Gerontology最新文献

{"title":"Toward Senior-Friendly Hospitals: An Overview of Programs, Their Elements and Effectiveness in Improving Care.","authors":"Kira Scheerman, Julio R Klaverweide, Carel G M Meskers, Andrea B Maier","doi":"10.1159/000540655","DOIUrl":"10.1159/000540655","url":null,"abstract":"<p><strong>Background: </strong>Comprehensive \"senior-friendly hospital\" (SFH)-programs have been developed to counteract negative health outcomes in hospitalized older adults. The aim of this narrative review was to provide an overview of published SFH-programs and their elements and to summarize evidence of their effect on quality of care and patient satisfaction.</p><p><strong>Summary: </strong>A search of the databases Pubmed/Medline from inception to July 2023 and of governmental, regional, and hospital websites was performed. Programs were earmarked as SFH-programs if they primarily focused on the hospital setting, and comprised a hospital wide, multilevel approach and consisted of multiple elements. Articles and reports were included if participants were hospitalized and aged 60 years and older, and described the effect on quality of care or patient satisfaction. Articles focusing on specific patient groups or wards or on a health system or network were excluded. Ten SFH-programs were identified, with mutual elements like \"organizational support,\" \"social climate and services,\" \"processes of care,\" and \"physical environment.\" Only for the \"Acute Care for Elders\" program (USA), evidence was found showing positive effects on functional abilities, falls, delirium, length of stay, and patient satisfaction; effectiveness of other SFH-programs could not be found.</p><p><strong>Key message: </strong>Elements of SFH-programs may improve care for hospitalized older adults, but the evidence of their effectiveness is scarce.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1-12"},"PeriodicalIF":3.1,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased phagocytosis and intracellular killing of bacteria in leukocytes of geriatric patients with Clostridioides difficile infections.","authors":"Jana Seele,Kaya S Heinen,Volker Meier,Melissa Ballüer,Ellea Liedtke,Marija Djukic,Helmut Eiffert,Roland Nau","doi":"10.1159/000541244","DOIUrl":"https://doi.org/10.1159/000541244","url":null,"abstract":"INTRODUCTIONPatients suffering from a Clostridioides (C.) difficile infection have a higher overall mortality than patients with similar co-morbidities.METHODSWhole blood samples of 15 patients with C. difficile enteritis and 15 control patients matched for age and sex were used to analyse the capacity of blood phagocytes to internalize and kill encapsulated Escherichia (E.) coli. The median age of C. difficile patients and control patients was 81 and 82 years, respectively. Blood samples were co-incubated with E. coli for 15 or 30min. After 15min of co-incubation, extracellular bacteria were killed by gentamicin for 15-45 minutes. Then eukaryotic cells were lysed with distilled water, and the number of intracellular bacteria per ml whole blood was determined by quantitative plating on agar plates. Both groups were compared by Mann-Whitney U-test.RESULTSAfter 15 or 30min of co-incubation, blood phagocytes from patients with C. difficile enteritis showed a reduced density of phagocytosed or adherent bacteria in comparison to blood phagocytes from control patients (15min: p=0.046, 30min: p=0.005). The density of intracellular bacteria decreased less rapidly over time in the blood from C. difficile patients [median Δlog CFU/ml x h (25th/ 75th percentile) -0.893 (-1.893/ -0.554) versus -1.483 (-2.509/ -1.028); p=0.02]. In line with these results, the percentage of intracellularly killed bacteria was decreased in phagocytes from C. difficile-infected patients compared to controls (median intracellular killing rate 64.3% for blood phagocytes from C. difficile patients versus 81.9% for blood phagocytes from control patients within 30 min of co-incubation, p = 0.048).CONCLUSIONBlood phagocytes from patients with C. difficile enteritis exhibited a reduced capacity to phagocytose and kill bacteria in comparison to blood phagocytes from age- and sex-matched control patients. Patients with C. difficile infection may have a higher disposition to develop infectious diseases than age- and sex-matched control patients.","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"3 1","pages":"1-12"},"PeriodicalIF":3.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142250464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A SIMPLE FRAILTY INDEX PREDICTS IN-HOSPITAL MORTALITY.","authors":"Zvi Shimoni,Natan Dusseldorp,Yael Cohen,Izack Barnisan,Paul Froom","doi":"10.1159/000541397","DOIUrl":"https://doi.org/10.1159/000541397","url":null,"abstract":"INTRODUCTIONComparing frailty models in different settings that predict in-hospital mortality might modify patient disposition and treatment, but models are often complex.METHODSIn the following study we selected all acutely admitted adult patients in 2020- 2021 to the three internal medicine departments at a regional 400-bed hospital. We attempt to determine (a) if a new scale (Laniado-4 scale) that includes only three yes/no questions derived from the Norton scale and the presence of a urinary catheter performs as well as the graded Norton scale (including all five domains), in predicting in-hospital mortality and (b) to determine the predictive value of a simple frailty index that includes the new scale as well as categories of age, serum albumin, and creatinine values. We calculated odds ratios with 95% confidence intervals and c-statistics for the various models predicting in-hospital mortality.RESULTSThe mean patient age was 73±19 years, and 49.1% (5665/11542) were males. A Laniado-4 scale performed better than the Norton scale for predicting in-hospital mortality. A simple frailty index ranging from 0 to ≥8 points was associated with rates of in-hospital mortality that increased from 0 to 37.7%, with an odds ratio of 2.13(2.03-2.25) per 1 index point. The c-statistic was 0.887 (0.881-0.893).CONCLUSIONSWe conclude the Laniado-4 scale performed better than the Norton scale in predicting in-hospital mortality and that a simple frailty index that included the 4-question scale and categories of age, serum creatinine, and serum albumin performed as well or better than more complicated models.","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"2021 1","pages":"1-11"},"PeriodicalIF":3.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expecting Relocation to a Nursing Home: Longitudinal Links with Functional Limitations, Self-Rated Health, and Life Satisfaction.","authors":"Emmie A M Verspeek,Yvonne Brehmer,Joran Jongerling,Alexandra Hering,Manon A van Scheppingen","doi":"10.1159/000541336","DOIUrl":"https://doi.org/10.1159/000541336","url":null,"abstract":"INTRODUCTIONDeveloping realistic expectations of future old age constitutes an adaptational process which facilitates the anticipation of- and adjustment to challenges, such as relocation to a nursing home. Developing such expectations might minimize negative impacts of relocation. This pre-registered study examined (a) to which extent lower levels and declines in health (i.e., functional limitations and self-rated health) and life satisfaction before relocation were associated with higher levels and increases in expectations to relocate, and (b) to which extent higher expectations to relocate were associated with more positive changes in health and life satisfaction after relocation.METHODSUsing data from the Health and Retirement Study (HRS; 2006-2018), we selected older adults (aged 65 years and older) who relocated to a nursing home. We used latent growth curve models (LGMs) to assess the longitudinal links between self-reported measures of health, life satisfaction, and expectations to relocate to a nursing home from up to seven years before (n = 1,048) until up to five years after relocation (n = 307).RESULTSAs hypothesized, more functional limitations and lower self-rated health were related to higher expectations of relocation. Surprisingly, changes in expectations to relocate were not related to changes in health and life satisfaction before relocation. Moreover, expectations to relocate were not associated with changes in health and life satisfaction after relocation.CONCLUSIONThe absence of a link between expectations to relocate to a nursing home with changes in health and well-being suggests that these expectations did not constitute adaptational processes before or after this transition.","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":"24 1","pages":"1-19"},"PeriodicalIF":3.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of Average and Maximum Daily-Life Mobility Performance Using the Timed Up-and-Go: Exploring the Added Value of an Instrumented Timed Up-and-Go.","authors":"Patrick Heldmann, Alexander Elser, Franziska Kramer-Gmeiner, Carl-Philipp Jansen, Sabato Mellone, Michael Schwenk","doi":"10.1159/000535846","DOIUrl":"10.1159/000535846","url":null,"abstract":"<p><strong>Introduction: </strong>The association between specific motor capacity variables obtained in a laboratory and parameters of daily-life mobility performance (MP) obtained via wearables is still unclear. The Timed Up-and-Go (TUG) test is a widely used motor capacity tests available either as traditional hand-stopped TUG or as instrumented TUG (iTUG), providing specific information about its subphases. This study aimed to: (1) estimate the association between the TUG and specific parameters reflecting average and maximum daily-life MP, (2) estimate the benefits of the iTUG in terms of explaining MP in daily life compared to the TUG.</p><p><strong>Methods: </strong>The present study was a cross-sectional analysis using baseline data of 294 older persons (mean age: 76.7 ± 5.3 years). Univariate linear regression analysis was performed to delineate the coefficient of determination between TUG time and participants' MP. MP variables containing mean cadence (MCA) to represent average performance and the 95th percentile of mean cadence of walks with more than three steps (p95&gt;3stepsMCA) to represent maximum performance. To determine whether the iTUG variables give more information about MP, a stepwise multivariate regression analysis between iTUG variables and the p95&gt;3stepsMCA variable to represent maximum performance was conducted.</p><p><strong>Results: </strong>The univariate regression models revealed associations of the TUG with MCA (adjusted R2 = 0.078, p &lt; 0.001) and p95&gt;3stepsMCA (adjusted R2 = 0.199, p &lt; 0.001). The multivariate stepwise regression models revealed a total explanation of maximum daily-life MP (p95&gt;3stepsMCA) of the TUG (adjusted R2 = 0.199, p &lt; 0.001) versus iTUG (adjusted R2 = 0.278, p &lt; 0.010).</p><p><strong>Discussion/conclusion: </strong>This study shows that the TUG better reflects maximum daily-life MP than average daily-life MP. Moreover, we demonstrate the added value of the iTUG for a more accurate estimation of daily MP compared to the traditional TUG. The iTUG is recommended to estimate maximum daily-life MP in fall-prone older adults. The study is a step toward a specific assessment paradigm using capacity variables from the iTUG to estimate maximum daily-life MP.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"327-335"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138800657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Proteomic Signatures of Common Health Outcomes among Older Adults.","authors":"Jackson A Roberts, Sayantani Basu-Roy, Jong Shin, Vijay R Varma, Andrew Williamson, Chad Blackshear, Michael E Griswold, Julián Candia, Palchamy Elango, Ajoy C Karikkineth, Toshiko Tanaka, Luigi Ferrucci, Madhav Thambisetty","doi":"10.1159/000534753","DOIUrl":"10.1159/000534753","url":null,"abstract":"<p><strong>Introduction: </strong>In aging populations, the coexistence of multiple health comorbidities represents a significant challenge for clinicians and researchers. Leveraging advances in omics techniques to characterize these health conditions may provide insight into disease pathogenesis as well as reveal biomarkers for monitoring, prognostication, and diagnosis. Researchers have previously established the utility of big data approaches with respect to comprehensive health outcome measurements in younger populations, identifying protein markers that may provide significant health information with a single blood sample.</p><p><strong>Methods: </strong>Here, we employed a similar approach in two cohorts of older adults, the Baltimore Longitudinal Study of Aging (mean age = 76.12 years) and InCHIANTI Study (mean age = 66.05 years), examining the relationship between levels of serum proteins and 5 key health outcomes: kidney function, fasting glucose, physical activity, lean body mass, and percent body fat.</p><p><strong>Results: </strong>Correlations between proteins and health outcomes were primarily shared across both older adult cohorts. We further identified that most proteins associated with health outcomes in the older adult cohorts were not associated with the same outcomes in a prior study of a younger population. A subset of proteins, adiponectin, MIC-1, and NCAM-120, were associated with at least three health outcomes in both older adult cohorts but not in the previously published younger cohort, suggesting that they may represent plausible markers of general health in older adult populations.</p><p><strong>Conclusion: </strong>Taken together, these findings suggest that comprehensive protein health markers have utility in aging populations and are distinct from those identified in younger adults, indicating unique mechanisms of disease with aging.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"269-278"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining a Healthy Lifestyle as a Moderator of the Relationship between Psychological Distress and Cognitive Decline among Older Adults in the NuAge Study.","authors":"Danielle D'Amico, Udi Alter, Danielle Laurin, Guylaine Ferland, Alexandra J Fiocco","doi":"10.1159/000535978","DOIUrl":"10.1159/000535978","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to examine whether a healthy lifestyle composite score of social engagement, physical activity, and Mediterranean diet adherence moderates the association between psychological distress and global cognitive decline among cognitively healthy older adults (67+ years of age at baseline).</p><p><strong>Methods: </strong>A total of 1,272 cognitively intact older adults (Mage = 74.1 ± 4.1 years, 51.9% female) in the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge) completed a series of self-reported questionnaires to measure psychological distress and lifestyle behaviors, and the Modified Mini-Mental Examination (3MS) to assess cognitive performance at baseline and annually over 3 years.</p><p><strong>Results: </strong>Controlling for sociodemographic and health-related characteristics, greater psychological distress was associated with steeper cognitive decline over time among males (B = -0.07, 95% CI: [-0.12, -0.02]), but not females (B = 0.008, 95% CI: [0.03, 0.04]). Although a healthy lifestyle composite score did not statistically significantly moderate the distress-cognition relationship (B = -0.005, 95% CI: [-0.02, 0.01]), there was an association between higher psychological distress and greater cognitive decline at low levels of social engagement (B = -0.05, 95% CI: [-0.09, -0.006]), but not at high levels of social engagement (B = 0.02, 95% CI: [-0.03, 0.07]).</p><p><strong>Conclusion: </strong>This study suggests that the potentially harmful impact of stress on cognitive function may be malleable through specific healthy lifestyle behaviors and emphasizes the importance of taking a sex-based approach to cognitive aging research.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"418-428"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139734911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Effects and Impressions of Minimal Footwear in Older Adults.","authors":"Erin Futrell, Regina Kaufman, Julia Chevan","doi":"10.1159/000540957","DOIUrl":"10.1159/000540957","url":null,"abstract":"<p><strong>Introduction: </strong>Foot pathologies can lead to difficulty walking and falls in older adults. Intrinsic foot muscles contribute to the structural support and alignment of the foot and provide somatosensory input from the ground. Minimally cushioned footwear may naturally strengthen intrinsic foot muscles and enhance sensory input to the foot; however, these effects are largely unknown in older adults. Further, there is little evidence regarding the prescription of minimal footwear and the perceptions of this footwear by older adults.</p><p><strong>Methods: </strong>Twenty-four adults age ≥65 volunteered to use minimal footwear for prescribed times during daily activities for 16 weeks. The cross-sectional area (CSA) of 5 intrinsic foot muscles was measured using ultrasound imaging at baseline, 8 weeks, and 16 weeks. Semi-structured interviews were recorded regarding participants' impressions of the footwear, the progressive wear schedule, the footwear's effects on orthopedic-related pain, balance, and foot awareness/sensation.</p><p><strong>Results: </strong>Across the cohort, there was no significant difference in CSA of the 5 muscles after 16 weeks of minimal footwear use. Thirteen participants had clinically meaningful increased CSA of the abductor hallucis muscle (Abh). These positive responders had no significant differences in age, grip strength, foot structure, or fall risk scores compared to participants with little to no CSA change. Interview results indicated a generally positive experience with minimal footwear for 68.1% of the cohort. A large percentage of the cohort reported no difficulty with the progressive wear schedule (77.2%), no aggravation of preexisting conditions and no new pain (77.2%), improved balance (63.6%), and improved foot awareness/sensation (72.7%) with minimal footwear use. The progressive wear schedule was perceived as inconvenient by some in the first few weeks (22.8%), but resulted in mild to no adverse effects when followed as prescribed.</p><p><strong>Conclusion: </strong>Sixteen weeks of progressive minimal footwear use in older adults did not lead to changes in intrinsic foot muscle CSA; however, half of the cohort had clinically meaningful increased CSA in the Abh muscle. It is unclear what individual qualities were associated with this positive response. Older adults reported generally positive experiences with minimal footwear with self-reported improvements in balance and foot awareness/sensation. The wear schedule may have been too conservative or not long enough to produce foot muscle hypertrophy, but subjective reports suggest beneficial neuromuscular adaptations and sensory changes occurred. Future research may need a greater length of time and larger samples to further determine the effects of long-term minimal footwear use in older adults.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"1137-1147"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Subjective Age in Predicting Post-Hospitalization Outcomes of Older Adults.","authors":"Anna Zisberg, Nurit Gur-Yaish, Efrat Shadmi, Ksenya Shulyaev, Juliana Smichenko, Amos Rogozinski, Yuval Palgi","doi":"10.1159/000536364","DOIUrl":"10.1159/000536364","url":null,"abstract":"<p><strong>Introduction: </strong>Studies of community-dwelling older adults find subjective age affects health and functional outcomes. This study explored whether younger subjective age serves as a protective factor against hospital-associated physical, cognitive, and emotional decline, well-known consequences of hospitalization among the elderly.</p><p><strong>Methods: </strong>This study is a secondary data analysis of a subsample (N = 262; age: 77.5 ± 6.6 years) from the Hospitalization Process Effects on Mobility Outcomes and Recovery (HoPE-MOR) study. Psychological and physical subjective age, measured as participants' reports on the degree to which they felt older or younger than their chronological age, was assessed at the time of hospital admission. Independence in activities of daily living, life-space mobility, cognitive function, and depressive symptoms were assessed at hospital admission and 1 month post-discharge.</p><p><strong>Results: </strong>The odds of decline in cognitive status, functional status, and community mobility and the exacerbation of depressive symptoms were significantly lower in those reporting younger vs. older psychological subjective age (odds ratio [OR] = 0.68, 95% CI = 0.46-0.98; OR = 0.59, 95% CI = 0.36-0.98; OR = 0.64, 95% CI = 0.44-0.93; OR = 0.64, 95% CI = 0.43-0.96, respectively). Findings were significant after controlling for demographic, functional, cognitive, emotional, chronic, and acute health predictors. Physical subjective age was not significantly related to post-hospitalization outcomes.</p><p><strong>Conclusion: </strong>Psychological subjective age can identify older adults at risk for poor hospitalization outcomes and should be considered for preventive interventions.</p>","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"361-367"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11008723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139520463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.1159/000536266","DOIUrl":"10.1159/000536266","url":null,"abstract":"","PeriodicalId":12662,"journal":{"name":"Gerontology","volume":" ","pages":"336"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139520492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}