Joint Commission journal on quality and patient safety最新文献

{"title":"Healthcare Staff Experience During JCI Accreditation Preparation and Survey: Evidence From Dubai, United Arab Emirates.","authors":"Sravan Kumar, Johan Snygg, Pavan Kumar","doi":"10.1016/j.jcjq.2026.07.004","DOIUrl":"https://doi.org/10.1016/j.jcjq.2026.07.004","url":null,"abstract":"<p><strong>Background: </strong>Accreditation is widely used to improve healthcare quality and patient safety; however, staff experiences during accreditation preparation and survey activities remain inadequately understood, particularly in Middle Eastern healthcare settings. The objective of this study was to examine healthcare staff experiences during Joint Commission International (JCI) accreditation and identify organizational factors associated with positive accreditation experiences and perceived outcomes.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among clinical and nonclinical staff at a tertiary academic medical center in Dubai, United Arab Emirates, following a JCI accreditation survey. Descriptive statistics, bivariate analyses, and multivariable logistic regression were used to evaluate associations between organizational factors and staff-reported experiences.</p><p><strong>Results: </strong>A total of 304 staff responses were analyzed. Overall perceptions of accreditation were highly favorable, with more than 90% of respondents reporting positive perceptions of patient safety, quality of care, teamwork, and leadership engagement. Leadership engagement (adjusted odds ratio [AOR] 2.45), perceived improvements in patient safety (AOR 2.89), and quality of care (AOR 2.63) were independently associated with positive accreditation experiences. Workload manageability (AOR 0.61) and psychological safety (AOR 0.68) were negatively associated with positive experience. Nurses and allied health professionals reported more favorable perceptions than physicians, although differences were small. Qualitative findings highlighted the need for continuous readiness, protected time for accreditation activities, improved coordination, and ongoing training.</p><p><strong>Conclusion: </strong>Healthcare staff generally perceived JCI accreditation positively and associated it with improvements in patient safety and quality of care. Leadership engagement emerged as a key facilitator of positive accreditation experiences, whereas workload burden and psychological safety represented important challenges. Organizations implementing accreditation programs should prioritize continuous readiness, workforce support, psychological safety, and targeted physician engagement strategies to sustain accreditation benefits.</p>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712413","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":"What Weighs into a Clinician's Decision to Request an Interpreter? A Discrete Choice Experiment.","authors":"Rose L Molina, Nayantara Biswas, Elysia Larson, Leonor Fernández","doi":"10.1016/j.jcjq.2026.07.005","DOIUrl":"10.1016/j.jcjq.2026.07.005","url":null,"abstract":"<p><strong>Background: </strong>When a patient and clinician do not speak the same language, the absence of language-concordant care necessitates professional interpretation to ensure safety. However, many clinicians proceed without a professional interpreter, often relying on informal interpreters such as family members or other methods, which may increase the risk of medical errors and incomplete communication. Understanding factors that influence interpreter use is necessary to improve language access. This study sought to quantify the trade-offs clinicians consider when deciding whether to request a professional medical interpreter for patients with non-English language preferences.</p><p><strong>Methods: </strong>The authors conducted an electronic discrete choice experiment at a large urban academic medical center. Participants evaluated choice sets describing theoretical clinical encounters characterized by seven attributes. Data were analyzed using Hierarchical Bayesian modeling to estimate relative importances of attributes.</p><p><strong>Results: </strong>Ninety-three clinicians (attending physicians, residents/fellows, nurse practitioners, and physician assistants) from various specialties (49.5% from Medicine) participated. The most important attribute driving clinicians' decision to request a professional medical interpreter was whether the patient's \"English proficiency is good enough for the encounter\" (27.1%), followed by clinical complexity of the encounter (19.4%) and having a bilingual family member present (18.8%).</p><p><strong>Conclusion: </strong>Decisions to request professional interpreters are primarily driven by clinicians' subjective perception of their patient's English proficiency, followed by the clinical complexity of the encounter and the availability of untrained or informal interpretation. Interventions should promote interpreters whenever patients report a non-English language preference and simplify interpreter access.</p>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148724755","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":"The Next Generation of Quality Measurement: Development and Evaluation of an Electronic Diagnostic Quality Measure in Pneumonia.","authors":"Lindsay D Visnovsky, Brittany Kent, Elizabeth D Rutter, Jorie M Butler, Alec B Chapman, Makoto M Jones, McKenna R Nevers, Peter A Taber, Jian Ying, David C Classen, Barbara E Jones","doi":"10.1016/j.jcjq.2026.07.002","DOIUrl":"10.1016/j.jcjq.2026.07.002","url":null,"abstract":"<p><strong>Background: </strong>Traditional quality measures in pneumonia require manual chart review and focus on treatment and outcomes, resulting in inconsistent target populations and missed opportunities to improve diagnosis. Advances in electronic health records (EHRs) enable the use of electronic clinical quality measures (eCQMs), which can simultaneously improve diagnosis at the point of care and provide a consistent target population for other quality measures. The authors developed and validated an eCQM for pneumonia diagnostic quality for feasibility, accuracy, and interoperability across systems.</p><p><strong>Methods: </strong>Using EHR data from 2015-2022 in two US health systems (federal and academic), the research team developed, validated, and implemented an eCQM that assesses the percentage of patients hospitalized with pneumonia who also have standard confirmatory chest imaging using routinely collected EHR data. Measure accuracy was validated using clinician review of 102 charts as a reference standard. Pneumonia diagnostic quality-the percentage of pneumonia hospitalizations with a positive chest image-was calculated overall and for each facility to examine variation.</p><p><strong>Results: </strong>The eCQM demonstrated high sensitivity (federal system: 98.3%; academic system: 97.8%) and positive predictive value (100.0% both systems). Among 92,797 hospitalizations for pneumonia at 101 hospitals across both systems, overall diagnostic quality was 90.1%, with variation across facilities (100.0% in the highest-performing hospital vs. 78.3% in the lowest-performing hospital; 83.5% (standard deviation [SD] 2.6%) in the lowest-performing decile vs. 98.3% (SD 1.3%) in the highest-performing decile).</p><p><strong>Conclusion: </strong>An eCQM measuring diagnostic quality for hospitalized pneumonia patients was feasible, accurate, and scalable for implementation at two different healthcare systems. Approximately 10% of hospitalizations with a pneumonia diagnosis lack chest imaging confirmation, demonstrating clinically significant variation and opportunities for improvement through real-time measurement and diagnostic decision support.</p>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148724676","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":"Automating Aspiration Precautions to Reduce Latent Safety Risk in the Emergency Department.","authors":"Rohit B Sangal, Suresh K Pavuluri, John Sather, Jeanie Haggan, Vivek Parwani, Justin Cahill, Christopher Davison, Craig Mittleman, Cynthia Tucker, Seth Dubin, Michelle DeWitt, Alan H Friedman, Deborah Rhodes, Allen Hsiao, Arjun K Venkatesh","doi":"10.1016/j.jcjq.2026.07.003","DOIUrl":"https://doi.org/10.1016/j.jcjq.2026.07.003","url":null,"abstract":"<p><strong>Background: </strong>Aspiration events in hospitals are preventable yet difficult to systematically identify and mitigate. In high-risk environments such as the emergency department (ED), fragmented documentation and high clinician cognitive load create latent safety risks. Traditional strategies such as education or interruptive alerts have shown limited effectiveness.</p><p><strong>Methods: </strong>A multisite quality improvement initiative across nine EDs within a large northeastern health system from July 2022 through May 2025 was conducted on timely implementation of aspiration precaution and \"nothing by mouth\" (NPO) orders. The intervention progressed through three phases: an initial interruptive pop-up alert, a revised interruptive alert, and an automated standing order. Primary outcomes were the proportion of ED encounters in which aspiration precautions and NPO orders were placed and time from ED arrival to order placement.</p><p><strong>Results: </strong>During the preintervention period, aspiration precautions and NPO orders were placed in 37 of 550,621 ED encounters (0.007%), with median time to order placement of 597 minutes (interquartile range [IQR] 346-1,973) for NPO orders and 704 minutes (IQR 479-2,115) for aspiration precautions. During the initial and revised interruptive alert phases, orders were placed in 438 of 54,407 encounters (0.81%) and 918 of 182,434 encounters (0.50%), respectively. After implementation of the automated standing order system, orders were placed in 16,393 of 559,744 encounters (2.93%), and median time decreased to 24 minutes (IQR 11-53) for both NPO and aspiration precautions. No aspiration-related ED safety events were reported during the one-year post-automation period.</p><p><strong>Conclusion: </strong>An automated, standing order workflow was associated with decreased duration of latent aspiration risk. This approach transformed a low-reliability, human-dependent process into a high-reliability system-level safeguard and offers a scalable model for addressing safety risks in emergency care.</p>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818601","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":"Enhancing Patient Access Through Scheduling Innovation, Patient Facing Tools, and Workforce Redesign at a Comprehensive Cancer Center.","authors":"Mahir Raza Sayeed, Alexandra Blake Martinez, Patricia Amado, Laura Burke, Judy Moore, Sandy Benitez, William Standish, Daria S Bryant, Melanie Adams, Victor J Hassid","doi":"10.1016/j.jcjq.2026.06.011","DOIUrl":"https://doi.org/10.1016/j.jcjq.2026.06.011","url":null,"abstract":"<p><strong>Background: </strong>Access to healthcare and timely patient scheduling are essential for early diagnosis, effective treatment, enhanced operational efficiency, and patient satisfaction in healthcare systems.</p><p><strong>Methods: </strong>This study examined five access initiatives at a tertiary oncological center: redesigned scheduling algorithms, expedited appointment-offering protocols (same-day/next-day [SD/ND] scheduling), optimization of four-hour patient contact workflows, developing a patient-facing access tracking tool (My Referral Status), and a workforce redesign that empowered access leaders with data analytics, process improvement skills, and career advancement strategies. The authors analyzed new patient referrals from January 2023 to December 2024, focusing on three domains: appointment scheduling, operational performance, and patient experience.</p><p><strong>Results: </strong>Median time to appointment creation decreased from five to two calendar days. The four-hour patient contact rate increased by nearly 40 percentage points, reaching 90%. Press Ganey scheduler courtesy scores exceeded the 97th percentile nationally (an improvement from the 41st percentile). SD/ND scheduling improved from 38% to 62% across all patient cohorts and from 48% to 74% within the target population. Use of the My Referral Status tool contributed to a 5% increase in Press Ganey Top Box communication scores. Workforce stability improved substantially, with turnover declining from approximately 30% to below 5%, vacancy rates falling below 5%, and engagement scores increasing across multiple institutional survey domains.</p><p><strong>Conclusion: </strong>Coordinated, data-driven access strategies reduced structural barriers, improved scheduling timeliness, enhanced transparency, and strengthened workforce stability. This integrated model provides a replicable framework for healthcare systems seeking to expand access, improve patient experience, and support sustainable oncology operations.</p>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603325","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":"Utilizing Quality Improvement Methodology to Implement a Perioperative Intravenous Acetaminophen Protocol in Neonatal Gastrointestinal Surgery.","authors":"Gemma Barber, Abbey Arnott, Jacob Davidson, Claire Parent, Emily Walser, Kelly Mendham, Kevin Coughlin, Natashia M Seemann, Jennifer Y Lam","doi":"10.1016/j.jcjq.2026.07.001","DOIUrl":"https://doi.org/10.1016/j.jcjq.2026.07.001","url":null,"abstract":"<p><strong>Background: </strong>Enhanced Recovery After Surgery (ERAS®) guidelines in the pediatric population recommend appropriate multimodal analgesia to limit opioid exposure, with the goal of preventing deleterious effects. Acetaminophen offers an alternative to opioids in neonatal surgical patients, but oral and rectal administrations cannot always be used. The authors used quality improvement methodology to implement a perioperative intravenous (IV) acetaminophen protocol for neonates undergoing gastrointestinal surgery.</p><p><strong>Methods: </strong>A multidisciplinary stakeholder team was created that included pediatric surgeons, neonatal intensive care physicians and nurses, nurse practitioners, pharmacists, and information technologists. Special approval was issued for IV acetaminophen in neonatal surgical patients. The first Plan-Do-Study-Act (PDSA) cycle implemented a standardized perioperative dosing protocol accompanied by training. The second PDSA cycle involved implementation of an online order set for ease of administration and compliance. The primary process measure was protocol compliance. The primary balancing measure was postoperative pain, measured by the Neonatal Pain, Agitation, and Sedation Scale (NPASS).</p><p><strong>Results: </strong>Fifty prospective cases were included. The overall rate of compliance was 43.9%, with 46.0% preoperative compliance and 90.2% postoperative compliance. Compliance was greater when the order set was used, though the preoperative order set was used less frequently than the postoperative order set (67.7% vs. 77.4%). Median NPASS scores at 24 and 48 hours were 2.4 (interquartile range [IQR] 1.5-3.3) and 2.3 (IQR 1.0-3.5), respectively, indicating adequate analgesia.</p><p><strong>Conclusion: </strong>This project provides a model for implementing perioperative IV acetaminophen as an analgesic for neonates undergoing gastrointestinal surgery. Continuing education and sustainability efforts are required to ensure ongoing compliance to the protocol.</p>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648727","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":"Generational Change in the Healthcare Workforce: Perspectives from Health System Leaders.","authors":"Andrew A White, Thomas H Gallagher, Keegan D Warren, Jasmine Kaur, William M Sage","doi":"10.1016/j.jcjq.2026.06.009","DOIUrl":"https://doi.org/10.1016/j.jcjq.2026.06.009","url":null,"abstract":"<p><strong>Background: </strong>The healthcare workforce has never included so many different generations, creating both important opportunities and vexing challenges. Little is known about how health system leaders conceptualize generational differences among clinicians, respond to mismatched expectations, promote patient safety despite employee turnover, and minimize conflict.</p><p><strong>Methods: </strong>The authors conducted semistructured interviews with 17 key informants in executive leadership roles, including chief officers for operations, medicine, nursing, human resources, and academic affairs. A qualitative analysis using a thematic content approach was performed.</p><p><strong>Results: </strong>All participants and their institutions were wrestling with tensions arising from a multigenerational clinical workforce, including differing perspectives on complex issues such as burnout, well-being, and clinical expectations. Some issues represented aftershocks from major events or trends, such as trainee duty hour regulation, the corporatization of medicine, and the COVID-19 pandemic. Respondents described both reactive and proactive adaptations, and expressed interest in developing organizational frameworks and solutions to minimize intergenerational conflict around work duties, manage end-of-career transitions, and address issues caused by rapid employee turnover. Human resources professionals demonstrated expertise in managing turnover and benefits but felt underutilized by clinical leaders.</p><p><strong>Conclusion: </strong>Generational change in the healthcare workforce is an urgent but understudied area for clinical and safety leaders, given worsening stresses on the healthcare system. Respondents recommended strategies to enhance the value of multigenerational workforces, including tighter collaboration with human resources professionals, new retention strategies for early-career clinicians, and creative job design for senior health professionals.</p>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535909","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":"Calibrated Consent: The Next Step for Personalized Video Surgical Education.","authors":"Henry Bair","doi":"10.1016/j.jcjq.2026.06.010","DOIUrl":"https://doi.org/10.1016/j.jcjq.2026.06.010","url":null,"abstract":"","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603345","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":"Toward a Learning Hospital: The Case for Quality Intelligence Systems","authors":"Kedar S. Mate MD (is Senior Scholar, Clinical Excellence Center, Stanford University School of Medicine, and Co-Founder and Chief Medical Officer, Qualified Health, Palo Alto, California.),&nbsp;Justin D. Norden MD, MBA, MPhil (is Co-Founder and CEO, Qualified Health, and Adjunct Professor, Department of Biomedical Informatics Research, Stanford University School of Medicine.),&nbsp;Marc Lachs (is Vice President, Qualified Health. Please address correspondence to Kedar S. Mate)","doi":"10.1016/j.jcjq.2026.03.010","DOIUrl":"10.1016/j.jcjq.2026.03.010","url":null,"abstract":"","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"52 7","pages":"Pages 324-327"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772007","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":"Large Language Models as Physician Recommenders: Limitations, Alternatives, and the Path Toward Hybrid AI Systems","authors":"Mohammad Mahdi Bagheri Asl MD (is Researcher, Department of Neurosurgery, Medical University of South Carolina.),&nbsp;Alejandro M. Spiotta MD (is Professor, Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina. Please address correspondence to Alejandro M Spiotta)","doi":"10.1016/j.jcjq.2026.03.011","DOIUrl":"10.1016/j.jcjq.2026.03.011","url":null,"abstract":"<div><div>Digital tools are increasingly used by patients to access health information and navigate care, including choosing clinicians, but the evidence supporting “best doctor” recommendations varies widely across available methods. This manuscript compares the emerging use of consumer-facing large language models (LLMs) for this purpose with four alternative physician-selection strategies: patient networks, expert referrals, consumer rating/search platforms, and outcome-informed artificial intelligence / machine learning (AI/ML) recommender systems.</div><div>Consumer rating platforms mainly reflect patient experiences rather than technical skills and often show weak or inconsistent links with objective performance measures. General-purpose LLMs may produce convincing rationales that highlight visibility and reputation, but they remain limited by hallucinations, prompt sensitivity, and uncertainty about whether their explanations truly reflect the underlying reasoning. Outcome-informed AI/ML recommender systems could, in theory, incorporate risk-adjusted clinical performance, but they face significant challenges, including unreliable physician-level measurement, incomplete data, residual confounding, and limited transparency, which can undermine trust and informed consent.</div><div>We suggest that a hybrid system should be seen as a guiding concept and a testable approach rather than a final solution. Such a system could integrate proven, auditable performance measures with transparent patient-preference filters and verifiable, patient-facing explanations. We present key design principles, including clinical relevance, explainability, autonomy, equity, and governance, in line with current US Food and Drug Administration (FDA) guidance related to clinical decision support and adaptive AI life cycle management.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"52 7","pages":"Pages 316-323"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772009","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}