training practices and implementation approaches; (ii) training challenges and systemic gaps; and (iii) strategies for strengthening CHW and OTL training. Training is undermined by varying educational backgrounds and literacy barriers between CHWs and OTLs, a shortage of master trainers, and systemic constraints, particularly the absence of a dedicated training budget, inaccessible updated training materials, and logistical issues, including limited internet access and transport.</p><p><strong>Conclusions: </strong>Findings highlight the need for standardised, updated training materials, practical skills training, and translation of resources into local languages. Formal mentorship programmes, leadership and communication training for OTLs, and a dedicated training budget would alleviate systemic constraints. Increasing master trainers and partnerships with external organisations, to transfer skills and build internal capacity can strengthen support for CHWs and OTLs, improving service delivery and health system outcomes.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e102"},"PeriodicalIF":1.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972277","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":"Self-reported physical activity in a randomized study from Norwegian Healthy Life Centres.","authors":"Martin Svege Iglebæk, Jardar Espeland, Eivind Meland, Thomas Mildestvedt","doi":"10.1017/S1463423626101686","DOIUrl":"10.1017/S1463423626101686","url":null,"abstract":"<p><strong>Aim: </strong>This study examines firstly if participation in a three-month intervention at Norwegian Healthy Life Centres (HLCs) improved self-reported physical activity (SR-PA), and secondly to what extent physical activity (PA) status at six months and changes from baseline were associated with demographic and motivational predictors.</p><p><strong>Background: </strong>Regular PA is promoted as a central component of public health initiatives aimed at preventing noncommunicable diseases.</p><p><strong>Methods: </strong>This randomized controlled trial included 118 participants (57 in the intervention group) recruited from HLCs in South-western Norway. The intervention effect was assessed by comparing the intervention group with the waiting-list control group after six months. We examined sociodemographic and motivational predictors of change combining both groups into a single cohort. This trial was registered at ClinicalTrials.gov (ID: NCT02247219).</p><p><strong>Findings: </strong>At six-month follow-up, participants in the intervention group reported higher levels of SR-PA compared with the control group. The estimated effect was modest (<i>B</i> = 0.26, 95% CI -0.01 to 0.53), equivalent to ≈0.37 SD. Although the confidence interval included zero, the estimate remained compatible with a modest positive effect. Autonomous motivation and social support were positively associated with SR-PA after 6 months, while psychological defiance showed a negative association. Autonomous motivation and psychological defiance impacted PA change during the 6-month period in opposite directions.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e100"},"PeriodicalIF":1.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932067","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":"Nutritional knowledge, dietary practices, and associated factors among pregnant women in Halaba town, central Ethiopia: a concurrent mixed-cross-sectional study design.","authors":"Fikremariam Endeshaw, Aynalem Belay, Abdulaziz Assefa, Ayele Sahile Abdo, Fentahun Tamene Zeleke, Haimanot Abebe Geletie, Eyob Tefera, Shimelis Tadesse Abebe, Wudit Wassu, Alemayehu Wondie, Daniel Tsega, Mangistu Abera","doi":"10.1017/S146342362610173X","DOIUrl":"10.1017/S146342362610173X","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy is a critical period when women are particularly vulnerable to nutritional deficiencies. However, limited evidence exists on nutritional knowledge, dietary practices, and associated factors among pregnant women in the study area.</p><p><strong>Aim: </strong>To assess nutritional knowledge, dietary practice, and associated factors among pregnant women in Halaba town.</p><p><strong>Methods: </strong>A concurrent mixed-methods cross-sectional study was conducted in Halaba Town from August 2 to November 25, 2025. Quantitative data were collected from 403 randomly selected pregnant women, while qualitative data were obtained from five FGDs with 35 purposively selected participants. Data were collected through face-to-face interviews and analyzed using descriptive and thematic analyses.</p><p><strong>Results: </strong>Of the 403 selected participants, 398 pregnant women completed the study, yielding a response rate of 97.7%. Half of the respondents (51%) had good nutritional knowledge, yet only 42.4% of pregnant women reported practicing healthy dietary behaviors. Educational status (AOR: 2.0; 95% CI: 1.3-4.2), pregnancy status (AOR: 2.3; 95% CI: 1.5-4.5), and nutritional information (AOR: 3.1; 95% CI: 1.5-4.9) were significantly associated with nutritional knowledge. Educational status (AOR: 1.9; 95% CI: 1.4-4.3), nutritional information (AOR: 3.9; 95% CI: 2.5-7.9), occupational status (AOR: 1.7; 95% CI: 1.3-4.1), and food security status (AOR: 1.9; 95% CI: 1.5-5.4) were significantly associated with dietary practices. Qualitative findings showed that cultural food taboos and economic constraints limited dietary diversity, while spousal support, shared decision-making, and home gardening promoted healthier dietary practices.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e99"},"PeriodicalIF":1.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932016","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":"Percutaneous image-guided pain procedures for low back pain in an Australian suburban primary care centre: findings from a retrospective single-year audit.","authors":"Jordan Lesicar, Joshua Tinnion, Nik Glynatsis, Yun-Hom Yau, Ian Whittle, Derek Yull","doi":"10.1017/S1463423626101741","DOIUrl":"10.1017/S1463423626101741","url":null,"abstract":"<p><strong>Aims: </strong>To describe the incidence, indications and outcomes of percutaneous image-guided pain procedures (PIGPPs) for low back pain (LBP) in an Australian suburban primary care centre.</p><p><strong>Background: </strong>PIGPPs are widely used in secondary and tertiary care for LBP but there is little information about their use in primary care.</p><p><strong>Methods: </strong>A retrospective audit in an Australian city suburban primary care centre, during 2022.</p><p><strong>Findings: </strong>Of 2828 patients coded with terms relating to LBP 673 had a consultation for LBP and 90 (13%: 95% CI 11-16%) had a PIGPP. These patients were significantly (<i>p</i> < 0.001) older and more likely (<i>p</i> < 0.001) to have chronic lower limb pain. Outcome documentation by GPs was high (87%: 95% CI 75-95%) but subjective. Future studies of PIGPPs for LBP in primary care should address deficiencies in objective patient assessment to facilitate evaluation of their appropriateness and both clinical and cost effectiveness.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e98"},"PeriodicalIF":1.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932033","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":"Child health behaviour screening in Primary Health Care: Nominal Group Technique workshops with Australian practitioners.","authors":"Dimity Dutch, Sarah C Hunter, Lucinda Bell, Alexandra C Manson, Elizabeth Denney-Wilson, Rebecca K Golley","doi":"10.1017/S1463423626101650","DOIUrl":"10.1017/S1463423626101650","url":null,"abstract":"<p><strong>Aim: </strong>Workshops with Primary Health Care (PHC) practitioners aimed to (1) identify and prioritise key features to include in a child health behaviour screening tool, and (2) understand prioritised supports needed to implement screening in PHC.</p><p><strong>Background: </strong>PHC is a key setting for monitoring and promoting child health behaviours including dietary intake, physical activity, sedentary behaviour and sleep. Screening tools to monitor children's health behaviours in PHC are needed.</p><p><strong>Methods: </strong>South Australian practitioners were recruited to participate in virtual workshops. The four-step Nominal Group Technique method was followed including individual brainstorming, round robin, group discussion, and voting. Collaborative recording of participant ideas and discussions, including workshop transcripts and live notes, enabled collection of qualitative quotes. Quantitative voting data were analysed to determine the relative importance of ideas.</p><p><strong>Findings: </strong>Nine workshops were facilitated with two practitioner groups: 1) General Practice and Allied Health (n = 21) and 2) Child and Family Health (n = 8) . Ten practitioner-generated features of a screening tool and 10 supports to facilitate implementation of a screening tool were identified. Top ranked features included <i>'Clear results and next steps'</i> and <i>'Question design and response format'</i>. <i>'Practitioner training'</i> and <i>'Practitioner resources'</i> were key supports for implementation. Consistent findings across practitioner groups demonstrate tool features and implementation strategies that are likely to be widely accepted. Unique findings demonstrate context specific tool features and implementation strategies. This study provides important insight to guide the development of an acceptable child health behaviour screening tool to facilitate a supportive prevention environment in PHC.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"27 ","pages":"e95"},"PeriodicalIF":1.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901728","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}