Journal of the American Geriatrics Society最新文献

{"title":"Associations Between Inflammation and Multisensory Impairment Among Older Adults","authors":"Willa D. Brenowitz,&nbsp;Christina R. Sheppler,&nbsp;Yue Leng,&nbsp;Kristine Yaffe","doi":"10.1111/jgs.19547","DOIUrl":"10.1111/jgs.19547","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Impairment in multiple senses (multisensory impairment) is common in older adults but the underlying mechanisms are unclear. We evaluated whether common blood-based markers of inflammation (e.g., Interleukin 6 (IL-6), C-Reactive Protein (CRP), and Tumor Necrosis Factor Alpha (TNF-α)) were associated with multisensory impairment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from 1674 participants in the Health, Aging, and Body Composition Study, a prospective cohort study of Black and White older adults who were aged 70–79 at enrollment. IL-6, CRP, and TNF-α were assayed from blood samples at Year 1. Sensory function in 4 domains was assessed in Years 3–5; impairment was defined with clinical cut-points. Vision was measured by visual acuity and contrast sensitivity; hearing by pure tone audiometry (500, 1000, 2000, and 4000 Hz); smell by the 12-item Cross Cultural Smell Identification Test; and touch by vibration detection threshold and monofilament of the big toe. A previously developed multisensory impairment score (0–12) was calculated based on sample quartiles and summed across sensory domains. Regression models evaluated the associations of inflammation markers with individual and multiple sensory impairments (as separate outcomes) with adjustment for demographics, health conditions, and health behaviors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher CRP (<i>ß</i> = 0.07; 95% CI: 0.01–0.12; <i>p</i> = 0.01) and IL-6 (<i>ß</i> = 0.11; 95% CI: 0.04–0.18; <i>p</i> = 0.003) levels were associated with the number of sensory impairments. Participants with the highest quartile of IL-6 (OR = 1.45; 95% CI: 1.09–1.92; <i>p</i> = 0.01) and TNF-α (OR = 1.46; 95% CI: 1.12–1.91; <i>p</i> = 0.005) had higher odds of a poor multisensory impairment score. High CRP was associated with impaired vision (OR = 1.45; 95% CI:1.08–1.93; <i>p</i> = 0.01) and high TNF-α was associated with touch impairment (OR = 1.63; 95% CI:1.15–2.30; <i>p</i> = 0.006). Having multiple high markers was also associated with multisensory (OR: 1.76; 95% CI: 1.20–2.58; <i>p</i> = 0.004) and vision impairment (OR: 1.55; 95% CI: 1.13–2.13; <i>p</i> = 0.004).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Markers of inflammation were associated with multisensory impairment, but there were fewer associations with individual sensory impairments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 9","pages":"2846-2852"},"PeriodicalIF":4.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236308","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":"The Idea of Health","authors":"Jeremiah A. Barondess","doi":"10.1111/jgs.19514","DOIUrl":"10.1111/jgs.19514","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 9","pages":"2966-2968"},"PeriodicalIF":4.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236311","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":"Mapping the Final Journey: End-Of-Life Frailty Trajectories and Cause of Death","authors":"Jianhong Xu,&nbsp;Jonathan Ka-Long Mak,&nbsp;Qian-Li Xue,&nbsp;Chenkai Wu","doi":"10.1111/jgs.19567","DOIUrl":"10.1111/jgs.19567","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Frailty changes associated with aging have been well-documented in existing research. However, there is limited evidence on how frailty progresses during the end-of-life stage. We aimed to explore trajectories of frailty in the last year of life and explore how the distribution of these trajectories differs according to the conditions leading to death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Based on national death registries linkage data in the UK Biobank, 37,465 decedents were included in the analytic sample. Monthly frailty scores were obtained for 1 year prior to death using the Hospital Frailty Risk Score (HFRS; a cumulative deficit measure of frailty). Latent class trajectory models were used to estimate trajectories of frailty. We further analyzed the distribution of these frailty trajectories across different conditions leading to death. Multinomial logistic regression models were applied to examine the associations between predictors and frailty trajectories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 37,465 decedents, 2895 (7.7%) died from neurodegenerative diseases. Three distinct frailty trajectories were identified among these decedents: rapidly progressive frailty (6.9%), moderate progression of frailty (21.1%), and advanced and stable frailty (72.0%). These patterns differed significantly from those observed in decedents with other causes of death, who exhibited persistently low frailty (24.7%), intermediate and progressive frailty (46.5%), and advanced and progressive frailty (28.8%). Compared to cancer decedents, individuals with neurodegenerative diseases had higher baseline frailty and a dominant trajectory of advanced and stable frailty. Older age, lower education, and greater chronic disease burden were associated with the advanced and progressive frailty trajectory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Frailty trajectories at the end of life varied by cause of death, with neurodegenerative disease decedents exhibiting more severe frailty. These findings underscored the need for early identification of frailty and tailored end-of-life care strategies, particularly for individuals with neurodegenerative diseases who often experienced prolonged and severe frailty.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 9","pages":"2695-2706"},"PeriodicalIF":4.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236310","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":"Under Documentation of Anemia in Older Ambulatory Patients","authors":"Min Woo Hwang,&nbsp;Hirra A. Chaudhary,&nbsp;William B. Ershler","doi":"10.1111/jgs.19503","DOIUrl":"10.1111/jgs.19503","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 8","pages":"2616-2618"},"PeriodicalIF":4.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236313","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":"Does Documenting a Dementia Diagnosis Improve Outcomes?","authors":"Jerry H. Gurwitz","doi":"10.1111/jgs.19557","DOIUrl":"10.1111/jgs.19557","url":null,"abstract":"&lt;p&gt;With the aging of the U.S. population, and in the absence of major breakthroughs in prevention and treatment, the numbers of Americans with dementia will dramatically increase over the coming decades [&lt;span&gt;1&lt;/span&gt;]. Identifying opportunities to improve the care of this growing population is of paramount importance.&lt;/p&gt;&lt;p&gt;As reported in this issue of the &lt;i&gt;Journal of the American Geriatrics Society&lt;/i&gt;, Burgdorf and colleagues studied the relationship between awareness of a dementia diagnosis by a home health clinician and subsequent care delivery and outcomes in these patients [&lt;span&gt;2&lt;/span&gt;]. The research team used a complicated approach to investigate this issue in a large national sample of Medicare skilled home health patients. First, they identified home health patients with a Medicare claim associated with an ICD-10 code related to Alzheimer's disease or related/other dementias (ADRD) prior to home health admission and defined these patients as having dementia. Of this population, those with an ADRD ICD-10 code in their Outcomes and Assessment Information Set (OASIS) assessment were characterized as having “&lt;span&gt;documented dementia&lt;/span&gt;.” The remaining home health patients with dementia, but who did not have an ADRD ICD-10 code in their OASIS assessment, were considered to have “&lt;span&gt;undocumented dementia&lt;/span&gt;.” The investigators assumed that undocumented dementia reflected a lack of recognition by the home health clinician, which in turn would negatively impact care delivery and outcomes.&lt;/p&gt;&lt;p&gt;True enough, those patients characterized as having undocumented dementia had an increased risk of hospitalization and ED use, and a lower likelihood of discharge to self-care. The authors concluded that dementia documentation could be “protective against negative outcomes,” and that when home health agencies are aware of a dementia diagnosis, they more effectively tailor care. According to the authors, “documentation of a dementia diagnosis may indicate that clinicians are both aware of the patient's dementia status and have the willingness and capacity to incorporate this information in care planning.” Additionally, they stated that “there is likely an underlying set of constructs influencing both documentation of dementia and subsequent care delivery and outcomes, including elements such as staff training and experience related to dementia care, home health agency resources and culture regarding tailored care for those with cognitive impairment, clinical information available to staff upon referral, and even community level resources to address dementia-specific needs.”&lt;/p&gt;&lt;p&gt;Are these conclusions plausible? Maybe, but maybe not.&lt;/p&gt;&lt;p&gt;In many ways, the investigators may have been comparing apples to oranges. In this study, those with documented dementia, when compared with those having undocumented dementia, differed substantially across a range of important characteristics. Those with undocumented dementia were younger, had lower c","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 7","pages":"2010-2011"},"PeriodicalIF":4.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19557","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236309","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":"Transitional Care Management in Persons With Dementia After Heart Failure Hospitalization and Skilled Nursing Facility Care","authors":"Thomas A. Bayer,&nbsp;Hiren Varma,&nbsp;Peter A. Hollmann,&nbsp;Pedro L. Gozalo","doi":"10.1111/jgs.19563","DOIUrl":"10.1111/jgs.19563","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dementia complicates care transitions, such as discharge from heart failure hospitalization to a skilled nursing facility (SNF) and then to home. Transitional care management (TCM), a bundled service that includes telephone communication within 2 business days and an office visit within 14 days, potentially addresses this problem.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed trends in TCM among Medicare beneficiaries with dementia hospitalized for heart failure in 2013–2017, comparing hospital–home discharges to hospital–SNF–home discharges. We then used a retrospective cohort study to estimate the risk-adjusted association of TCM with successful discharge home.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>\u0000 TCM occurred in 45 (2.3%) of 1990 eligible hospital–SNF–home discharges in year 2013, increasing to 205 (9.8%) of 2095 eligible in year 2017. In a cohort of 11,376 hospital–SNF-home transitions, the relative risk (95% CI) of successful community discharge was 1.24 (1.11–1.40) with TCM compared with no office visit within 14 days of discharge or TCM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Persons with dementia transitioning from heart failure hospitalization to SNF to home receive TCM less frequently than persons discharged directly home from the hospital. Nonetheless, TCM is associated with successful discharge in this vulnerable group of patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 9","pages":"2853-2858"},"PeriodicalIF":4.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236312","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":"A Large Health System Quality Improvement Intervention Providing Training and Tools to Improve Detection of Cognitive Impairment in Primary Care","authors":"Barak Gaster,&nbsp;Monica Zigman Suchsland,&nbsp;Joshua M. Liao,&nbsp;Sarah McKiddy,&nbsp;Annette L. Fitzpatrick,&nbsp;Basia Belza,&nbsp;Amy P. Hsu,&nbsp;Jaqueline Raetz","doi":"10.1111/jgs.19565","DOIUrl":"10.1111/jgs.19565","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Primary care providers (PCPs) are at the forefront of evaluating cognitive concerns and detecting Alzheimer's disease and related dementias (ADRD), but they generally lack the training and tools to do so.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a 2-year pragmatic intervention across a large health system of 14 community-based primary care clinics (94 PCPs). The intervention consisted of an education series integrated with workup tools in the exam room to assist PCPs in evaluating cognition. Electronic health record (EHR) data was extracted for 9 months before and 9 months after the intervention. Outcome measures were the number of cognitive assessments that PCPs recorded as discrete results in the EHR and the number of patients who PCPs newly diagnosed with an ADRD-related diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Comparing EHR data from the 9 months before the intervention to the 9 months after the intervention, the number of cognitive assessments documented in the EHR increased from 2.8 per month to 19.8 per month (<i>p</i> &lt; 0.001), and the number of new ADRD-related diagnoses made by PCPs increased from 6.2 per month to 14.6 per month (<i>p</i> = 0.012).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An intervention integrating tools for PCPs to use in the exam room, together with concise continuing education, increased the number of cognitive evaluations and the number of ADRD-related diagnoses in a large primary care health system. Such interventions are essential for building age-friendly ambulatory health systems and connecting patients to improved and innovative models of ADRD care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 9","pages":"2886-2892"},"PeriodicalIF":4.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228089","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":"An Initiative to Address Health Disparities: Calls, Advocacy, and Resources for OldEr Adults (CARE)","authors":"Morgan M. Nakatani,&nbsp;Victoria Lue,&nbsp;Nicole J. Schindler,&nbsp;Sandro Pinheiro de Oliveira,&nbsp;Liza Genao","doi":"10.1111/jgs.19558","DOIUrl":"10.1111/jgs.19558","url":null,"abstract":"<p>Goals and components of the Calls, Advocacy, and Resources for OldEr Adults program.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </p>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 7","pages":"2319-2322"},"PeriodicalIF":4.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228090","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":"Reply to: Comment on “Accelerating the Pace of Elder Justice Policy to Meet the Needs of a Growing Aging Population”","authors":"Kristin E. Lees Haggerty,&nbsp;Gary Epstein-Lubow","doi":"10.1111/jgs.19523","DOIUrl":"10.1111/jgs.19523","url":null,"abstract":"&lt;p&gt;Thank you for the opportunity to respond to Dr. Marian Liu's thoughtful letter regarding our recent article, “Accelerating the Pace of Elder Justice Policy to Meet the Needs of a Growing Aging Population” [&lt;span&gt;1&lt;/span&gt;]. We are grateful for Dr. Liu's insights and her deep, ongoing contributions to the field of elder justice.&lt;/p&gt;&lt;p&gt;We especially appreciate Dr. Liu's emphasis on the critical importance of sustained and expanded investment in Adult Protective Services (APS). As we highlighted in our article, APS serves as the front line in responding to elder abuse, neglect, and exploitation. In addition to leading investigations to understand the context of abuse, neglect, exploitation, and self-neglect, APS staff address risks and act to prevent crises, provide essential referrals to resources to address financial barriers, provide legal services, and address mental and physical health needs.&lt;/p&gt;&lt;p&gt;At this moment, APS faces significant headwinds. The broader political climate—including increasing calls to cut federal domestic spending—poses real risks to the future of APS. Some states' APS workers may have few co-workers and higher caseloads, or their APS system may become diminished to almost no activities. Proposed funding reductions, along with recent and ongoing administrative changes such as the reorganization of the Administration for Community Living (ACL), could destabilize essential elder justice infrastructure to such a degree that access to APS will become impossible at a time when the need is growing.&lt;/p&gt;&lt;p&gt;In this context, it is critical that we stand firmly behind APS. Federal leadership and investment remain vital—not only to maintain the current workforce and ensure consistency and equity across states, but also to foster innovation, workforce development, and data-driven improvements. We must advocate not just to preserve existing supports, but to expand them meaningfully.&lt;/p&gt;&lt;p&gt;At the same time, we recognize the importance of building a broader, more resilient elder justice ecosystem. This requires a “both/and” approach—one that continues to grow and protect federal investments while also activating local, philanthropic, and private−sector partnerships. These additional channels can amplify impact, foster cross-sector collaboration, and sustain momentum, especially in times of federal uncertainty.&lt;/p&gt;&lt;p&gt;Finally, we would like to extend our sincere appreciation to Dr. Liu for her leadership and for acknowledging the historic and ongoing work of the U.S. Senate Special Committee on Aging. The Committee has played a critical role in advancing elder justice policy, raising awareness, and holding systems accountable. Its continued productivity and bipartisan commitment are deeply valued.&lt;/p&gt;&lt;p&gt;Thank you again for the opportunity to respond, and for helping to advance this dialogue. We look forward to continued collaboration to accelerate progress and strengthen protections for older adults nationwide.&lt;/p&gt;&lt;p&gt;Kristin Lees Haggerty ","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 8","pages":"2625-2626"},"PeriodicalIF":4.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://agsjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19523","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228007","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":"Readiness and Barriers to Participate in Alzheimer's and Dementia Research Among Older Adults","authors":"Oshadi Jayakody,&nbsp;Helena M. Blumen,&nbsp;Morgan Grabanski,&nbsp;Mirnova Ceïde,&nbsp;Claudene George","doi":"10.1111/jgs.19568","DOIUrl":"10.1111/jgs.19568","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 9","pages":"2935-2938"},"PeriodicalIF":4.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228006","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}