Innovation in Aging最新文献

{"title":"Types of Social Group Participation and Long-Term Cognitive Preservation in Older Ages.","authors":"MinJia Hsieh, TienYu Owen Yang, TzuYi Li, Chi Chiao, TeTien Ting, YenLing Chiu, YiFang Chuang","doi":"10.1093/geroni/igaf009","DOIUrl":"https://doi.org/10.1093/geroni/igaf009","url":null,"abstract":"<p><strong>Background and objectives: </strong>Participating in social groups predicts better cognitive preservation in older adults in the short term (<5 years). Long-term evidence with direct comparison between specific types of social groups is needed.</p><p><strong>Research design and methods: </strong>In the Taiwan Longitudinal Study of Aging (<i>n</i> = 4,009, mean age 64 years), 1,479 individuals reported participation in at least 1 of the 4 common types of social groups at baseline in 2003, including socializing, volunteering, religious, and networking groups. Cognitive function was measured by a modified Short Portable Mental Status Questionnaire at years 0 (baseline), 4, 8, and 12. Linear mixed-effects models were used to estimate relative cognitive preservation (in %) compared with individuals who did not participate in social groups at baseline or compared with individuals who participated in different social groups at baseline.</p><p><strong>Results: </strong>We found volunteering group participation was associated with most consistent cognitive preservation at year 4 (35%, 95% CI: +10% to +60%), 8 (+64%, +44% to +84%), and 12 (+57%, +24% to +89%) compared with the individuals who did not participate in social groups, and at year 12 compared with participants of other social groups (+65%, +16% to +114%).</p><p><strong>Discussion and implications: </strong>Our findings support a long-term prediction of better cognitive preservation among volunteering group participants.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 4","pages":"igaf009"},"PeriodicalIF":4.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963440","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":"Door Decals for Wayfinding and Redirection: A Quality Improvement Project Involving the Use of Clinical Real-Time Location Systems for Evaluation of Environmental Design Changes.","authors":"Leia C Shum, Twinkle Arora, Yasser Karam, Amy Cockburn, Shehroz S Khan, Andrea Iaboni","doi":"10.1093/geroni/igaf020","DOIUrl":"10.1093/geroni/igaf020","url":null,"abstract":"<p><strong>Background and objectives: </strong>Environmental design modifications are important non-pharmacological interventions for people with dementia in older adult residential care, but their effects are difficult to measure objectively. In this paper, we present the assessment of the impact of door decals installed on patient rooms, offices, and exit doors on patient movements as an example of the uses of location data in evaluating environmental design interventions.</p><p><strong>Research design and methods: </strong>We undertook a quality improvement project in an inpatient specialized dementia unit using de-identified data from a clinical location monitoring system from 79 individuals with dementia admitted over time to 15 patient rooms to measure patient movements. In the first phase, decals were applied to 1 office and 6 patient room doors, and doors with and without decals were compared. In the second phase, patient movements were compared before and after a decal was applied to the remaining exit, office, and 9 patient doors. Main outcomes of interest were the number of daily approaches to concealed doors and daily approaches and entrances to patients' own and others' rooms.</p><p><strong>Results: </strong>Using location data, we identified a significant reduction in the number of approaches to and dwell time at office doors and exits. No differences were found in patient movements in relation to their own or others' rooms in either phase, although patients assigned a room with a decal tended to approach others' rooms with decals less often than those with a plain door.</p><p><strong>Discussion and implications: </strong>Door decals successfully reduced patient contact with staff-only doors and exits but did not have a large impact on patient movement with respect to wayfinding. Location tracking systems provide an important opportunity to evaluate the impact of design interventions in situ in specific older adult care contexts.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf020"},"PeriodicalIF":4.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101803","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":"Self-Reported Visual Difficulty and Mortality Risk Among Older Adults: The Mediating Role of Recurrent Falls.","authors":"Shu Xu, Jeffrey A Burr, Qian Song, Joshua R Ehrlich","doi":"10.1093/geroni/igaf016","DOIUrl":"10.1093/geroni/igaf016","url":null,"abstract":"<p><strong>Background and objectives: </strong>Visual difficulty is associated with an increased risk of mortality, however the mechanisms accounting for the link between visual difficulty and mortality have not been described. This study examined the association between visual difficulty, recurrent falls, and mortality risk among Americans aged 65 and older.</p><p><strong>Research design and methods: </strong>This longitudinal study employed data from the <i>2015-2020 waves of the National Health and Aging Trends Study</i> (<i>N</i> = 7,039). Visual difficulty was assessed by questions regarding self-reported near and distance vision and the use of visual aids. Recurrent falls were defined as experiencing a fall more than one time within the last year. Discrete-time survival models with a structural equation modeling-based approach were estimated for the associations between visual difficulty, recurrent falls, and all-cause mortality.</p><p><strong>Results: </strong>Among the respondents, 8.1% reported visual difficulty at baseline. Compared to those without visual difficulty, older adults with visual difficulty were more likely to experience recurrent falls. Having visual difficulty at baseline was associated with experiencing recurrent falls in the following wave (β (log-hazard odds) = 0.12, <i>p</i> < .001) and with mortality in subsequent waves (β = 0.39, <i>p</i> < .001). The association of visual difficulty with mortality was mediated by recurrent falls (β = 0.05, <i>p</i> < .001).</p><p><strong>Discussion and implications: </strong>Compared to those with normal vision, older adults with visual difficulty are more likely to experience recurrent falls, which may in turn increase the risk of mortality. Future research should investigate other potential pathways to gain a more complete understanding of the relationship between visual difficulty and mortality risk.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf016"},"PeriodicalIF":4.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093388","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":"Social Work During Skilled Home Healthcare: Prevalence and Determinants.","authors":"Julia G Burgdorf, Adrianne Smiley, Yolanda Barron, Jeri Goodman, Margaret V McDonald","doi":"10.1093/geroni/igaf018","DOIUrl":"10.1093/geroni/igaf018","url":null,"abstract":"<p><strong>Background and objectives: </strong>Medicare-funded home health (HH) delivers skilled care via visits to patients' homes. Social work (SW) services are included within the HH benefit and may positively affect outcomes for HH patients with complex needs. However, no prior work has quantitatively assessed SW provision during HH.</p><p><strong>Research design and methods: </strong>We examined 2018 linked HH claims, assessment, and HH agency data for a national sample of 1 372 570 Medicare HH patients. We described the prevalence, number, and timing of SW visits, compared characteristics of those who did versus did not receive SW, and modeled odds of receiving SW using a multilevel logistic model clustering at the HH agency level and adjusting for patient sociodemographic characteristics and clinical status and HH agency characteristics.</p><p><strong>Results: </strong>Just 11.3% of HH patients received SW. On average, those who received SW had a single SW visit (mean = 1.3; standard deviation [<i>SD</i>] = 0.6) occurring about a week (mean = 8.8 days; <i>SD</i> = 6.6) after HH admission. The patient-level factors most significantly associated with receiving SW included being non-Hispanic Black compared to non-Hispanic White (adjusted odds ratio [aOR]: 1.70; 95% confidence interval [CI]: 1.66-1.74), being Medicaid-enrolled (aOR: 1.26; 95% CI: 1.24-1.28), living alone (aOR: 1.31; 95% CI: 1.28-1.33), having high cognitive impairment (aOR: 2.12; 95% CI: 2.07-2.18), and exhibiting depressive symptoms (aOR: 2.17; 95% CI: 2.10-2.23). Patients also had greater odds of a SW visit if receiving care from an HH agency that was nonprofit (aOR: 1.31; 1.19-1.45) and lower odds if the HH agency had a rural service area (aOR: 0.67; 95% CI: 0.61-0.74).</p><p><strong>Discussion and implications: </strong>Findings indicate that SW access remains rare during HH and is driven by both demand-side (ie, patient needs) and supply-side (ie, agency characteristics) factors. There is a need to identify patient profiles most likely to benefit from SW services during HH and to develop strategies to mitigate agency-level barriers to access.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf018"},"PeriodicalIF":4.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093523","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":"Social Care Costs of Depressive Symptoms in the English Older Population: Then Role of Housing Quality Improvements.","authors":"Bo Hu, Nicola Brimblecombe, Javiera Cartagena-Farias","doi":"10.1093/geroni/igaf017","DOIUrl":"https://doi.org/10.1093/geroni/igaf017","url":null,"abstract":"<p><strong>Background and objectives: </strong>Poor housing conditions pose a substantial threat to older people's mental health and create inequalities in social care needs. However, their economic consequences for the social care sector have not been thoroughly investigated. This study projects the costs of social care for community-dwelling older people with depressive symptoms under different housing intervention scenarios in England.</p><p><strong>Research design and methods: </strong>Drawing on data collected from 10,601 individuals (33,461 observations across 4 waves) participating in the English Longitudinal Study of Ageing, we combined a Markov model with a Macrosimulation model to make projections of social care costs. Multinomial logistic regression and linear regression analyses were conducted to derive the parameters for the 2 simulation models.</p><p><strong>Results: </strong>We estimate that the costs of unpaid care for older people with depressive symptoms will rise from £33.6 billion in 2022 to £59.9 billion in 2042, and the costs of formal home care will rise from £4.2 billion in 2022 to £8.1 billion in 2042 in the base case scenario of no interventions to improve housing quality. In a scenario where the number of housing problems is reduced to zero, the costs of unpaid care and formal home care in 2042 are projected to rise to be £3.5 billion lower and £0.3 billion lower, respectively, than the no intervention scenario.</p><p><strong>Discussion and implications: </strong>Housing improvements reduce social care demand in the older population by delaying and reversing the progression of depressive symptoms, which has the dual benefits of elevating personal well-being and generating long-term cost savings in the social care sector.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 4","pages":"igaf017"},"PeriodicalIF":4.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010244","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":"Access to Neighborhood Amenities and Services and the Risk of 2-Year Nursing Home Placement Among Persons Living With Dementia.","authors":"Yeon Jin Choi, Gillian Fennell, Jennifer A Ailshire","doi":"10.1093/geroni/igaf011","DOIUrl":"10.1093/geroni/igaf011","url":null,"abstract":"<p><strong>Background and objectives: </strong>Older adults prefer to age in their homes and communities, but due to increased care needs associated with dementia, persons living with dementia are much more likely to move into nursing homes. Living in communities with greater access to neighborhood amenities and supports may reduce the risk of nursing home placement by helping persons living with dementia maintain their health and independence and lowering caregiving burden and stress. This study aims to identify neighborhood amenities and services that are associated with nursing home transitions among persons living with dementia.</p><p><strong>Research design and methods: </strong>We used data from the 2004-2016 waves of the Health and Retirement Study (HRS), which includes 3 507 older adults with dementia, linked with the HRS Contextual Data Resource and the National Neighborhood Data Archive. Logistic regression models were estimated adjusting for sociodemographic and neighborhood characteristics.</p><p><strong>Results: </strong>Findings suggest that access to more park areas, healthy food outlets, and home health services was associated with a lower risk of 2-year nursing home placement.</p><p><strong>Discussion and implications: </strong>These findings emphasize the importance of neighborhood amenities and services as essential components of supportive communities, enabling persons living with dementia to age in place.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf011"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093520","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":"Cultural Safety in Clinical Research: A Conceptual Overview and Call to Action.","authors":"Hector Salazar, Carey E Gleason, Jennifer H Lingler","doi":"10.1093/geroni/igaf015","DOIUrl":"https://doi.org/10.1093/geroni/igaf015","url":null,"abstract":"<p><p>Black Americans are two to three times more likely to develop ADRD than their white counterparts, yet Black Americans make up only 2.4% of ADRD clinical trial participants. Here we provide an overview of the current state of initiatives to maximize racial and ethnic inclusivity in clinical research, particularly among ethnoracialized groups, and introduce the Indigenous-rooted concept of cultural safety through an integrative review and outline of its applicability to the research context. Cultural safety ensures that cultural identities, values, and experiences of minoritized persons are respected, understood, and integrated in their health care journey, empowering them to define and evaluate their own experiences. Implementing cultural safety challenges individuals to confront and critically examine their own perspectives on the dominant culture's traditions and values, as well as their implicit racism, biases, privileges, and inherent power structures. We extend prior conceptual work on cultural safety by proposing two subdimensions: environmental and internal. These must be synergistically integrated to heal fractured relationships between communities of color and researchers. By championing cultural safety, we can create a workforce of self-aware researchers who embody cultural safety's true essence as defined by the communities they serve. Community-engaged research serves as an ideal platform for cultural safety to be meaningfully implemented and sustained. This approach can uplift previously silenced voices in research, build long-term relationships, and generate empirical data that substantiates its positive effects. Importantly, applying environmental and internal cultural safety can empower participants in ADRD research where it is critically needed.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 4","pages":"igaf015"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984524","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":"Climate Change and Healthy Aging: What Are the Existing Data in Aging Studies?","authors":"Yu-Tzu Wu, Matthew Prina, Paola Zaninotto","doi":"10.1093/geroni/igaf008","DOIUrl":"https://doi.org/10.1093/geroni/igaf008","url":null,"abstract":"","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 4","pages":"igaf008"},"PeriodicalIF":4.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12019628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998806","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":"Healthcare Clinicians' Perspectives on Managing Suspected Elder Abuse: \"We Don't Want to Just Swoop in and Do What We Think Is Best\".","authors":"Lena K Makaroun, Naomi Shin, Kristina L Hruska, Tony Rosen, Melissa E Dichter, Carolyn T Thorpe, Keri L Rodriguez, Ann O'Hare, Ann-Marie Rosland","doi":"10.1093/geroni/igaf012","DOIUrl":"10.1093/geroni/igaf012","url":null,"abstract":"<p><strong>Background and objectives: </strong>Elder abuse (EA) is common and has significant health impacts. New initiatives seek to capitalize on opportunities to respond to EA from within the healthcare system, but little is known about what clinicians may need to be successful in these efforts. Our objective was to understand perceived barriers and facilitators to managing all phases of EA within an integrated healthcare system from the perspectives of frontline clinicians from a range of different disciplines.</p><p><strong>Research design and methods: </strong>Thirty-seven clinicians (10 social workers, 9 physicians, 7 psychologists, 6 nurses, and 5 advanced practice providers) from different clinical sites within 2 large Veterans Health Administration (VHA) medical centers participated in semistructured interviews. The interview guide was designed to elicit facilitators and barriers to discrete stages in the process of addressing EA, including detection, reporting, intervention, and monitoring. Transcripts were coded using deductive (based on a prespecified conceptual model) and inductive approaches and analyzed using thematic analysis.</p><p><strong>Results: </strong>Most (78%) participants were women, ranging in age from 33 to 64 years, and practicing in a variety of settings (e.g., primary care and emergency department) with between 4 and 25 years of VHA experience. We identified 5 interrelated themes that cut across the different stages of EA care: situational context (theme 1), degree of trust in familial and healthcare relationships (theme 2), extent of education and skills (theme 3), and existing system infrastructure (theme 4) all contributed to clinician empowerment and motivation toward action (theme 5).</p><p><strong>Discussion and implications: </strong>Efforts to enhance skills training, build trusting relationships, and improve system infrastructure could help to equip clinicians to engage in healthcare system interventions to reduce harm from EA.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 5","pages":"igaf012"},"PeriodicalIF":4.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093521","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":"Trajectories of Burden or Benefits of Caregiving Among Informal Caregivers of Older Adults: A Systematic Review.","authors":"Yongjing Ping, Jeremy Lim-Soh, Truls Østbye, Shamirah D/O A'Azman, Yong Ting, Rahul Malhotra","doi":"10.1093/geroni/igaf014","DOIUrl":"https://doi.org/10.1093/geroni/igaf014","url":null,"abstract":"<p><strong>Background and objectives: </strong>Informal caregiving for older adults can be both burdensome and beneficial. Given that the informal caregiving situation may evolve over time, and care needs of older adults can result from diverse health conditions, it is valuable to understand the trajectories of burden or benefits of caregiving and how these trajectories vary across health conditions common among older care-recipients. This review is the first to summarize the literature on trajectories of burden or benefits of caregiving, including caregiver and care-recipient characteristics associated with the trajectories.</p><p><strong>Research design and methods: </strong>We reviewed longitudinal observational quantitative studies, from 5 bibliographic databases, that assessed burden or benefits of caregiving at 3 or more time points among informal caregivers of older adults (60 years or above).</p><p><strong>Results: </strong>The narrative synthesis included 41 studies, with only 7 (17%) considering trajectories of benefits. A stable average trajectory of burden or benefits of caregiving was the most common pattern over time across various care-recipient health conditions. However, an increasing burden over time was primarily observed among caregivers of persons with dementia, while a decreasing burden was noted among caregivers of persons discharged from the hospital after an acute health event. Only 6 (10%) studies, which reported heterogeneity in the progression of burden or benefits separately or jointly, identified distinctive trajectories within the same set of caregivers. Risk factors consistently identified to be associated with trajectories indicating persistently higher burden or persistently lower benefits included more care-recipient functional limitations and behavioral problems, being a non-spousal caregiver, being a solo caregiver, and perceiving less self-efficacy or competence.</p><p><strong>Discussion and implications: </strong>Future studies should focus on the trajectories of benefits of caregiving, untangle heterogeneity in trajectories of burden or benefits of caregiving, and consider both burden and benefits concurrently to identify factors that both enhance benefits and alleviate burden over time.</p>","PeriodicalId":13596,"journal":{"name":"Innovation in Aging","volume":"9 4","pages":"igaf014"},"PeriodicalIF":4.9,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020369","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}