Journal of Contextual Behavioral Science最新文献

{"title":"Physiological, behavioral, and self-report outcomes of acceptance- and regulation-based exposure for intrusive thoughts","authors":"Brooke M. Smith,&nbsp;Jennifer L. Barney,&nbsp;Clarissa W. Ong,&nbsp;Tyson S. Barrett,&nbsp;Michael E. Levin,&nbsp;Michael P. Twohig","doi":"10.1016/j.jcbs.2024.100850","DOIUrl":"10.1016/j.jcbs.2024.100850","url":null,"abstract":"<div><div>Leading theories regarding the mechanisms of exposure for OCD focus on Pavlovian fear reduction more than operant processes. Acceptance-based exposure directly targets operant behavior. Integrating these perspectives could lead to a more robust understanding of mechanisms of change in exposure and more effective and enduring treatments. The current study investigated acceptance and regulation of distress during exposure. Participants with intrusive thoughts were randomized into three groups, Acceptance (<em>n</em> = 23), Regulation (<em>n</em> = 20), and Control (<em>n</em> = 21), and completed two behavioral avoidance tests (BATs) 1 week apart. Active conditions completed a 30-min exposure plus 6 days of 10-min exposures at home; Control participants watched videos of the same durations. Self-report measures were collected at both sessions, and behavioral, subjective, and physiological repeated measures data were collected during both BATs. Compared to Control, active conditions decreased OCD symptom severity, rituals, and skin conductance levels, while Acceptance showed lower skin conductance levels than Regulation and Control. Acceptance showed greater willingness and psychological flexibility than Control, while Regulation did not. Results support theorized mechanisms of change in acceptance-based exposure and suggest willingness to experience distress may paradoxically lead to decreased physiological arousal, which has important implications for treatment and future research.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"34 ","pages":"Article 100850"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reintegration challenges among post-9/11 veterans: The role of mental health symptoms and resilience- and avoidance-based coping strategies","authors":"Samuel D. Spencer ,&nbsp;M. Bridget Zimmerman ,&nbsp;Nicte Donis ,&nbsp;Merlyn Rodrigues ,&nbsp;Dorothy O. Jackson ,&nbsp;Lilian Dindo","doi":"10.1016/j.jcbs.2023.09.007","DOIUrl":"https://doi.org/10.1016/j.jcbs.2023.09.007","url":null,"abstract":"<div><p><span><span>Many returning service members deployed in the wars of Iraq and Afghanistan (Operations Enduring Freedom, Iraqi Freedom and New Dawn) face numerous challenges within post-deployment community reintegration (PDCR), including </span>mild traumatic brain injury<span><span><span>, chronic pain, and psychological disorders such as PTSD– a constellation of symptoms referred to as polytrauma. Within a transdiagnostic </span>acceptance and commitment therapy (ACT) framework, optimal PDCR is hindered by excesses in maladaptive avoidance-based coping and deficits in resilience-based coping. The present cross-sectional study examined the relationship between vulnerability (psychological distress, </span>PTSD symptomology, and experiential avoidance) and resilience (values-based living; VBL) factors with PDCR in a sample of 298 Veterans with polytrauma-related concerns (</span></span><em>N</em>_{<em>male</em>} = 244, <em>M</em>_<em>age</em><span> = 40.6). Results indicated: 1) higher psychological distress, PTSD symptomology, and experiential avoidance, respectively, and low VBL were significantly associated with greater PDCR difficulty; and 2) Veterans high in VBL (versus low) demonstrated a strengthened association between psychological distress and PTSD symptomology, respectively, with PDCR difficulty. These slope differences revealed a lack of differentiation in PDCR at high levels of distress/PTSD: PDCR difficulty was high for all levels of VBL. Conversely, at low-to-moderate levels of distress/PTSD, differences in PDCR difficulty were observed across VBL levels: PDCR difficulty was lower for Veterans high in VBL (versus low), suggesting VBL as a potential catalyst for facilitating optimal PDCR, but only for a limited range of symptom severity. Findings support the use of transdiagnostic ACT to improve outcomes for Veterans with polytrauma-related concerns.</span></p></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"30 ","pages":"Pages 97-105"},"PeriodicalIF":5.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49725835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the ACT matrix to improve sleep: A practical guide for implementing the \"what\" and the \"how\" of sleep hygiene","authors":"Jennifer M. Leckey ,&nbsp;Alexandra Dagher ,&nbsp;Dayna L. Lee-Baggley","doi":"10.1016/j.jcbs.2023.10.002","DOIUrl":"https://doi.org/10.1016/j.jcbs.2023.10.002","url":null,"abstract":"<div><p><span>Insufficient sleep duration and quality among adults is a growing public health<span> concern. While cognitive behavioural therapy for insomnia is effective in treating clinical levels of sleep difficulty, intervention for subclinical sleep difficulty has been lacking. </span></span><span><em>The \"What\" and the \"How\" of </em><em>Sleep Hygiene</em></span><span> is an Acceptance and Commitment Therapy-based (ACT) psychoeducation group focused on improving sleep hygiene and supporting long term behaviour change. The group involved 8 sessions, each focused on a different aspect of sleep hygiene throughout the day (e.g., morning routine). Three behaviour change principles and the well-established ACT tool, the Matrix, were central to the intervention designed to help implement sleep hygiene. The session summaries are intended to provide clinicians with a practical guide for implementation.</span></p></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"30 ","pages":"Pages 142-154"},"PeriodicalIF":5.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49726021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age differences in acceptance and commitment therapy for chronic pain","authors":"Joel N. Fishbein ,&nbsp;Mara Tynan ,&nbsp;Lynn Truong ,&nbsp;Julie L. Wetherell ,&nbsp;Matthew S. Herbert","doi":"10.1016/j.jcbs.2023.09.006","DOIUrl":"https://doi.org/10.1016/j.jcbs.2023.09.006","url":null,"abstract":"<div><h3>Objective</h3><p>Chronic pain is prevalent and debilitating, especially among older adults. Acceptance and commitment therapy<span> (ACT) is an evidence-based treatment for chronic pain that, in a prior study, has shown greater benefit among older adults. Critical questions remain regarding the time course and extent of age differences in ACT for chronic pain. The current study sought to inform clinical decision-making by addressing these remaining questions.</span></p></div><div><h3>Methods</h3><p>This study reanalyzed data from a prior trial of ACT for chronic pain in US Veterans. We estimated piecewise latent curve models to capture the time course of change in pain intensity, pain interference, pain acceptance, and depression during and after ACT. Then, we examined age as a moderator of longitudinal effects and used pick-a-point models to generate age-specific trajectory predictions.</p></div><div><h3>Results</h3><p>Older age was associated with significantly greater improvement in pain intensity (<em>p</em> = .003) and marginally greater improvement in pain interference (<em>p</em> = .078) at posttreatment. However, during the six-month follow-up period, older adults relapsed on these outcomes (<em>p</em>s ≤ .029), whereas younger adults maintained their gains or even continued to improve. Older age was only marginally associated with greater depression improvement during the intervention (<em>p</em> = .069), and other moderation effects on depression and pain acceptance were nonsignificant.</p></div><div><h3>Conclusion</h3><p>Older adults may experience greater initial improvement than younger adults during ACT for chronic pain. However, older adults may then need adjunctive maintenance treatment. Future studies are needed to characterize the mechanisms driving this moderation effect.</p></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"30 ","pages":"Pages 106-111"},"PeriodicalIF":5.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49726085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric properties of the Psy-flex scale: A validation study in a community sample in Korea","authors":"Duckhyun Jo ,&nbsp;Byeori Seong ,&nbsp;Eunjoo Yang","doi":"10.1016/j.jcbs.2023.09.004","DOIUrl":"https://doi.org/10.1016/j.jcbs.2023.09.004","url":null,"abstract":"<div><p>This study examined the psychometric<span> properties of the recently developed six-item Psy-Flex among community samples in Korea. Using a cross-sectional design, data were collected from 1059 participants. Three bilingual experts translated the scale to ensure content validity. Factor analysis was employed to confirm the factor structure, and a polytomous item response theory model was used to examine the individual items and entire scale. The theory-based single-factor structure was confirmed using a Korean community sample, and measurement invariances were found across sex and age groups. In addition, the scale showed a moderate relationship with established measures of interest. Furthermore, item and categorical functioning were investigated using the polytomous Item Response Theory (IRT) model (i.e., the Generalized Partial Credit Model [GPCM]), identifying well-functioning (e.g., items 4, 5, and 6) and suboptimal (e.g., item 2) items. Additionally, the results suggest that the participants might not be able to meaningfully differentiate the original five-response categories. To the best of our knowledge, this is the first attempt to validate the Psy-Flex in Korea. We believe that the findings are of considerable value in facilitating our understanding of the scale and, more broadly, the construct of psychological flexibility.</span></p></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"30 ","pages":"Pages 70-79"},"PeriodicalIF":5.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49725914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the measurement of relational responding","authors":"Jamie Cummins","doi":"10.1016/j.jcbs.2023.10.003","DOIUrl":"https://doi.org/10.1016/j.jcbs.2023.10.003","url":null,"abstract":"<div><p>Psychologists increasingly recognize the importance of relational responding in understanding human behavior. As a result, there is a growing need for valid, reliable, and precise measures of relational responding. One promising measure is the Relational Abilities Index (RAI). However, its measurement properties have not been explored in-depth. There is little understanding, for example, of how precise the RAI is as a measure of individual-level abilities. In this paper I examine the precision of the RAI at the individual-level, quantify the item characteristics of the task using Item Response Theory, and more generally assess its quality as a measure of relational responding. Although broadly promising, the measure exhibits several substantial shortcomings which limit its utility and interpretability. I make recommendations for how to improve the task and highlight the importance of in-depth examinations of measurement for future research.</p></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"30 ","pages":"Pages 155-168"},"PeriodicalIF":5.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49725576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of psychological flexibility in the context of parenting: A scoping review","authors":"Stephanie V. Caldas ,&nbsp;Lindsay R. Antonsen ,&nbsp;Andrew S. Hamilton ,&nbsp;Danielle N. Moyer","doi":"10.1016/j.jcbs.2023.09.001","DOIUrl":"https://doi.org/10.1016/j.jcbs.2023.09.001","url":null,"abstract":"<div><p>Psychological flexibility in the context of parenting (i.e., parenting flexibility) is associated with positive outcomes for parents and children, and it is a target of psychological interventions. Psychological flexibility as a construct has been historically difficult to define and measure, and parenting flexibility is subject to the same challenges. This scoping review aims to map and summarize the literature on development and validation of measures of parenting flexibility, and to provide recommendations for measurement selection to inform research and clinical practice. OVID MEDLINE, PsycINFO, SocINFO, and google scholar were searched for articles pertaining to the development and/or validation of a measure of parenting flexibility, supplemented with solicitation from professionals in the field. Two independent reviewers screened 820 titles and abstracts and assessed 32 full-text articles for inclusion criteria: peer reviewed, published in English, empirical studies using parent samples, assessed a construct related to parenting flexibility, and involved the development and/or validation of a measurement tool. Translated measures were included in the final article synthesis if a full-text English version was available. A total of 18 studies were included in the final scoping review. Charting was used to map demographic and sample characteristics, relevant results, and indications for measurement selection. Seven measures were identified, four for general parenting flexibility and three for specific parenting contexts. Validity and reliability across measures was variable, but generally demonstrated utility of use. There is overlap and divergence with regard to item wording, aspects of psychological flexibility being measured, and relevancy to different aspects of parenting. Limited evidence exists to determine which measure best applies to specific purposes. Recommendations are made for measurement selection and areas of future research.</p></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"30 ","pages":"Pages 61-69"},"PeriodicalIF":5.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49726087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living well on haemodialysis: Feasibility and acceptability trial of an online Acceptance and Commitment Therapy (ACT) programme for people receiving kidney haemodialysis","authors":"James Elander ,&nbsp;Carol Stalker ,&nbsp;Morten Arborg ,&nbsp;Emma Coyne ,&nbsp;Romaana Kapadi ,&nbsp;Maarten W. Taal ,&nbsp;Nicholas M. Selby ,&nbsp;Kathryn Mitchell","doi":"10.1016/j.jcbs.2023.08.008","DOIUrl":"10.1016/j.jcbs.2023.08.008","url":null,"abstract":"<div><h3>Background</h3><p>People receiving kidney haemodialysis need psychological support.</p></div><div><h3>Objectives</h3><p>To assess feasibility and acceptability of a 4-week online video-based Acceptance and Commitment Therapy (ACT) programme for people receiving kidney haemodialysis.</p></div><div><h3>Design</h3><p>Single group before-and-after study.</p></div><div><h3>Participants</h3><p>People with end-stage kidney disease currently receiving dialysis, who had received in-centre haemodialysis at least 90 days in the last two years.</p></div><div><h3>Measures</h3><p>Recruitment, retention and engagement (feasibility); weekly and post-programme feedback (acceptability); pre-intervention and 4-week follow-up (potential outcome measures): kidney disease quality of life (KDQOL-SF), psychological flexibility (Acceptance and Action Scale) and acceptance of illness (Acceptance of Illness Scale).</p></div><div><h3>Results</h3><p>The study recruited 13 participants of whom 85% completed at least half the programme and 69% completed the whole programme. Health and medical treatment issues were the main known reasons for non-participation and drop-out. Of the 16 separate elements of the programme (four ‘story’ videos and 12 videos explaining ACT techniques), 13 were positively evaluated by at least 75% of participants. Of 11 aspects of the programme, 8 were positively evaluated by at least 75% of participants, and 89% found the programme easy to use, understood how it worked, found it easy to access, trusted the information, had no technical difficulties, and understood the activities. However, only 66.7% agreed the programme was interesting and only 62.5% agreed they enjoyed the programme. All responding participants indicated they would recommend the programme to people starting dialysis. The direction of change was positive for 17/21 potential outcome measures, with significant (p &lt; 0.05) improvements in psychological flexibility and energy/fatigue.</p></div><div><h3>Conclusions</h3><p>An online video-based ACT intervention was feasible and acceptable for people receiving kidney haemodialysis and the results provide pilot data for a planned larger trial.</p></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"30 ","pages":"Pages 41-49"},"PeriodicalIF":5.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44805373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary efficacy of an acceptance-based diabetes education (ACT-DE) programme for people with type 2 diabetes on diabetes distress and self-care behaviours: A pilot randomised controlled trial","authors":"Hau Yi Ngan ,&nbsp;Yuen Yu Chong ,&nbsp;Kit Man Loo ,&nbsp;Wai Tong Chien","doi":"10.1016/j.jcbs.2023.09.002","DOIUrl":"https://doi.org/10.1016/j.jcbs.2023.09.002","url":null,"abstract":"<div><h3>Background</h3><p>Diabetes distress is often characterised by aversive feelings about diabetes and avoidance of diabetes self-care, leading to suboptimal blood glucose<span><span> control, diabetes complications and depression. Evidence from a recent review has indicated the potential efficacy of acceptance-based diabetic self-management programmes for improving blood glucose levels and </span>mental health outcomes by fostering psychological flexibility.</span></p></div><div><h3>Methods</h3><p>We conducted a two-arm and assessor-blinded pilot randomised controlled trial<span> (RCT) with 48 participants aged 18–64 with type 2 diabetes and moderate distress levels, in which we compared a 6-week acceptance and commitment therapy and diabetes education (ACT-DE) programme intervention with diabetes education. Diabetes distress (the primary outcome), self-care behaviour, self-efficacy in diabetes management, and psychological inflexibility were measured at baseline and post-intervention. Focus group interviews were conducted to explore the intervention group's perceptions of the benefits and limitations of the intervention.</span></p></div><div><h3>Results</h3><p><span>Results of ANCOVA test showed that the intervention group exhibited significantly greater decrease in diabetes distress (effect size [Cohen's </span><em>d</em>] = 0.65), and increase in exercise frequency (<em>d</em> = 1.16), and foot-care frequency (<em>d</em><span> = 0.59) than the diabetes education group. The qualitative feedback of the intervention group revealed that the learnt ACT skills can be effectively applied in self-care and highlighted the utility of some of the intervention's therapeutic components, primarily mindfulness practices, metaphors, and interactive diabetes education. The intervention was well-accepted, with an 87.5% completion rate, but caution is needed due to a low recruitment rate (28.1%) during COVID-19 pandemic peak.</span></p></div><div><h3>Conclusion</h3><p>This pilot study confirmed that ACT-DE programme is an acceptable intervention for people with type 2 diabetes. It demonstrated preliminary efficacy with medium-to-large effect sizes in alleviating the participants’ diabetes distress and improving their self-care. Recruitment strategies can be improved to enhance the feasibility. Moreover, a full-scale RCT with longer-term follow-up is warranted to examine the intervention effects on diabetes distress, blood glucose control and other health outcomes.</p></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"30 ","pages":"Pages 50-60"},"PeriodicalIF":5.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49762560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying concepts of relational density theory to climate related consumer behavior: A contextual extension study","authors":"Lauren Hutchison ,&nbsp;Jordan Belisle ,&nbsp;Meredith Matthews ,&nbsp;Elana Sickman","doi":"10.1016/j.jcbs.2023.08.006","DOIUrl":"10.1016/j.jcbs.2023.08.006","url":null,"abstract":"<div><p>Predicting and influencing consumer behavior can aid in combating the climate crisis. Previously, Matthews et al. (2022) modelled the influence of relational framing on consumer purchasing, where relational training established pro- and anti-environmental coordinated classes. The current paper extends Matthews et al.’s (2022) analysis by empirically modelling complex relational networks consistent with Relational Density Theory (RDT; Belisle &amp; Dixon, 2020). In the experiment, participants completed a pre- and post- relational training multidimensional scaling procedure including positive and negative valence environmental related imagery and unfamiliar symbols. The relational training was designed to establish coordination between the symbols and evaluative climate functions. This analysis allowed for the development of a geometric model of complex relational behavior that were consistent with shifts in purchasing behavior observed in the prior study, supporting the link between relational behavior and overt behavior that may be of interest to behavior and climate scientists. Moreover, the current study provides a direct translational extension of existing research on RDT to a topic of immense social importance.</p></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"30 ","pages":"Pages 8-19"},"PeriodicalIF":5.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48518256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}