Health Care Management Review最新文献

{"title":"Do no harm? How health care management research can advance environmentally sustainable health care.","authors":"Maike V Tietschert, Jülide N Çelik, Alexander Negron Price, Sara J Singer, Andrew N Garman, Erik M Van Raaij","doi":"10.1097/HMR.0000000000000503","DOIUrl":"10.1097/HMR.0000000000000503","url":null,"abstract":"<p><strong>Issue: </strong>Health care organizations face pressure to advance environmental sustainability. Core challenges include pursuing distant-future goals (e.g., climate neutrality by 2050), leading sustainability initiatives beyond formal authority, and making mitigation decisions whose benefits accrue in the future and outside the organization.</p><p><strong>Critical theoretical analysis: </strong>Dominant management theories tend to treat the future as a strategic context or planning horizon rather than as an object of sustained organizational work. Long-term orientation is often assumed rather than explained. Leadership is conceptualized as hierarchical or professionally anchored, leaving distributed and extra-professional leadership weakly theorized. Moreover, prevailing theories assume alignment between decision-makers and beneficiaries, privileging value creation and capture while inadequately addressing harm reduction and externalized and future-oriented environmental benefits and costs.</p><p><strong>Insight/advance: </strong>We suggest a shift from treating the future as a given condition to be anticipated or adapted to, toward actively pursuing distant futures as ongoing organizational work. We conceptualize sustainability leadership as distributed across fragmented authority structures and reframe environmental sustainability as a governance challenge of managing asymmetric costs and benefits alongside clinical priorities. Reframing of sustainability leadership provides opportunities for healthcare management research to advance environmentally sustainable health care through managerial work.</p><p><strong>Practice implications: </strong>We highlight the need for health care managers to actively sustain future-oriented goals over time, lead sustainability initiatives without relying solely on formal authority, and develop decision and performance frameworks capable of integrating temporally and spatially uneven payoffs.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"273-283"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing through transformation: Organizational responses to financial precarity and the Rural Health Transformation Program.","authors":"Larry R Hearld, Cheryl Rathert","doi":"10.1097/HMR.0000000000000507","DOIUrl":"10.1097/HMR.0000000000000507","url":null,"abstract":"","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 4","pages":"271-272"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809137","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":"Why physicians resist artificial intelligence: A systematic review through the lens of diffusion of innovations.","authors":"Michele L Heath, Kristin Burton, Navneet C Grant, Tracy H Porter","doi":"10.1097/HMR.0000000000000500","DOIUrl":"10.1097/HMR.0000000000000500","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) enabled systems hold significant promise for transforming health care delivery. These technologies are frequently developed and commercialized by firms focused on creating innovative products or services and positioning them as essential solutions for clinical and organizational needs. However, despite their transformative potential, the integration of artificial intelligence into routine clinical practice has been met with notable resistance from physicians.</p><p><strong>Purpose: </strong>The purpose of this systematic review was to examine the factors contributing to physicians' resistance to AI-enabled technologies in clinical practice. Rogers' Diffusion of Innovations (DOI) theory was employed as the guiding theoretical framework to analyze how perceived innovation attributes shape physician resistance.</p><p><strong>Methodology/approach: </strong>We conducted a PRISMA-guided systematic literature review across five databases, examining sixteen empirical studies from the United States published in English.</p><p><strong>Conclusion: </strong>We identified resistance factors for AI among physicians in clinical practice using a deductive approach guided by Rogers' Diffusion of Innovations (DOI) framework, focusing on perceived relative advantage, compatibility, and complexity of AI-enabled technologies.</p><p><strong>Practice implications: </strong>These findings show that physician adoption of AI tools depends on whether innovations demonstrably improve clinical quality, efficiency, and workload compared with existing practices. Adoption is strengthened when hospital leaders make benefits visible through data, pilots, physician champions, and collaborative testing environments that build trust and reduce uncertainty about the technology's value.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"316-325"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449885","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":"M&A reality check: A longitudinal study of operational cost performance in U.S. hospitals.","authors":"Yousef Abdulsalam, Mikaella Polyviou, Eugene Schneller","doi":"10.1097/HMR.0000000000000502","DOIUrl":"10.1097/HMR.0000000000000502","url":null,"abstract":"<p><strong>Background: </strong>Hospital mergers and acquisitions (M&As) reduce resource dependence on sources of input and purchasers of output, via market power, service diversification, and operational efficiency. While prior research has examined M&A effects on quality and pricing, less is known about their effects on supply chain cost performance-a core input to health care delivery and a frequently cited but not always realized driver of consolidation.</p><p><strong>Purpose: </strong>To determine the impact of hospital M&As on acquired hospital operating costs, in terms of magnitude and timing, and compare possible efficiencies in supply expenses relative to other expense categories.</p><p><strong>Methodology: </strong>We analyzed a longitudinal data set of U.S. acute care hospitals (2016-2021) using propensity score matching and panel regression. This approach isolated the effect of merger events on total operating expenses, salary expenses, supply expense categories (medical-surgical and pharmaceutical), and net income.</p><p><strong>Findings: </strong>Acquired hospitals experienced significant reductions in total operating expenses in the postmerger period. These savings were largely attributable to streamlined payroll costs. We observed a modest reduction in medical-surgical supply costs 1 year post-acquisition, but no significant change in pharmaceutical supply costs.</p><p><strong>Practice implications: </strong>Supply chain cost savings from hospital acquisitions are easy to imagine but elusive to realize. Hospital leaders should first seek targets whose supply chain operations, strategies, and partners fit their own, and proactively communicate and integrate supply chain operations during post-acquisition planning to realize the anticipated operational synergies.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"336-345"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burned out and ready to leave? How workplace violence drives turnover among Chinese nurses and the role of well-being HRM.","authors":"Timothy Bartram, Patricia Pariona-Cabrera, Qinyan Gong, Xiaoyan Liang, Di Fan, Jessica Borg, Hannah Meacham, Tse Leng Tam, Shea Fan, Jillian Cavanagh, Justine Ferrer, Peter Holland","doi":"10.1097/HMR.0000000000000499","DOIUrl":"10.1097/HMR.0000000000000499","url":null,"abstract":"<p><strong>Background: </strong>Workplace violence is a growing phenomenon in health care settings, which negatively impacts nurses' physical and mental well-being and intention to leave. Understanding the forces that shape nurses' intention to leave is therefore fundamental to safeguarding the quality of patient care, patient safety, and system sustainability, a critical and central concern for health care management.</p><p><strong>Purpose: </strong>Against a backdrop of workplace violence, high workloads, and chronic nurse burnout, we test the mediating role of burnout on the relationship between workplace violence and intention to leave. We also test the buffering role of well-being human resource management (WBHRM) on the relationship between burnout and intention to leave, so that higher levels of WBHRM will mitigate the positive relationship between burnout and intention to leave.</p><p><strong>Methodology/approach: </strong>We test these hypotheses using the conservation of resources (COR) theory and a three-wave matched sample of 179 nurses working in a large Chinese health service.</p><p><strong>Findings: </strong>We confirm one of our two hypotheses. We report that nurse burnout positively mediates the relationship between workplace violence and intention to leave. However, interestingly, we find that WBHRM does not buffer the relationship between nurse burnout and intention to leave but actually exacerbates this relationship.</p><p><strong>Practical implications: </strong>We discuss the health care management implications of our findings and suggest various possible explanations for WBHRM exacerbating the relationship between burnout and intention to leave. We suggest that health care managers need to understand WBHRM within its wider social context, the proactive use of HRM practices to prevent violence and burnout before significant personal resource loss, and the need for structural changes in hospital settings to tackle systemic workforce challenges such as high workloads and work intensification.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 4","pages":"307-315"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808902","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 impact of organizational inclusion for a diverse workforce on organizational climate assessments and hospital recommendations among nurse practitioners.","authors":"Hyunmin Yu, Kathryn A Connell, Daniela Golinelli, Matthew D McHugh, Tari Hanneman, Jose A Bauermeister, Heather Brom","doi":"10.1097/HMR.0000000000000505","DOIUrl":"10.1097/HMR.0000000000000505","url":null,"abstract":"<p><strong>Background: </strong>While the nursing profession has advocated for workforce diversity, limited research has examined how institutional inclusion efforts are associated with the experiences of nurse practitioners (NPs), particularly in hospital settings.</p><p><strong>Purpose: </strong>To examine whether institutional inclusion efforts were associated with NPs' strong recommendation of their hospital and whether this relationship was explained by NPs' assessments of organizational climate.</p><p><strong>Methods: </strong>This cross-sectional study analyzed 2023 data from 742 NPs across 412 U.S. hospitals, drawing on the Penn Nurses4All Survey, the Healthcare Equality Index (HEI), and the American Hospital Association Annual Survey. The independent variable was employment in an HEI-participating hospital, and the dependent variable was NPs' strong recommendation of their hospital to family and friends. Mediating variables included NPs' assessments of organizational climate. Mediation analysis using weighting estimators was conducted to adjust for confounding and evaluate the extent to which organizational climate explained the relationship between HEI participation status and hospital recommendation.</p><p><strong>Results: </strong>NPs in HEI-participating hospitals were 15% more likely to strongly recommend their hospital (95% CI: .07-.22). Significant indirect associations were observed and accounted for the total association through overall organizational climate (26.6%), professional visibility (26.6%), and NP-administration relations (20%), respectively.</p><p><strong>Practice implications: </strong>Hospital participation in the HEI is associated with stronger hospital recommendations among NPs, partly through more favorable assessments of organizational climate. As health care systems work to improve work environments and job outcomes for a diverse workforce, cultivating a climate of inclusion through meaningful, everyday practices will be essential.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 4","pages":"357-365"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809128","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 interplay of nurse staffing, financial performance, and patient outcomes in rural hospitals: A longitudinal analysis from Pennsylvania.","authors":"Dinesh R Pai, Esmaeil Bahalkeh","doi":"10.1097/HMR.0000000000000506","DOIUrl":"10.1097/HMR.0000000000000506","url":null,"abstract":"<p><strong>Background: </strong>Nurse staffing directly affects patient outcomes and hospital performance, creating a cost-versus-care dilemma, especially in rural areas with nursing shortages.</p><p><strong>Purpose: </strong>To examine the impact of nurse staffing patterns on Pennsylvania's rural hospital performance using 2000-2023 data.</p><p><strong>Data source/study setting: </strong>Data from 2000 to 2023 on Pennsylvania rural hospitals were drawn from several sources, including the Pennsylvania Department of Health, the Pennsylvania Healthcare Cost Containment Council, and the American Hospital Directory. After excluding hospitals with incomplete or unavailable data, the final sample comprised 1,606 hospital-year observations.</p><p><strong>Methodology/approach: </strong>This retrospective, longitudinal study analyzed acute care hospitals in Pennsylvania's rural counties using unbalanced panel data. We use robust econometric modeling to investigate how nurse staffing levels, skill mix, and flexibility influence financial sustainability, operational efficiency, and quality of care.</p><p><strong>Results: </strong>Increased staffing and a higher skill mix increased costs per adjusted patient day but significantly reduced readmissions, mortality, and average length of stay (ALOS). Interestingly, staffing flexibility, while not impacting costs, increased ALOS, a finding consistent with previous research. Staffing decisions and patient outcomes are intertwined, demanding careful consideration in resource-constrained rural settings.</p><p><strong>Conclusions: </strong>Rural hospital performance is strongly linked to nurse staffing. While increasing staffing and skill mix may incur higher initial costs, they ultimately enhance patient outcomes and operational efficiency, contributing to long-term financial stability despite any short-term expenses.</p><p><strong>Practice implications: </strong>The insights from this study are vital for administrators and policymakers focused on enhancing healthcare in rural areas. Therefore, a shift is required: from cost-centric to value-based staffing, emphasizing RNs, a balanced skill mix, data-driven decisions, and policy support to address rural health care challenges.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"366-374"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674536","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":"Exploring the underlying mechanisms through which financial strategies translate into improved performance in U.S. health care organizations.","authors":"Manisha Mathur, Ethan Burns, Andrew Farach, Sunil Mathur","doi":"10.1097/HMR.0000000000000501","DOIUrl":"10.1097/HMR.0000000000000501","url":null,"abstract":"<p><strong>Background: </strong>Prior studies have examined the relationship between financial strategies and organizational performance in health care facilities; however, the underlying mechanisms through which financial strategies translate into improved performance remain largely unexplored. In particular, value appropriation mechanisms, such as advertising intensity and relationship investment, have received limited attention in health care management and marketing literature despite their potential importance for managerial and policy decision-making.</p><p><strong>Purpose: </strong>This study investigates the mechanisms through which financial strategies translate into improved organizational performance by examining the mediating role of value appropriation mechanisms, specifically, advertising intensity and relationship investment. By focusing on these underexplored pathways, the study aims to examine how financial resources are effectively leveraged to generate performance gains in U.S health care organizations.</p><p><strong>Methodology: </strong>This cross-sectional study uses secondary data from U.S. health care organizations, including hospitals, ambulatory care centers, and long-term care facilities. Drawing on the resource-based view and financial ratio theory, we analyzed 10 years of financial and operational data from Standard & Poor's Global Market Intelligence and the Center for Research in Security Prices databases. Structural equation modeling was used to estimate direct and indirect effects through two mediation pathways.</p><p><strong>Findings: </strong>Results show that value appropriation mechanisms support financial sustainability by enhancing patient awareness and retention. Financial flexibility, distress risk, and operating efficiency had significant direct effects on performance. Relationship investment strengthened connections between financial metrics and performance, while advertising intensity amplified these effects. Although service orientation had a negative direct effect, it showed a positive indirect effect through relationship investment.</p><p><strong>Practice implications: </strong>health care managers may enhance organizational performance by aligning financial strategies with targeted advertising and relationship-building initiatives that strengthen patient engagement and organizational reputation.</p><p><strong>Conclusions: </strong>This study demonstrates that value appropriation mechanisms play a central role in translating financial resource management into improved firm performance in health care organizations.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"326-335"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399580","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 patient participation puzzle: Organizing patient participation in health care networks.","authors":"Roos G F M van der Ven, Robin Peeters, Aggie T G Paulus, Lisann de Ruijsscher, Felice N van Erning, Ignace H J T de Hingh, Daan D Westra","doi":"10.1097/HMR.0000000000000498","DOIUrl":"10.1097/HMR.0000000000000498","url":null,"abstract":"<p><strong>Introduction: </strong>Health care is increasingly organized in interorganizational networks, with patient participation gaining prominence to better tailor care to patient needs. However, these often occur independently, limiting understanding of how to organize interorganizational patient participation. Poorly implemented participation risks draining time and energy from vulnerable groups without creating meaningful change.</p><p><strong>Methods: </strong>We conducted an in-depth case study of a multihospital network, using 23 semistructured interviews with patients, health care staff, and network administrators, 77 hours of observations, and 276 documents to explore how interorganizational patient participation functions.</p><p><strong>Results: </strong>Our findings reveal the patient participation puzzle : the tension between the aspiration for patient participation at all interorganizational levels and its potential burden and unclear impact. Four interrelated themes emerged: aim, organizational structure, participant attributes, and impact. We distinguished participation within the network's operational level, closely tied to care delivery, and in network strategy, where patients' contributions are less clearly defined.</p><p><strong>Conclusion: </strong>Patient participation in network strategy often lacks clear aims, leaving patients' roles unclear and imposing undue burden. Key participant attributes like experiences and perspectives influence engagement but can also pose challenges. Participation's impact is not inherent; without clear aims, structures, and roles, it risks becoming symbolic and burdensome without meaningful impact.</p><p><strong>Practice implications: </strong>Organizing patient participation in health care networks is quite the puzzle. To avoid window dressing, network managers should acknowledge patient burden, set clear goals, act on patient input, and organize carefully to prevent tokenism. Accreditation bodies and policymakers should prioritize guidance and support over mandates to ensure meaningful impact.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"295-306"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meeting demands & bridging gaps: The relationship between market characteristics and the utilization of enabling services in Federally Qualified Health Centers.","authors":"Shanequa S Roscoe-Nelson, Nancy Borkowski, Monica Aswani, Philip Cendoma, Michelle Brown, Geoffrey A Silvera","doi":"10.1097/HMR.0000000000000496","DOIUrl":"10.1097/HMR.0000000000000496","url":null,"abstract":"<p><strong>Background: </strong>Health education and community outreach provided through enabling services help increase access to care, promote preventive services, and improve health outcomes. Given the vulnerable populations served by Federally Qualified Health Centers (FQHCs), it is critical to examine how resources, like enabling services staffing, are utilized to address patient needs.</p><p><strong>Purpose: </strong>This study aimed to explore whether market characteristics indicating resource availability and resource demands are related to the utilization of enabling services workers providing health education and community outreach in FQHCs.</p><p><strong>Methodology/approach: </strong>A two-part model using data from the 2022 Uniform Data System (UDS) was conducted to estimate the probability of FQHCs utilizing enabling services workers with logistic regression and the extent of utilization of these workers if present using linear regression.</p><p><strong>Findings: </strong>Study findings revealed variability in resource availability and resource demand factors that are related to the utilization of enabling services workers, with several factors not found to be significant.</p><p><strong>Conclusion: </strong>The findings suggest that FQHCs may not be sufficiently responsive to patients and community needs or organizational resource levels with the current staffing patterns. This misalignment may lead to negative impacts on patient health outcomes and process measures.</p><p><strong>Practice implications: </strong>There is a need for policy to prioritize non-clinical support roles and ensure sustainable funding to support the delivery of comprehensive, equitable care to the patients served by FQHCs. There is also a need to understand how other healthcare organizations might be employing resources beyond traditional clinical roles.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 4","pages":"284-294"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809170","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}