Journal of the American Geriatrics Society最新文献

{"title":"Examining Factors Influencing Older Adult Engagement in Fall Prevention: A Comparative Analysis Among Stakeholders","authors":"Jessica M. Wiseman,&nbsp;Carmen E. Quatman,&nbsp;Catherine C. Quatman-Yates","doi":"10.1111/jgs.19330","DOIUrl":"10.1111/jgs.19330","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Falls are a leading cause of fatal and non-fatal injuries for older adults in the United States with significant consequences for health, mobility, and independence. Understanding what barriers influence older adult engagement is essential to facilitating uptake of evidence-based interventions to prevent falls and fall-related injuries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured focus groups were held with 59 participants in three stakeholder groups: (1) community-dwelling older adults, (2) caregivers of older adults, and (3) healthcare providers who engage with older adults. Themes that emerged were categorized by the stakeholder group that identified them and evaluated using the social-ecological model and assigned to a level within that framework (individual, interpersonal, community, or societal).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Barriers identified to older adult participation in fall prevention activities had the most themes emerge at the individual-level, which included denial; discomfort avoidance; fear of being a burden; pride; and self-perception. Interpersonal-level themes were the normalization of falls; healthcare provider attitude, behavior, and practices; social support; and well-intentioned family. Finally, the themes observed at the community level included cost; lack of education and awareness; limited healthcare resources; lack of transportation; and healthcare system timing and weaknesses. Some themes were identified across all stakeholder types, while others were recognized by only one or two. The only theme at the societal level was age-related stigma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings demonstrate a variety of barriers across stakeholder types and provide valuable insights for developing strategies to effectively promote older adult participation in fall prevention activities to reduce falls and enhance healthy aging.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 4","pages":"1135-1143"},"PeriodicalIF":4.3,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19330","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Potentially Inappropriate Prescribing: Longitudinal Investigation of Outpatient EHR Prescriptions","authors":"Steven M. Albert,&nbsp;Xiaotong Li,&nbsp;Sandra L. Gill-Kane,&nbsp;Jacob Lombardi,&nbsp;Krishi Akenapalli,&nbsp;Richard D. Boyce","doi":"10.1111/jgs.19340","DOIUrl":"10.1111/jgs.19340","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Importance&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The incidence of potentially inappropriate medication (PIM) prescribing among older adults is not as well studied as its prevalence. Estimates of factors associated with PIM incidence, such as patient age, sex, race-ethnicity, medication subsidy support, and comorbidity, are also limited.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To estimate the incidence of PIM prescribing in older adult outpatients, as well as the incidence and predictors for each PIM class, in a large outpatient electronic health records (EHR) cohort.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Retrospective study of PIM prescribing among outpatients with encounters leading to prescription orders, 2015–2018, excluding prevalent cases.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Outpatients receiving care from a multi-site health system in western Pennsylvania.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;342,405 patients, contributing 893,754 person-years of follow-up.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcomes and Measures&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The incidence of PIM prescribing based on automated coding of 2019 Beers criteria. A multivariable Poisson regression model was estimated to assess the impact of age, sex, race-ethnicity, comorbidity, and medication subsidy (PACE/PACENET) on PIM risk. For each PIM class, the association between predictors and time to PIM prescribing was evaluated using proportional hazard models.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The incidence rate (IR) for 1 or more PIM was 193.5 per 1000 person-years, led by short- and intermediate-acting benzodiazepines (37.6), first-generation antihistamines (32.8), and skeletal muscle relaxants (22.0). The incidence of PIM prescribing was 15% higher among white patients and 35% lower among males. High comorbidity (Charlson score ≥ 3) was associated with a 59% higher risk. Participation in the PACE/PACENET program, a medication subsidy program, was associated with an 83% increase in incidence. Each additional year of age was associated with a 1.2% reduction in incidence.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions and Relevance&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study establishes benchma","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 3","pages":"728-736"},"PeriodicalIF":4.3,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19340","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clementines and Kinder Surprises","authors":"Antonio Yaghy","doi":"10.1111/jgs.19359","DOIUrl":"10.1111/jgs.19359","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 3","pages":"956-957"},"PeriodicalIF":4.3,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoporosis management in hospitalized older adults with vertebral compression fracture: A missed opportunity","authors":"Mayuri Ravi DO,&nbsp;Jared Honigman DO,&nbsp;Samantha Gibbons BA,&nbsp;Stuart Cohen MD,&nbsp;Lynn McNicoll MD,&nbsp;Liron Sinvani MD,&nbsp;Alex Makhnevich MD","doi":"10.1111/jgs.19307","DOIUrl":"10.1111/jgs.19307","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 4","pages":"1292-1296"},"PeriodicalIF":4.3,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap: Virtual Interprofessional Education on the Hospital-to-Skilled Nursing Facility Transition","authors":"Collin Burks,&nbsp;Geraldine Kanne,&nbsp;Cindy Leslie A. Roberson,&nbsp;Rachel Hughes,&nbsp;Colette Allen,&nbsp;Aubrey Jolly Graham,&nbsp;Camila Reyes,&nbsp;Heidi White,&nbsp;Mamata Yanamadala","doi":"10.1111/jgs.19357","DOIUrl":"10.1111/jgs.19357","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 2","pages":"669-671"},"PeriodicalIF":4.3,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty screening in older patients undergoing elective colorectal surgery: Comparative study of seven screening instruments","authors":"Katleen Fagard MD, PhD,&nbsp;Lisa Geyskens RN, MSN,&nbsp;Björk Van den Bogaert MSc,&nbsp;Sarah Willems MSc,&nbsp;Johan Flamaing MD, PhD,&nbsp;Albert Wolthuis MD, PhD,&nbsp;Mieke Deschodt RN, MSN, PhD","doi":"10.1111/jgs.19317","DOIUrl":"10.1111/jgs.19317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Frailty screening instruments are increasingly studied as risk predictors for adverse postoperative outcomes. However, because of the lack of comparative research, it is unclear which screening instrument performs best. This study therefore compared the diagnostic accuracy of seven frailty screening instruments for adverse postoperative outcomes in patients aged ≥70 years undergoing colorectal surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a prospective cohort study at an academic hospital, examining the Fried and Robinson frailty criteria, the Edmonton Frail Scale, the Rockwood Clinical Frailty Scale, the Modified Frailty Index, the FRAIL questionnaire, and the Geriatric 8 for predicting postoperative complications with a Clavien-Dindo (CD) severity grade ≥2. Secondary outcomes were complications with CD severity grade ≥3, prolonged length of stay, increased care level after discharge, and functional decline in basic or instrumental activities of daily living up to 1 month after surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 172 consecutive patients. Positive frailty screening ranged from 13.4% to 73.8%. CD≥2 complications were present in 37.8% of patients. At the original cutoffs, most instruments had a high specificity (76.7%–92.4%) at the expense of sensitivity (21.5%–38.5%) with a moderate negative predictive value (NPV) for predicting CD≥2 complications. The Geriatric 8 showed the opposite pattern (sensitivity 81.5%—specificity 30.8%) and a high NPV. Diagnostic accuracy was moderate for all screening instruments, since the areas under the receiver operating characteristic curve did not exceed 0.61 across instruments. Altering the cutoff scores did not yield sufficient improvement. Comparable results were found for the secondary outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Comparing the predictive value of the screening instruments showed that frailty screening cannot be used in isolation as risk predictor for adverse postoperative outcomes. Further research should focus on a two-step approach in which additional diagnosis of frailty by means of comprehensive geriatric assessment is included in the prediction model.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 4","pages":"1060-1072"},"PeriodicalIF":4.3,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19317","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiver reported experiences of not-for-profit hospice agencies with a religious affiliation","authors":"Xiao (Joyce) Wang PhD,&nbsp;Joan M. Teno MD, MS,&nbsp;Momotazur Rahman PhD,&nbsp;Emmanuelle Bélanger PhD","doi":"10.1111/jgs.19314","DOIUrl":"10.1111/jgs.19314","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 4","pages":"1310-1313"},"PeriodicalIF":4.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of prostate cancer patients seeking integrative medicine","authors":"Jared Silberlust MD, MPH,&nbsp;Kaitlin Lampson BA,&nbsp;Katherine Han BS,&nbsp;Susan Qing Li MS,&nbsp;Jun J. Mao MD,&nbsp;Kevin T. Liou MD","doi":"10.1111/jgs.19312","DOIUrl":"10.1111/jgs.19312","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 4","pages":"1306-1309"},"PeriodicalIF":4.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual and prescription level factors associated with overdose in opioid naïve older people","authors":"Kacey Little MPH,&nbsp;Sanae El Ibrahimi PhD, MPH,&nbsp;Jiah Yoo PhD,&nbsp;Diana Flores BS,&nbsp;Michelle Hendricks PhD,&nbsp;Christi Hildebran MSW,&nbsp;Grant Ritter PhD,&nbsp;Dagan Wright PhD, MSPH,&nbsp;Bryan Loy PhD,&nbsp;Scott G. Weiner MD, MPH","doi":"10.1111/jgs.19323","DOIUrl":"10.1111/jgs.19323","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Opioid naïve older adults may be at risk of overdose after receiving an initial opioid prescription.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This population-based cohort study from a linked dataset of patients in Oregon, linking all payer claims data to other administrative datasets, aimed to assess the prescription- and patient-level characteristics associated with increased odds of opioid overdose after an initial opioid prescription. Included patients were ≥65 years old and received an index pain-formulation opioid prescription between 2016 and 2019. The primary outcome was an index nonfatal or fatal overdose within 6- or 12-months following index prescription. Patient characteristics included age, sex, insurance plan, number of medical comorbidities, and presence of psychiatric comorbidities. Prescription characteristics included opioid type, duration of action, and days' supply. A logistic regression model was used to determine the association with opioid overdose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 223,799 individuals included for analysis (58.6% 65–74 years old, 53.9% female). There were 183 fatal or nonfatal opioid overdoses in 6 months and 232 in 12 months following the index prescription. Adults aged ≥85 years were less likely to experience an overdose versus those 65–74 years (6-month adjusted odds ratio (aOR) 0.35, [95% confidence interval, 0.20–0.59]; 12-month aOR 0.38 [0.24–0.60]). Multiple factors were associated with increased odds, including dually enrolled in Medicare/Medicaid compared to commercial insurance (6-month aOR 5.99, [1.93–19.65]; 12-month aOR 3.53, [1.58–7.90]), three or more comorbidities compared to none: (6-month aOR 3.69, [1.91–8.13]; 12-month aOR 4.24, [2.32–7.74]), history of depression: (6-month aOR 1.94, [1.34–2.81]; 12-month aOR 2.20, [1.60–3.04]), received long-acting opioids (6-month aOR 5.76, [1.56–21.22]; 12-month aOR 4.0, [1.39–11.55]) compared to short-acting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For older adults, there is an association between opioid overdose risk and factors including patient insurance type, patient comorbidities, and receiving a long-acting opioid prescription. Providers should be aware of the risks of opioids in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 4","pages":"1105-1114"},"PeriodicalIF":4.3,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative anticholinergic exposure and white matter hyperintensity burden in community-dwelling older adults","authors":"Kevin H. Li PharmD,&nbsp;Chloe Krakauer PhD,&nbsp;Jennifer C. Nelson PhD,&nbsp;Paul K. Crane MD, MPH,&nbsp;Jalal B. Andre MD,&nbsp;Patti K. Curl MD,&nbsp;Esther Yuh MD, PhD,&nbsp;Mahmud Mossa-Basha MD,&nbsp;James D. Ralston MD, MPH,&nbsp;Christine L. Mac Donald PhD,&nbsp;Shelly L. Gray PharmD, MS, AGFS","doi":"10.1111/jgs.19325","DOIUrl":"10.1111/jgs.19325","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Anticholinergic exposure is associated with dementia risk; however, the mechanisms for this association remain unclear. The objective of this study was to examine the association between anticholinergic exposure and white matter hyperintensity (WMH) burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective analysis of data from the Adult Changes in Thought (ACT) study, a prospective cohort study among adults aged ≥65 years on dementia risk factors. We used data collected through March 2020 for this analysis. The sample included ACT participants who were referred for and had a clinical magnetic resonance imaging (MRI) scan and ≥10 years of continuous healthcare enrollment prior to the scan. Our primary exposure was total standardized daily dose (TSDD) of anticholinergics. Outcomes included three semi-quantitative ratings of WMH volume. We used separate linear regression models for each outcome to estimate and compare covariate-adjusted mean values of WMH ratings in each exposure group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 1043 individuals included in the analyses, 28% had no use, 33% had 1–90 TSDD, 15% had 91–365 TSDD, 7% had 366–1095 TSDD, and 17% had ≥1096 TSDD. The mean age was 81 years, most were female (58%) and White race (88%). Compared to those with no use, the ≥1096 TSDD group had a higher (worse) adjusted mean [95% confidence intervals] Fazekas (4.0 [3.8, 4.2] vs. 3.4 [3.2, 3.5]; <i>p</i>: &lt;0.001), Modified Scheltens (14.3 [13.4, 15.2] vs. 12.2 [11.5, 12.9]; <i>p</i>: &lt;0.001), and Age-Related White Matter Changes (5.6 [5.3, 6.0] vs. 4.8 [4.5, 5.1]; <i>p</i> = 0.001). A dose–response relationship was not found.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The highest anticholinergic exposure was associated with greater WMH burden. Future studies should focus on longitudinal changes of WMH burden to better understand the biological mechanisms underlying the link between anticholinergics and dementia risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 4","pages":"1115-1124"},"PeriodicalIF":4.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}