Primary health care research & development最新文献

{"title":"Diagnostic process of cancer in a health system without gatekeeping: a single centre survey analysis.","authors":"Ayşenur Duman Dilbaz, Saliha Serap Çifçili","doi":"10.1017/S146342362400029X","DOIUrl":"https://doi.org/10.1017/S146342362400029X","url":null,"abstract":"<p><strong>Introduction: </strong>It is essential to increase the rates of early diagnosis in cancer control, and the diagnostic process needs to be improved to achieve this goal. Previous studies showed that in countries where there is a gatekeeping system, there might be a delay in cancer diagnosis. Our aim is to examine the process of cancer diagnosis in a healthcare system without gatekeeping.</p><p><strong>Method: </strong>A quantitative descriptive study has been conducted in various outpatient clinics of Pendik Training and Research Hospital, between 1 February and 31 May 2019, with individuals aged over 18 and diagnosed with cancer in the last six months. The data was collected through a questionnaire filled in by face-to-face interview method. Patient's socio-economic characteristics, their symptoms at the time of the diagnosis and the diagnosis process were questioned.</p><p><strong>Result: </strong>The median diagnostic interval was 30 days (min-max 1-365), and the median patient interval was 60 (1-600) days. Patients pointed out that the diagnostic tests, especially the pathology reporting process, caused the diagnostic interval to be prolonged. Of the patients, 84% (<i>n</i> 135) stated that they did not consider their symptoms as a sign of serious illness. The patient interval was shortest with symptoms of haematuria and haematochezia and longest with dysuria and change in bladder habit.</p><p><strong>Discussion: </strong>The study examined the diagnosis process in our health system, where patients can apply for health services at any stage. The results showed that there were no superior outcomes to those observed in primary care-led health systems. Patients reported that waiting times for medical tests led to prolongation of the diagnosis time. Cancer awareness of patients should also be increased to shorten patient admission times.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e47"},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482660","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":"Reporting study results in primary health care: the CRISP guidelines.","authors":"William R Phillips, Elizabeth A Sturgiss, Sally Kendall, Mehmet Akman","doi":"10.1017/S1463423624000458","DOIUrl":"10.1017/S1463423624000458","url":null,"abstract":"","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e52"},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482666","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":"Exploring health worker absenteeism at public healthcare facilities in Chhattisgarh, India.","authors":"Priyanka Kerketta, Karthika Maniyara, Edukondal Palle, Prakash Babu Kodali","doi":"10.1017/S1463423624000343","DOIUrl":"10.1017/S1463423624000343","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to assess the health worker absenteeism and factors associated with it in a high-focus district in Chhattisgarh, India.</p><p><strong>Background: </strong>Human resources for health are among the key foundations to build resilient healthcare systems. Chhattisgarh is a high-focus Indian state with a severe shortage of health care workers, and absenteeism further aggravates the shortage.</p><p><strong>Methods: </strong>This study was conducted as a mixed-methods study employing sequential explanatory design. Absenteeism was defined as the absence of health worker in the designated position without a formal leave or official reason in two different unannounced visits. A facility survey across all the public healthcare facilities in Jashpur district, Chhattisgarh, was conducted through random, unannounced visits employing a checklist developed based on Indian Public Health Standards. Twelve participants were purposively sampled and interviewed from healthcare facilities to explore factors associated with absenteeism. Survey data were analysed descriptively, and thematic analysis was employed to analyse qualitative interviews.</p><p><strong>Findings: </strong>Among all the positions filled at primary health centre level (<i>n</i> = 339), close to 8% (<i>n</i> = 27) were absent, whereas among the positions filled at community health centre level (<i>n</i> = 285), only 1.14% (<i>n</i> = 4) were absent. Absenteeism was not found in the district hospital. Qualitative interviews reveal that macro-level (geographical location and lack of connectivity), meso-level (lack of equipment and amenities, makeshift health facilities, doctor shortage, and poor patient turnover), and micro-level (unmet expectations) factors contribute to health worker absenteeism.</p><p><strong>Conclusion: </strong>Health worker absenteeism was more at PHC level. Systemic challenges, human resource shortages, and infrastructural shortcomings contributed to health worker absenteeism.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e44"},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482665","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":"Social prescription for the elderly: a community-based scoping review.","authors":"Rute Sadio, Adriana Henriques, Paulo Nogueira, Andreia Costa","doi":"10.1017/S1463423624000410","DOIUrl":"10.1017/S1463423624000410","url":null,"abstract":"<p><strong>Aim: </strong>This scoping review aimed to identify the social prescription activities that exist for the elderly in a community context.</p><p><strong>Background: </strong>The increase in population ageing imposes the need to implement specific actions that guarantee elderly people the possibility of experiencing this phase with quality. The pandemic significantly exacerbated the needs of the elderly, leading to, regarding the loss of functional capacity, quality of life, well-being, mental health, and increased loneliness. Social prescription emerges as an innovative and non-clinical strategy, being a personalized approach that focuses on individual needs and objectives (Islam, ). By referring primary health care users to resources available in the community, obtaining non-medical support that can be used in conjunction with, or instead of, existing medical treatments (Chng <i>et al.</i>, ).</p><p><strong>Methods: </strong>A scoping review was conducted based on preferred reporting items for systematic reviews and meta-analyses, extension for scoping reviews (PRISMA-ScR). Searches were performed in electronic databases for potential studies: Scopus, PubMed, Medline, and Psychology and Behavioral Sciences Collection. Studies were included if they: (1) addressed social prescription interventions; (2) were community based; and (3) included elderly participants. Data extraction followed predefined criteria.</p><p><strong>Findings: </strong>Of a total of 865 articles identified, nine were selected. The social prescription activities identified fall into eight main domains: arts, personal development, social interaction, physical activity, gardening, cultural activities, religious activities, and technological activities. The interventions resulted in improved well-being, enhanced quality of life, health promotion, and reduced isolation and loneliness. Social prescription, while innovative, is still an evolving intervention, which can respond to the needs of the elderly population, given the range of activities that may exist in the community. Primary care professionals must develop these interventions, establish a link between health and the community, respond to these needs, and promote healthy ageing.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e46"},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482670","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":"Electronic referral system policy analysis: a qualitative study in the context of Iran.","authors":"Mohammad Javad Kabir, Alireza Heidari, Mohammad Reza Honarvar, Zahra Khatirnamani","doi":"10.1017/S1463423624000239","DOIUrl":"10.1017/S1463423624000239","url":null,"abstract":"<p><strong>Background: </strong>Referral system is among the key elements of primary health care that leads to enhanced efficiency, reduced costs, reduced waiting time, and patients' enhanced access to more specialized services. The present study was aimed at analysing the policies of the electronic referral (e-Referral) system in Iran.</p><p><strong>Methods: </strong>This qualitative study was conducted based on Walt and Gilson's policy triangle and Kingdon's models. Data were collected through document analysis and 51 semi-structured interviews with managers at various levels, experts, family physicians, specialist physicians, and patients. Document analysis was performed by content analysis method, and interview analysis was performed through framework analysis method in Atlas.ti 8.</p><p><strong>Results: </strong>The e-Referral system was launched with the aim of equitable access to services and to benefit from better management of health resources. Valid scientific evidences were used to formulate policies. Numerous meetings were held with domestic and foreign stakeholders at the provincial, city, and rural levels. The implementation of the programme followed a bottom-up approach, and the main obstacles to the implementation of the programme included the change of senior managers of the health system and their not being fully aware of the importance of the programme, inadequate allocation of financial resources, and unwillingness of some patients to follow the referral system.</p><p><strong>Conclusions: </strong>The policy triangle framework, while explaining the components of the e-Referral system programme, revealed the obstacles to the proper implementation of the programme. In order to ensure that the programme goes on continuously and successfully, it is essential to create the necessary determination and commitment on the part of the minister of health and medical education and senior managers of the health system, earmark resources for the programme, improve resource allocation with insurance management, reform the payment system, plan to raise public awareness, and attract community participation.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e45"},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482662","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":"Evaluating physical activities in clinical diabetes: lifestyle scores hypothesis.","authors":"Phillip Bwititi, Solomon Egwuenu, Echinei Oshionwu, John Okuzor, Alex Odufu, Charles Ofili, Ezekiel Uba Nwose","doi":"10.1017/S1463423624000434","DOIUrl":"https://doi.org/10.1017/S1463423624000434","url":null,"abstract":"<p><strong>Background: </strong>The concept of lifestyle-based risk scores is known but not evaluated in most rural communities of low- to mid-income countries. This study investigated the correlation of lifestyle scores with health indices.</p><p><strong>Methods: </strong>This was a descriptive cross-sectional investigation. A total of 203 participants (141 females and 62 males), 18-90 years, had anthropometric assessments and lifestyle scores determined from a 12-item framework. Data analysis included average age in different health conditions, lifestyle scores in age groups, and correlations with age.</p><p><strong>Results: </strong>Average age of healthy subpopulation was 39 years while diabetes, hypertension, and obesity subpopulations were 58, 64, and 56 years, respectively. The percentage of participants whose activities of daily living (ADL) were unaffected by ill-health decreased with age (<i>P</i> < 0.0001), and lifestyle scores also decreased with age (<i>P</i> < 0.01) and negatively correlated with physical activities.</p><p><strong>Conclusion: </strong>This report contributes to diabetes cardiovascular complications management. Sedentary ADL factors need integration in healthy lifestyle education especially among the elderly.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e50"},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482664","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":"Sexually transmitted infections in Belgian general practices: a nationwide continuing surveillance study, data from 2015 to 2020.","authors":"Sherihane Bensemmane, Sarah Moreels, Amaryl Lecompte, Wim Vanden Berghe, Robrecht De Schreye","doi":"10.1017/S1463423624000422","DOIUrl":"10.1017/S1463423624000422","url":null,"abstract":"<p><strong>Aim: </strong>The current study aims at describing sexually transmitted infections (STI) surveillance data collected from 2015 to 2020 as well as investigating patients' characteristics and risk factors in the sample population.</p><p><strong>Background: </strong>Reported STI cases are continuously increasing in Europe. In Belgium, 94.1% of citizens have a regular general practitioner (GP) or are affiliated to a general practice. By using GPs for surveillance, STIs can be monitored in the general population. Between January 2015 and December 2020, the Sentinel General Practitioners (SGP) network retrospectively reported five STIs: chlamydia, gonorrhoea, genital warts, herpes, and syphilis.</p><p><strong>Methods: </strong>In the SGP network database on STIs, participating GPs report on case-by-case basis through paper or online registration forms. We performed descriptive statistics, X² test and logistic regression using SAS^® 9.4. Multivariate multiple logistic regression was performed to investigate the relationship between STIs and patients' characteristics.</p><p><strong>Findings: </strong>During the study period, 1009 cases were reported, corresponding to an episode-based incidence estimated at 121 per 100,000 inhabitants. The majority of patients (59.8%) were men, and 83.6% were under age 30. Among female patients 92.7% had heterosexual contacts whereas 64.4% of male patients did. Women were more likely to be diagnosed with chlamydia (odds ratio [OR] 1.56; 95% confidence interval [CI] 1.12-2.17) and herpes (OR 1.72, 95% CI 1.04-2.86) than men.In this study, STI surveillance data were in agreement with literature. Continuous surveillance through the SGP network remains an important tool to obtain information about populations at risk and STI incidence in the general population.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e51"},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482667","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":"Effects of the WHO analgesic ladder on pain severity, pain interference, and blood pressure control in hypertensive patients with chronic musculoskeletal pain: a cross-sectional study.","authors":"Siwaluk Srikrajang, Narucha Komolsuradej, Sirawee Chaovalit, Chaiwat Chuaychoosakoon","doi":"10.1017/S1463423624000367","DOIUrl":"10.1017/S1463423624000367","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to investigate the effects of pain management according to the World Health Organization (WHO) analgesic ladder on pain severity, pain interference, and blood pressure (BP) in treated hypertensive patients with chronic musculoskeletal pain.</p><p><strong>Background: </strong>Pain management can affect BP control owing to the proposed mechanism by which persistent pain contributes to increased BP. However, there are inadequate studies investigating the benefit of pain management in controlling both pain and BP in hypertensive patients who have chronic pain.</p><p><strong>Methods: </strong>In this cross-sectional study, demographic data and pain characteristics (resting pain score on the numerical pain rating scale, pain severity, and pain interference subscale of the Brief Pain Inventory) were collected via face-to-face interviews. BP was measured thrice on the same day. Data on pain medications taken in the previous 1 month were retrieved from the medical records. Participants were categorized into three groups following pain management patterns according to the WHO analgesic ladder: no, partial, and complete treatment. Multivariate logistic regression analysis (MLRA) was used to analyse the association between the variables and uncontrolled BP.</p><p><strong>Findings: </strong>Among 210 participants, the mean (standard deviation) age was 68 (15.5) years, and 60.47% had uncontrolled BP. The resting pain score, pain severity, and pain interference subscale scores of the complete treatment group were significantly lower than that of the partial treatment group (<i>P</i> = 0.036, 0.026, and 0.044, respectively). The MLRA revealed that pain management patterns were associated with uncontrolled BP (adjusted odds ratio [AOR]: 6.75; 95% confidence interval [CI]: 2.71-16.78; <i>P</i> < 0.001) and resting pain scores (AOR: 1.17; 95% CI: 1.04-1.38; <i>P</i> = 0.048). Our findings suggest that pain management patterns adhering to the WHO analgesic ladder can reduce pain severity and pain interference and also control BP in hypertensive patients with chronic musculoskeletal pain.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e43"},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482661","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":"Translation and cultural adaptation of evidence-informed leaflets on the work-health interface: a pragmatic approach to cultural adaptation.","authors":"Pål André Amundsen, Martin Engedahl, Kim Burton, Ira Malmberg-Heimonen, Margreth Grotle, Robert Froud","doi":"10.1017/S1463423624000380","DOIUrl":"10.1017/S1463423624000380","url":null,"abstract":"<p><strong>Aim: </strong>Our aim was to translate and culturally adapt three evidence-informed leaflets on the work-health interface from English into Norwegian. Integral to this aim was the exploration of the quality and acceptability of each of the adapted leaflets to Norwegian-speaking stakeholders; general practitioners, people who deal with health issues in the workplace, and the general population.</p><p><strong>Background: </strong>Common health problems, such as musculoskeletal pain, account for most workdays lost and disability benefits in Norway. To facilitate return to work, it may be important to have access to evidence-informed information on the work-health interface for stakeholders involved in sickness absence processes. However, there is limited information material available in Norwegian that is tailored for the different stakeholders. Cultural adaptation is an emerging strategy for implementing health information across different populations and regions. Guidelines on cultural adaptation are not well-suited for translating and adapting evidence-informed health information material.</p><p><strong>Methods: </strong>We conducted a pragmatic cultural adaptation process informed by existing guidelines. Our conceptual framework for adaptation is situated between adaptation and translation and comprises appraisal, forward- and back-translation, review in multiple steps, sense checking, and re-designing using a transcreation approach. Using an online survey, we aimed to evaluate the overall quality, value, acceptability, and clarity of each of the adapted leaflets to a total of 30 end-users.</p><p><strong>Findings: </strong>We translated and culturally adapted three leaflets from English to Norwegian. Adapted leaflets were found to be clearly presented, acceptable, and valued by 45 Norwegian end-users. No differences in key concepts between original and back-translated leaflets emerged through the review process by the original author and forward translators. We used a pragmatic approach in this study that might be useful to others culturally adapting evidence-informed health information material.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e42"},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402295","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":"Analysis of high-risk human papillomavirus infections and cervical intraepithelial neoplasia: factors influencing awareness among women of childbearing age in southwest China.","authors":"Kexue Ning, Jing Gong, Xianghua Li, Lijuan He","doi":"10.1017/S1463423624000331","DOIUrl":"10.1017/S1463423624000331","url":null,"abstract":"<p><strong>Background: </strong>High-risk Human Papillomavirus (HPV) infections are a leading cause of cervical diseases among Han Chinese women of reproductive age. Despite studies like Mai <i>et al</i>. (2021) addressing HPV prevalence in Southern China, awareness remains low, especially in Southwest China. Our study addresses this gap.</p><p><strong>Objective: </strong>This hospital-based, retrospective study analyzes the prevalence of high-risk HPV and its association with cervical intraepithelial neoplasia (CIN) among Han Chinese women of reproductive age in Southwest China.</p><p><strong>Methods: </strong>Data were collected from 724 women undergoing routine health exams from December 2022 to April 2023. A total of 102 women with high-risk HPV infections were identified. A survey assessed HPV awareness, CIN incidence, and socio-demographic factors influencing awareness.</p><p><strong>Results: </strong>Of the 724 women, 102 (14.1%) were diagnosed with high-risk HPV, with HPV-16 being the most common subtype (22.5%). Awareness was significantly lower among unmarried women (OR: 6.632, <i>p</i> = 0.047), those with high school education or less (OR: 20.571, <i>p</i> = 0.003), and rural residents (OR: 19.483, <i>p</i> = 0.020). HPV-16 was detected in 54.55% of women with high-grade CIN.</p><p><strong>Conclusion: </strong>There is an urgent need for targeted education and HPV vaccination in Southwest China, particularly for women with lower education, rural residents, and older individuals. Subtype-specific strategies are essential for preventing and managing CIN.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"25 ","pages":"e41"},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382690","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}