Journal of Racial and Ethnic Health Disparities最新文献

{"title":"Obesity and Left Ventricular Function in American Indian Adolescents: Strong Heart Family Study.","authors":"Joseph Burns, Keila N Lopez, Sara B Stephens, Jason F Deen","doi":"10.1007/s40615-024-02216-5","DOIUrl":"https://doi.org/10.1007/s40615-024-02216-5","url":null,"abstract":"<p><strong>Objectives: </strong>Obesity is a known risk factor for developing cardiovascular disease (CVD). American Indian (AI) children have the highest obesity rates of all racial/ethnic groups in the United States (US). However, cardiometabolic health among AI adolescents is understudied. The purpose of this study was to describe the cardiometabolic characteristics of AI adolescents enrolled in the Strong Heart Family Study (SHFS), a longitudinal study of CVD from 12 AI communities, and associations with the development of abnormal left ventricular mass index (LVMI) and ejection fraction (EF).</p><p><strong>Study design: </strong>This study included AI youth ages 14-22 years. Primary outcome variables were depressed EF (< 55%) and abnormal LVMI at 6-year follow-up. The primary predictor variable was BMI. Covariates included sex, cholesterol levels, blood pressure, and hemoglobin A1c. Wilcoxon signed-rank test for matched pairs evaluated cardiometabolic trends over time. Stratified univariate logistic regression by obese/nonobese categories evaluated associations with depressed EF and abnormal LVMI.</p><p><strong>Results: </strong>There were 384 subjects, 58% of whom were overweight (n = 87) or obese (n = 122) at baseline. Among overweight/obese subjects, cholesterol and triglyceride levels were elevated. At 6-year follow-up, BMI increased while EF decreased among overweight/obese males, with 3.6 times the odds of having depressed EF (95% CI 1.22-10.98, p = 0.021) compared to normal-weight males. There were no significant cardiometabolic associations with LVMI.</p><p><strong>Conclusions: </strong>This is one of the largest longitudinal evaluations of CVD in AI adolescents. Concerning trends in BMI and depressed EF among AI males suggest the importance of culturally competent interventions to promote healthy weight and reduce cardiometabolic risk.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468399","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":"Spatial and Racial/Ethnic Variation in the Prevalence of Cesarean Delivery in a South Carolina Medical Center.","authors":"Jeffrey T Howard, Sam Lawton, Dulaney Wilson, Amartha Gore, Latha Hebbar, Christine Morton, Christopher Goodier, Myrtede Alfred","doi":"10.1007/s40615-024-02218-3","DOIUrl":"https://doi.org/10.1007/s40615-024-02218-3","url":null,"abstract":"<p><strong>Introduction: </strong>While racial/ethnic disparities in cesarean delivery have been noted in the literature, less is known about the intersection between individual-level race/ethnicity and community-level social vulnerability as factors in cesarean delivery. The goal was to use medical record data from a large medical center combined with census tract-level data to examine patterns of social vulnerability, racial population distribution, and prevalence of cesarean delivery.</p><p><strong>Methods: </strong>Data were obtained from electronic medical records of patients from a large medical center in South Carolina from 2019 to 2020. The outcome variable was cesarean delivery (yes/no), and covariates included the year of delivery; age of patient; race/ethnicity; spoken language; BMI categories; clinical indications of anemia, hypertension, preeclampsia, and diabetes; and census tract Social Vulnerability Index (SVI). Generalized linear mixed models for multilevel binary logistic regression were used to test the main hypothesis that the census tract level Social Vulnerability Index is positively associated with cesarean delivery.</p><p><strong>Results: </strong>Among a total of 5011 patients, we found that non-Hispanic Black mothers were more likely to have cesarean deliveries compared with non-Hispanic White mothers. After controlling for census tract-level SVI, the individual-level race/ethnicity association was no longer significant. Significant spatial autocorrelation across census tracts was evident for cesarean delivery prevalence, non-Hispanic Black population, and SVI. A high prevalence of cesarean delivery tended to cluster with high SVI and a high non-Hispanic Black population.</p><p><strong>Conclusions: </strong>We found that non-Hispanic Black mothers were more likely to have cesarean deliveries, which was explained by census tract differences in the SVI.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468400","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":"\"First, Trust Needs to Develop\": Hematologists' Perspectives on Factors Influencing Black Persons' Participation in Clinical Trials.","authors":"Shakira J Grant, Milenka Jean-Baptiste, Jiona A Mills, Paul Mihas","doi":"10.1007/s40615-024-02205-8","DOIUrl":"https://doi.org/10.1007/s40615-024-02205-8","url":null,"abstract":"<p><strong>Background: </strong>Cancer clinical trials are crucial for treatment standards and innovation but lack racial-ethnic diversity. Understanding physician perspectives on recruiting participants is critical due to their role in decision-making about trial candidacy and enrollment.</p><p><strong>Methods: </strong>From August 2021 to January 2022 we recruited 13 Academic hematologists experienced with treating blood cancers and enrolling clinical trial participants. Each hematologist participated in a 60-75-minute semistructured interview and completed a sociodemographic survey. Using the National Institute on Minority Health and Health Disparities multilevel model as a framework, we characterized hematologists' perceived barriers to clinical trial participation among Black persons. ATLAS.ti v9 and later v 23.2.1 was used for project management and to facilitate data analysis using the Sort and Sift, Think and Shift approach (ResearchTalk Inc).</p><p><strong>Results: </strong>All hematologists were White, with 70% being male. Three factors influenced their perspectives on enrolling Black individuals in clinical trials: individual attitudes and beliefs, such as perceptions that Black or socioeconomically disadvantaged persons will be less willing or less compliant with the requirements for trial participation and follow-up. The need to build trusting relationships between themselves and patients prior to discussing clinical trials and the prevailing legacy of medical mistrust among the Black community. Trust was found to be the underlying factor in determining communication between hematologists and Black persons about clinical trials across all three levels.</p><p><strong>Conclusion: </strong>This study highlights how hematologists' attitudes, beliefs, biases, and views on trust in patient relationships influence their communication with Black individuals about clinical trials. It emphasizes the need for further research to develop interventions that address the lack of racial and ethnic diversity in trials.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468388","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":"Barriers and Facilitators to the Success of Black Academic Physicians.","authors":"Barbara Jerome, Magali Fassiotto, Yvonne Bonnie Maldonado, Tamara Dunn","doi":"10.1007/s40615-024-02201-y","DOIUrl":"https://doi.org/10.1007/s40615-024-02201-y","url":null,"abstract":"<p><p>Despite efforts to recruit and retain Black physicians, Black individuals continue to be underrepresented in medicine in the USA. Although numerous studies have investigated the experiences of academic physicians from racial/ethnic backgrounds underrepresented in medicine, the experience of Black academic physicians, who may face additional unique challenges, remains underinvestigated. Using a qualitative research design, we investigate barriers to and facilitators of success and well-being of Black faculty at one academic medical center through interviews of 30 Black faculty members. Overall, ten themes emerged as barriers or facilitators to faculty success and well-being. Significant barriers include continued lack of representation; devaluing of research in community health and health disparities, as well as other diversity-related activities; and both overt and implicit discrimination, which contribute to feelings of isolation and disrespect. Facilitators include having a community to maintain sense of belonging, financial support for health disparities and diversity-related contributions, and collaboration with peers. Good mentorship and sponsorship as well as an institutional culture that supports inclusion can play significant roles as facilitators, whereas the lack of these factors can present substantial barriers. Institutional policies and external socio-political factors have a major influence on both the barriers and facilitators to the success and well-being of Black faculty. Our study has put a clearer focus on barriers that are unique to or more pronounced among Black faculty and the facilitators that may serve to mitigate these barriers. These findings can inform the design of interventions to recruit and retain Black faculty in medicine.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468392","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 Longitudinal Impact of Family, Religious, and School Support on the Mental Health of Filipino and Korean American Youth Across Adolescence.","authors":"Michael Park, In Young Park, Yoonsun Choi, Julia R Henly","doi":"10.1007/s40615-024-02200-z","DOIUrl":"https://doi.org/10.1007/s40615-024-02200-z","url":null,"abstract":"<p><p>Asian Americans, currently the most rapidly expanding racial group in the USA, are experiencing persistent mental health inequities. These inequities are particularly pronounced during adolescence, highlighting the critical need for dedicated focus on this demographic. Social support is a key shield against mental distress among these adolescents, yet little research has examined the collective impact of multiple sources of support over time, across developmental stages, and for different ethnic subgroups. Drawing on the integrated conceptual framework, this longitudinal study is the first to our knowledge to examine how support from families, religious organizations, and schools together predicts mental health over time across adolescents' developmental stages. We further examined how these relationships may be moderated by age groups, distinguishing between the early adolescence cohort and the middle adolescence cohort. Data were from the Midwest Longitudinal Study of Asian American Families (MLSAAF) project that survey-interviewed 378 Filipino American and 408 Korean American adolescents (M_age = 15 years). Findings reveal that family support consistently buffers against mental distress throughout adolescence for both groups. Religious support distinctly aids Filipino American early adolescents, while school support notably benefits early adolescents regardless of ethnicity. These findings emphasize the universal protective effects of social support, while also highlighting the nuanced ways that developmental stage and ethnicity may influence how different sources of support impact mental health. This underscores the need for developmentally and culturally sensitive mental health strategies for Asian American adolescents.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468401","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":"Climate Change, Racism, and Food Insecurity: Cyclical Impacts of Stressors Exacerbate Health Disparities.","authors":"Christina Ek, James R Hébert, Daniela B Friedman, Dwayne E Porter","doi":"10.1007/s40615-024-02202-x","DOIUrl":"https://doi.org/10.1007/s40615-024-02202-x","url":null,"abstract":"<p><strong>Introduction: </strong>Disadvantaged populations have higher rates of chronic disease, including heart disease, cancer, and diabetes. Race, ethnicity, lower socioeconomic status, and poverty all contribute to these disproportionate rates. Other factors, including systemic racism, climate change, poor diet, lack of food access, and epigenetic influences, that are distributed and experienced differently across vulnerable populations also play a significant role in the development of chronic diseases. This comprehensive review of contributors to chronic diseases emphasizes a unique focus on these identified emerging factors.</p><p><strong>Methods: </strong>An ad hoc literature review using OVID Medline and Web of Science was conducted.</p><p><strong>Results: </strong>Findings from prior studies indicate that multiple stressors, both in isolation and in combination, and their negative impacts on both physical and mental health of minorities are exacerbated by climate change.</p><p><strong>Discussion: </strong>Various stressors dramatically increase chronic disease risk in minority groups. Recommendations for future research to elucidate the impacts of climatic, racial, and dietary adversity with minority populations are presented. Further study in this area is critical for achieving the UN Sustainable Development Goals and improving public health outcomes.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468393","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":"Handoffs and Equity: Impact of a Patient Distribution Model on Handoffs for Black Patients.","authors":"Ethan Molitch-Hou, Thomas J Best, Ellis Green, Khanh T Nguyen, Grace LaShore, Matthew T Cerasale","doi":"10.1007/s40615-024-02196-6","DOIUrl":"https://doi.org/10.1007/s40615-024-02196-6","url":null,"abstract":"<p><strong>Background: </strong>Hospital medicine patient distribution models (PDM) assign patients to inpatient services on hospital admission. Models balance tradeoffs including patient handoffs, physician wellness, subspecialty care, and other factors to ensure optimal outcomes; however, equity is rarely considered. Handoffs during inpatient care can result in medical error and worse patient outcomes. This study evaluates the impact of a PDM that prioritizes use of specialty care services and an overflow service (OS) during high census on racial inequities in handoff frequency.</p><p><strong>Methods: </strong>A single-center retrospective cohort study of inpatient encounters on hospital medicine services from July 2017 to December 2019 was conducted. The primary exposures included being discharged by a general medicine service (GMS) or cared for by an OS. The primary outcome was handoffs per day of stay, analyzed by multivariable regression adjusted for age, gender, race, ethnicity, insurance, discharge from GMS, and care from OS.</p><p><strong>Results: </strong>A total of 4165 inpatient hospitalizations with the majority of their stay on a hospital medicine service were reviewed. Patients discharged by GMS (78.2% vs. 58.1%, p < .001) and cared for by OS (78.7% vs. 67.0%, p < .001) were more likely to identify as Black. Multivariable analysis showed a handoff risk ratio of 1.53 (p < .001) for OS patients and 1.06 (p = .01) if discharged from GMS, but race alone did not significantly affect risk of handoffs.</p><p><strong>Conclusion: </strong>The PDM prioritization drove increased handoffs disproportionately for Black patients. Multivariable analysis showed that race alone did not contribute to increased handoffs suggesting the creation of a systemic bias in patient care.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468397","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 Pilot Study Exploring the Feasibility of Virtual Written Exposure Therapy with Underserved Black Perinatal Women.","authors":"Angela Neal-Barnett, Robert E Stadulis, Eniolufolake E Ayoade, Alexis McGhee-Dinvaut","doi":"10.1007/s40615-024-02203-w","DOIUrl":"https://doi.org/10.1007/s40615-024-02203-w","url":null,"abstract":"<p><p>In the USA, Black pregnant women are at the highest risk for maternal morbidity. They also experience the highest rates of trauma exposure and posttraumatic stress disorder (PTSD). PTSD takes a toll on Black women's mental and physical health, placing them at risk for maternal morbidity. It increases several mental health symptoms such as suicidality, anxiety, re-living the trauma, and numbness. These mental health conditions adversely affect health behaviors, including those essential for maternal health, such as attending prenatal and postpartum appointments. Furthermore, untreated PTSD is associated with higher blood pressure, increasing Black mothers' risk of pre-eclampsia. For a variety of reasons including cultural mistrust, stigma, transportation, time constraints, and access to care, PTSD is frequently underassessed and undertreated among Black perinatal women. Written exposure therapy (WET) is a state-of-the-art brief treatment for PTSD. In this study, we explored the initial feasibility of the virtual delivery of WET to reduce PTSD symptoms among Black perinatal women. Results found the virtual delivery of WET to be feasible. Symptom reduction for PTSD in participants was 50-100% during follow-up, suggesting potential effectiveness of the intervention. Implications for virtual delivery of WET in reducing risk for Black maternal morbidity are discussed.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468389","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":"Ethnic-Specific Threshold Analysis and BMI and Waist Circumference Cutoffs for Cardiovascular Disease and Subjective Wellbeing: Results using Data from the UK Biobank.","authors":"Mubarak Patel, Mohammed Aadil Buchya, Olalekan Uthman","doi":"10.1007/s40615-024-02193-9","DOIUrl":"https://doi.org/10.1007/s40615-024-02193-9","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to identify ethnicity-specific BMI and waist circumference cutoffs for cardiovascular disease (CVD) and to define optimal thresholds for CVD risk and subjective wellbeing (SWB) through predictive modelling, to inform precise public health initiatives.</p><p><strong>Methods: </strong>We used data from 296,767 UK Biobank participants and adjusted logistic and linear regression models for CVD and SWB, respectively, complemented by receiver operating characteristic analysis, to explore optimal risk thresholds of CVD in six different ethnic groups and to calculate ethnicity-specific cutoffs of BMI and waist circumference (WC) to further elucidate the relationships between demographic factors and cardiovascular risk among diverse populations.</p><p><strong>Results: </strong>The logistic regression model of CVD revealed moderate discriminative ability (AUROC ~ 64-65%) across ethnicities for CVD status, with sensitivity and specificity values indicating the model's predictive accuracy. For SWB, the model demonstrated moderate performance with an AUROC of 63%, supported by significant variables that included age, BMI, WC, physical activity, and alcohol intake. Adjusted-incidence rates of CVD revealed the evidence ethnic-specific CVD risk profiles with Whites, South Asians and Blacks demonstrating higher predicted CVD events compared to East Asians, mixed and other ethnic groups.</p><p><strong>Conclusion: </strong>Alterations of ethnicity-specific BMI and waist circumference are required to ensure ethnic minorities are provided with proper mitigation of cardiovascular risk, addressing the disparities observed in CVD prevalence and outcomes across diverse populations. This tailored approach to risk assessment can facilitate early detection, intervention and management of CVD, ultimately improving health outcomes and promoting health equity. The moderate accuracy of predictive models underscores the need for further research to identify additional variables that may enhance predictive accuracy and refine risk assessment strategies.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400567","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 Scientific Program in Regenerative Engineering (ASPIRE): A Prospective Program Aimed at Tackling Health Disparities in the USA.","authors":"Kevin W-H Lo, Marsha Murray, Cato T Laurencin","doi":"10.1007/s40615-024-02140-8","DOIUrl":"https://doi.org/10.1007/s40615-024-02140-8","url":null,"abstract":"<p><p>The continued low numbers of Blacks in STEMM (Science, Technology, Engineering, Mathematics, and Medicine) represent an American crisis that threatens growing awareness and efforts to effectively address health disparities that affect the Black population. Regenerative engineering is an emerging STEMM field that seeks to combine principles from engineering, life sciences, physics, and medicine to develop new technologies for repairing and regenerating damaged tissues and organs. We believe that regenerative engineering has the potential to address some of the root causes of health disparities by developing new approaches that are more accessible and affordable, particularly for low-income communities and people living in rural areas. We have developed a new education program targeting to K-12 groups \"A Scientific Program in Regenerative Engineering (ASPIRE)\" that supports the mentoring and education of Black K-12 students to enter successfully and thrive as professionals in STEMM particularly in the area of regenerative engineering. We have been collaborating with several public-school systems in Connecticut, especially among the regions with health disparities to implement the program. We believe our new educational K-12 program would serve as a vehicle to reduce health disparities in the region.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400564","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}