Innovation in Aging最新文献

{"title":"Associations Between Regional Supply and Integration of Home and Community-Based Service Providers and Risk of Institutionalization: Evidence From South Korea.","authors":"Sunghun Yun, Hongsoo Kim","doi":"10.1093/geroni/igaf007","DOIUrl":"10.1093/geroni/igaf007","url":null,"abstract":"<p><strong>Background and objectives: </strong>To examine whether the regional density of integrated home and community-based services (HCBS) providers affects long-term care (LTC) service utilization pattern and institutionalization risk in South Korea.</p><p><strong>Research design and methods: </strong>This observational study utilized data from the National Health Insurance Service (NHIS) on individuals aged 65 and older who became newly eligible for LTC insurance benefits in 2018. The final sample excluded individuals admitted to long-term care hospitals during the previous year or those living away from home, resulting in a total of 91,302 individuals included in the study. We analyzed the impact of regional HCBS and integrated care provider density on 4 outcomes: choice of HCBS over LTC facilities (LTCF) as first LTC service, intensity and comprehensiveness of HCBS use, and risk of institutionalization within a year.</p><p><strong>Results: </strong>Higher regional densities of integrated care providers are associated with increased odds of using HCBS as the first LTC service (odds ratio 1.066, model 1, <i>p</i> < .01). Increased density was also associated with higher odds of using multiple HCBS (Odds Ratio 1.108, model 1, <i>p</i> < .01). Additionally, higher density of integrated care providers was associated to decreased risk of institutionalization into LTC facilities (hazard ratio 0.98, model 1, <i>p</i> < .01).</p><p><strong>Discussion and implications: </strong>The density integrated care providers significantly reduce institutionalization rates, by increasing the possibility of choosing HCBS over LTCF as their first LTC service and using a more comprehensive combination of HCBS services. Further investment in integrated care models may enhance the effectiveness of LTC systems.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 3","pages":"igaf007"},"PeriodicalIF":4.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648413","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":"Latent Class Analysis Identifies Four Distinct Patient Deprescribing Typologies Among Older Adults in Four Countries.","authors":"Kristie Rebecca Weir, Vincent D Marshall, Sarah E Vordenberg","doi":"10.1093/geroni/igaf002","DOIUrl":"10.1093/geroni/igaf002","url":null,"abstract":"<p><strong>Background and objectives: </strong>Polypharmacy, the concurrent use of multiple medicines, is a growing concern among older adults and those with chronic conditions. Deprescribing through dose reduction or discontinuing selected medicines is a strategy for reducing medicine-related harm. The Patient Deprescribing Typology was developed using qualitative methods to describe the varying factors that are important to older adults when they consider deprescribing. The objective of this study was to use quantitative methods to define distinct classes of older adults via the Patient Deprescribing Typology.</p><p><strong>Research design and methods: </strong>This study used a cross-sectional experimental design in which data was collected via an online survey from participants 65 years and older in Australia, the Netherlands, the United Kingdom, and the United States. A latent class analysis was performed using the 4-item Patient Deprescribing Typology that collected data about the beliefs about the importance of medicines, how older adults learn about medicines, medicine decision-making preferences, and attitudes towards stopping medicines.</p><p><strong>Results: </strong>Older adults (<i>n</i> = 2,250) were a median of 70 years and 2-thirds reported that their highest level of education was an associate's degree or trade school or less. We identified 4 distinct Patient Deprescribing Typology classes: Class 1 \"Trusts their doctor\" (41.6%), Class 2 \"Makes own decisions\" (30.2%), Class 3 \"Avoids deprescribing\" (15.5%), and Class 4 'Medicines not important' (12.7%).</p><p><strong>Discussion and implications: </strong>Older adults report diverse perspectives about deprescribing, emphasizing the need for tailored communication strategies in clinical settings. Additional research is needed to examine older adults' preferences in real-world contexts to refine and improve deprescribing interventions.</p><p><strong>Clinical trial registration: </strong>NCT04676282.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 2","pages":"igaf002"},"PeriodicalIF":4.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500844","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":"Neighborhood Characteristics and Loneliness in Later Life: The Role of \"Person-Environment Fit\".","authors":"Jack Lam, Janeen Baxter","doi":"10.1093/geroni/igaf006","DOIUrl":"10.1093/geroni/igaf006","url":null,"abstract":"<p><strong>Background and objectives: </strong>There is increasing acknowledgment that loneliness is associated with neighborhood characteristics in addition to individual characteristics. We use four waves of geocoded data to examine longitudinal associations between neighborhood characteristics and loneliness of older adults.</p><p><strong>Research design and methods: </strong>We draw on \"person-environment fit\" theory, utilizing individual assessments of neighborhoods, while also creating aggregate assessments by combining responses from other respondents from the same geographic area to test associations with loneliness.</p><p><strong>Results: </strong>Random-effects models demonstrate that both individual and aggregate assessments of neighborhoods are related to loneliness, however, in models that include control variables, the associations between aggregate assessments of neighborhood and loneliness were attenuated. Fixed-effects models show only individual assessments of the neighborhood are associated with variations in loneliness.</p><p><strong>Discussion and implications: </strong>Consistent with the \"person-environment fit\" theory, loneliness appears more sensitive to individual assessments of the neighborhood, irrespective of others' assessments. Our findings point to the subjective nature of loneliness and suggest that measures to reduce loneliness should focus on understanding and addressing individual perceptions of neighborhoods, emphasizing the importance of promoting age-friendly environments.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 3","pages":"igaf006"},"PeriodicalIF":4.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585589","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":"Association of Dementia Severity at Diagnosis With Health Care Utilization and Costs Around the Time of Incident Diagnosis.","authors":"Shengjia Xu, Niloofar Fouladi Nashta, Yi Chen, Julie Zissimopoulos","doi":"10.1093/geroni/igaf005","DOIUrl":"10.1093/geroni/igaf005","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study provides the first analysis of heterogeneity in health care use and costs by level of dementia symptom severity around the time of incident dementia diagnosis for a population-representative sample of older Americans.</p><p><strong>Research design and methods: </strong>We used the Aging, Demographics, and Memory Study (ADAMS), the Health Retirement Study (HRS), and traditional Medicare (TM) claims. We modeled dementia severity measured by the Clinical Dementia Rating scale for ADAMS respondents and applied parameter estimates to HRS respondents older than 70 years who had a claims-based incident dementia diagnosis in 2000-2016. We used claims-based measures of health care costs and use and quantified levels in the quarters before, at, and after a dementia diagnosis. We reported separate results for groups of persons diagnosed at mild, moderate, and severe stages of dementia.</p><p><strong>Results: </strong>Health care use and costs increased a quarter before dementia diagnosis and increased most significantly in the quarter of diagnosis. Both use and costs declined thereafter but remained elevated relative to prediagnosis. This general pattern was consistent for persons diagnosed at different stages of dementia. Acute care costs were similar across dementia severity categories throughout the period, whereas outpatient use and costs were consistently higher among persons diagnosed at mild stage disease.</p><p><strong>Discussion and implications: </strong>Findings from this study provide new insights on how heterogeneity of dementia severity at diagnosis is associated with health care use and costs. Under the current system of care in TM, early dementia diagnosis may not substantially reduce health care use and spending around the time of dementia diagnosis.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 3","pages":"igaf005"},"PeriodicalIF":4.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648388","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":"Evaluation and Modification of the Multifactorial Model of Driving Safety Among Older Adults.","authors":"Junyan Tian, Jacqueline Mogle, Kaarin J Anstey, Lesley A Ross","doi":"10.1093/geroni/igae113","DOIUrl":"10.1093/geroni/igae113","url":null,"abstract":"<p><strong>Background and objectives: </strong>Cognitive, visual, and physical performance are associated with driving safety. However, there are few comprehensive models that empirically evaluate how such factors together affect driving safety in older adults. The present study used structural equation modeling (SEM) to evaluate Anstey's original Multifactorial Model of Driving Safety (MMDS) (2005) as well as a modified MMDS that incorporates recent research.</p><p><strong>Research design and methods: </strong>We used the baseline data from the Advanced Cognitive Training for Independent and Vital Elderly study. Participants (<i>n</i> = 2,391) were drivers with a reported mean age of 73.28 (<i>SD</i> = 5.70; range 65-91), 75.7% White, and 73.3% women.</p><p><strong>Results: </strong>Using SEM, Anstey's original MMDS did not achieve adequate fit (CFI = 0.850, TLI = 0.777, RMSEA = 0.074). However, the modified MMDS had a good fit (CFI = 0.961, TLI = 0.934, RMSEA = 0.040). We found that better physical function was correlated with less driving avoidance (β = 0.28, <i>p</i> < .01) and a lower crash risk (β = -0.14, <i>p</i> < .01). Better cognitive abilities were associated with less driving avoidance (β = 0.08, <i>p</i> <.01) and better self-reported driving quality (β = 0.19, <i>p</i> < .01). Driving avoidance partially mediated the relationship between physical function and crash.</p><p><strong>Discussion and implications: </strong>This study highlights the importance of cognition and physical function in older adults safe driving. Implications for future directions and public policy considerations are discussed. Future research should examine possible dynamic changes between these predictors and driving in a longitudinal model.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 2","pages":"igae113"},"PeriodicalIF":4.9,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440506","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":"Changes in Long-term Services and Supports Among Adults With and Without Dementia During the First Year of the COVID-19 Pandemic.","authors":"Yulya Truskinovsky, Vicki A Freedman, Geoffrey J Hoffman, Amanda N Leggett, Emily Wiemers","doi":"10.1093/geroni/igaf003","DOIUrl":"10.1093/geroni/igaf003","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study draws upon local coronavirus disease 2019 (COVID-19) mortality rates as a proxy for pandemic severity to determine if the COVID-19 pandemic disrupted long-term services and supports (LTSS) for adults with dementia, relative to adults with care needs unrelated to dementia.</p><p><strong>Research design and methods: </strong>We used the Health and Retirement Study to estimate associations between local COVID-19 mortality rates from March 2020 through April 2021 and LTSS outcomes (receiving paid and unpaid help, monthly hours of paid and unpaid help, number of paid and unpaid helpers, living in a residential care setting, or living with adult children). We compared 2 groups of adults ages 51 and older: those with dementia (<i>n</i> = 522) and those without dementia but having difficulty with at least one activity of daily living (<i>n</i> = 2,036).</p><p><strong>Results: </strong>We found that higher local COVID-19 mortality rates were associated with a reduction in paid care and living in residential care settings for both groups of adults with care needs. In addition, higher local COVID-19 mortality rates were associated with a greater likelihood of living with adult children among those without dementia and greater hours of unpaid help among those with dementia.</p><p><strong>Discussion and implications: </strong>Although we did not find differences in disruptions of LTSS between persons with and without dementia, observed declines in paid LTSS and increases in unpaid care in the first year of the pandemic may nevertheless have different implications for persons with dementia. Future research should investigate if COVID-19 related disruptions in LTSS led to differential changes in health and unmet needs among adults with dementia, increased strain for their caregivers, and the equitable availability of high-quality paid care.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 2","pages":"igaf003"},"PeriodicalIF":4.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440530","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":"How Neighborhood Social Deprivation Is Associated With Nursing Home Quality: A Structure, Process, Outcome Model.","authors":"Rohit Pradhan, Justin Lord, Gregory Orewa, Ganisher Davlyatov, Robert Weech-Maldonado","doi":"10.1093/geroni/igaf004","DOIUrl":"10.1093/geroni/igaf004","url":null,"abstract":"<p><strong>Background and objectives: </strong>Nursing home (NH) quality often varies across socioeconomic gradients. The purpose of this study was to explore the relationship between social deprivation and NH quality.</p><p><strong>Research design and methods: </strong>Integrating resource dependence theory with Donabedian's structure-process-outcome model, this study utilized 2019 data from Payroll Based Journal, Care Compare: Five-Star Quality Rating System, and LTCFocus.org. The analytic file included 12,900 free-standing NH observations. The primary variable of interest was severe social deprivation index (SDI) defined as SDI ≥85/100. Structural equation modeling was used to explore the effects of severe deprivation on NH structural (nursing staff), processes (antipsychotic medications [APMs]), and outcomes (falls, pressure ulcers, activities of daily living [ADL] decline, and hospitalizations) quality indicators among long-stay NH residents.</p><p><strong>Results: </strong>Nursing homes in communities with severe SDI showed a decrease of 0.02 registered nurse (RN) hours per resident day (PRD) (<i>p</i> < .001) and an increase of 0.03 certified nursing assistant (CNA) hours PRD (<i>p</i> = .01). Higher licensed practical nurse (LPN) hours PRD (β = -1.03; <i>p</i> = .003) and higher CNA hours PRD (β = -0.80; <i>p</i> < .001) were significantly associated with reduced APM use. Increased APM use was significantly associated with ADL decline (β = 0.03; <i>p</i> < .001) and hospitalizations (β = 0.001; <i>p</i> = .013). Severe SDI indirectly resulted in higher hospitalizations (β = 0.01; <i>p</i> = .01) and falls (β = 0.01; <i>p</i> = .001) through lower RN staffing but lower pressure ulcers (β = -0.07; <i>p</i> < .001) through higher CNA staffing. Directly, severe SDI increased pressure ulcers (β = 0.69; <i>p</i> < .001) and hospitalizations (β = 0.09; <i>p</i> < .001) and decreased falls (β = -0.53; <i>p</i> < .001).</p><p><strong>Discussion and implications: </strong>Severe social deprivation affected nursing staff patterns, affecting care quality. These findings highlight the importance of considering environmental factors in the NH quality policymaking process.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 2","pages":"igaf004"},"PeriodicalIF":4.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440678","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":"Advancing Innovation.","authors":"Michelle Putnam","doi":"10.1093/geroni/igae104","DOIUrl":"https://doi.org/10.1093/geroni/igae104","url":null,"abstract":"","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 1","pages":"igae104"},"PeriodicalIF":4.9,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948159","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":"The Effects of Risky Behaviors and Social Factors on the Frequency of Fraud Victimization Among Known Victims.","authors":"Marguerite DeLiema, Siyu Gao, Daniel Brannock, Lynn Langton","doi":"10.1093/geroni/igae111","DOIUrl":"10.1093/geroni/igae111","url":null,"abstract":"<p><strong>Background and objectives: </strong>Routine activity theory (RAT) asserts that a suitable target's exposure to a motivated offender in the absence of capable guardians increases their likelihood of crime victimization. We use these principles to assess the extent to which engaging in risky routine activities-for example, entering sweepstakes drawings, answering unknown calls-is associated with victimization frequency among older adult mass marketing fraud victims across five types of scams: investment fraud, sweepstakes and lottery fraud, romance and family/friend imposter scams, fake products and services, and charity scams. We also examine whether financial and social vulnerability characteristics (loneliness, preference for taking financial risks, financial fragility) are associated with victimization frequency in older adults.</p><p><strong>Research design and methods: </strong>A survey was administered to households that the U.S. Postal Inspection Service identified as having recently responded to one or more mail scam solicitations. Respondents answered questions on their behaviors, financial risk preferences, social and demographic characteristics, and number of past-year victimization experiences with 5 types of fraud.</p><p><strong>Results: </strong>As predicted based on RAT, routine activities that increase a target's exposure to motivated offenders are positively associated with fraud victimization frequency, although more frequent online activity was negatively associated with victimization frequency contrary to hypotheses. Precarious financial and emotional states such as financial fragility and loneliness also were associated with greater victimization frequency, and more frequent social engagement and living with others (the presence of capable guardians) had no effect.</p><p><strong>Discussion and implications: </strong>Target suitability factors such as loneliness, financial fragility, and risky financial preferences and behaviors are associated with a higher frequency of fraud victimization among older adults. Consumer education should include information on reducing risky behaviors that can increase fraud exposure. More frequent social engagement may not be protective. Older adults who are financially fragile and experiencing loneliness require more safeguards.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 2","pages":"igae111"},"PeriodicalIF":4.9,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399089","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":"Effectiveness of Robot Care Intervention and Maintenance for People with Dementia: A Systematic Review and Meta-Analysis.","authors":"Su-Jung Nam, Eun-Young Park","doi":"10.1093/geroni/igae110","DOIUrl":"10.1093/geroni/igae110","url":null,"abstract":"<p><strong>Background and objectives: </strong>Robots have the potential to improve the quality of life of people with dementia. This study examined the effectiveness of robot care intervention and maintenance effect for people with dementia.</p><p><strong>Research design and methods: </strong>Meta-analytical procedures were used to identify and synthesize articles for analysis. Coding procedures were used to record the moderators, including robot type, outcomes, intervention length, intervention duration, and intervention frequency. Hedge's <i>g</i> statistic was employed to interpret effect sizes and quantify individual research findings.</p><p><strong>Results: </strong>The literature review identified 20 eligible randomized controlled trials. Meta-analysis results indicated an overall small effect of <i>g</i> = 0.286 for robot care intervention and <i>g</i> = 0.279 for robot care maintenance. Outcomes for robot care intervention indicated a small and significant effect size at <i>g</i> >0.2, whereas the Bomy robot type had an insignificant effect size. Outcomes for robot care maintenance showed a medium and significant effect size.</p><p><strong>Discussion and implications: </strong>This study confirmed the intervention effect of robot care on people with dementia and its sustainability for neuropsychiatric and social health outcomes. This highlights the effectiveness of humanoid-type robots in dementia care.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 3","pages":"igae110"},"PeriodicalIF":4.9,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585585","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}