Journal of Behavioral Medicine最新文献

{"title":"Mobile apps for diabetes self-management: An updated review of app features and effectiveness.","authors":"Joyce A Corsica, Mackenzie C Kelly, Lauren E Bradley, Madeline M Konsor, Elizabeth J Wilson, Isabel C Quinones, Rebecca W Jeddi, Megan A Markey","doi":"10.1007/s10865-024-00525-y","DOIUrl":"https://doi.org/10.1007/s10865-024-00525-y","url":null,"abstract":"<p><p>Self-management of diabetes is extremely challenging and non-adherence is common. Health consequences are significant for those unable to adhere to the complex treatment regimen, which includes regular oral medication and/or insulin use, frequent blood sugar checks, strict dietary management, and regular physical activity. Mobile applications (apps) present a tremendous opportunity to help patients improve adherence to these behaviors. The availability of commercial diabetes self-management apps is increasing exponentially, making it difficult for patients and providers to stay informed about app options and benefits. Previous reviews have described commercial diabetes apps and their features and usability for patients with diabetes. A smaller number have reviewed the effectiveness of these apps in improving blood glucose as well as other aspects of diabetes management. The aim of this article is to update our 2016 review, summarize the results of new reviews, review outcomes of diabetes apps described in the literature, and offer recommendations for app features, effectiveness research, and marketing in apps for diabetes self-management. Although higher-quality research is needed, current reviews suggest that many diabetes apps are effective in lowering HbA1c. Recommendations for future research include reporting critical details such as patient demographics and intervention elements and designing studies to identify the most effective components of diabetes management apps. Furthermore, clearly labeling apps that have data supporting clinical efficacy in app stores would allow both providers and patients to easily identify apps that might be most beneficial. Future research should explore the use of apps for the prevention of diabetes in individuals diagnosed with prediabetes.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569840","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 exercise interventions on sleep in adult populations with depression, anxiety, or posttraumatic stress: review of the current evidence and future directions.","authors":"Kristin L Szuhany, Abigail J Sullivan, Joshua L Gills, M Alexandra Kredlow","doi":"10.1007/s10865-024-00532-z","DOIUrl":"10.1007/s10865-024-00532-z","url":null,"abstract":"<p><p>Consistent evidence suggests that exercise leads to improvements in subjective sleep quality and also objective sleep metrics in non-psychiatric adult populations. However, the degree to which exercise provides sleep benefits for adults with psychiatric disorders is less known, despite the potential benefits given that sleep disturbance is prevalent in these populations. In this narrative review, we synthesize results of randomized controlled trials examining the influence of aerobic and/or resistance exercise interventions on sleep outcomes in adult psychiatric populations. We specifically focus on populations with elevated symptoms or diagnoses of depression, anxiety, or posttraumatic stress disorder. A systematic search through June 2024 yielded 26 relevant trials. Overall, most trials reported improvement of subjective sleep quality after aerobic and/or resistance exercise programs in samples with depression. Similar effects were observed for posttraumatic stress; however, larger trials are needed. Further research is needed to examine the impact of exercise on sleep in anxiety populations as only one trial with mixed results was identified. Results were more equivocal for the subpopulation of adult women with perinatal or postpartum depression, demonstrating the importance of understanding exercise effects on sleep in specific subpopulations. Few studies examined objective sleep outcomes, impact of acute exercise on next day sleep, or the interplay between exercise, sleep, and psychiatric symptom changes, all important areas of future research. Other implications and future directions are discussed, including potential moderators and mechanisms of action that warrant further study to better understand how exercise interventions may optimally target sleep in psychiatric populations.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548363","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":"Exposure to firearm injury and suicide in a rural Pennsylvania county: implications for mental and behavioral health.","authors":"Richard Stansfield, Daniel C Semenza, Devon Ziminski","doi":"10.1007/s10865-024-00529-8","DOIUrl":"https://doi.org/10.1007/s10865-024-00529-8","url":null,"abstract":"<p><p>To evaluate the association between self-reported gun violence exposures and mental health and behavioral health indicators in a rural population. Using cross-sectional survey responses from 630 residents of a rural county in Pennsylvania, logistic regression models estimate the likelihood of residents indicating moderate or severe levels of health outcomes as a function of gun violence exposure. We control for a series of variables related to gun ownership, behavior, history with firearms and demographic characteristics. Personal firearm victimization was associated with self-reported depressive symptoms and interrupted sleep. Secondary exposure to firearm violence, particularly exposure to friends attempting or completing a suicide, was associated with higher odds of reporting severe levels (14 days or more in the past month) of depressive symptoms, anxiety, and poor sleep. For firearm suicide involving a friend or family member, the odds of reporting severe levels of all three outcomes are 3 times greater (OR 2.984, 95% CI 1.457-6.108). For each additional firearm exposure, the odds of experiencing severe levels of mental health and sleep difficulties are 1.4 times greater (OR 1.384, 95% CI 1.115-1.720). Cumulative exposures also increase the odds of reporting binge drinking and drug use. Firearm violence exposure was associated with adverse health indicators in this rural population. Approaches to counter the effects of cumulative firearm exposure and firearm suicide exposure, including reinvigorating community spaces and strengthening social supports, may help to reduce mental health burden in rural communities.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523365","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":"Personality and cardiovascular mortality risk: a multi-cohort analysis in individuals with and without pre-existing cardiovascular disease.","authors":"Markus Jokela, Laura Pulkki-Råback, Marko Elovainio, G David Batty, Mika Kivimäki","doi":"10.1007/s10865-024-00528-9","DOIUrl":"https://doi.org/10.1007/s10865-024-00528-9","url":null,"abstract":"<p><p>This study investigated the associations between personality traits of the Five Factor Model and cardiovascular mortality, with a specific focus on whether pre-existing cardiovascular conditions modified these associations. We used data from 43,027 participants across five cohort studies: Health and Retirement Study (HRS); Wisconsin Longitudinal Study (WLS); National Social Life, Health, and Aging Project (NSHAP); Midlife in the United States (MIDUS); Household, Income, and Labour Dynamics in Australia (HILDA) with a mean age 55.9 years and 6493 individuals with pre-existing cardiovascular disease. We conducted meta-analyses examining conscientiousness, emotional stability, agreeableness, openness to experience, and extraversion in relation to mortality due to coronary heart disease and stroke. During a mean follow-up of 12.1 years, 1620 participants died from coronary heart disease and 454 from stroke. Lower conscientiousness was associated with higher mortality risk from both coronary heart disease (hazard ratio per 1SD = 0.82, 95%CI = 0.75-0.90) and stroke (HR = 0.84, CI = 0.72-0.99). Lower emotional stability predicted increased coronary heart disease mortality (HR = 0.91, CI = 0.85-0.97). The association between conscientiousness and cardiovascular mortality did not differ between individuals with or without baseline cardiovascular conditions. In addition, adjustments for health behaviors and other covariates only slightly attenuated this association. Other personality traits were not associated with cardiovascular disease mortality. Our findings highlight the role of low conscientiousness, and to a lesser extent low emotional stability, in the development and progression of fatal cardiovascular disease through pathways that may extend beyond established health behaviors.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523366","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 recent history and near future of digital health in the field of behavioral medicine: an update on progress from 2019 to 2024.","authors":"Danielle Arigo, Danielle E Jake-Schoffman, Sherry L Pagoto","doi":"10.1007/s10865-024-00526-x","DOIUrl":"https://doi.org/10.1007/s10865-024-00526-x","url":null,"abstract":"<p><p>The field of behavioral medicine has a long and successful history of leveraging digital health tools to promote health behavior change. Our 2019 summary of the history and future of digital health in behavioral medicine (Arigo in J Behav Med 8: 67-83, 2019) was one of the most highly cited articles in the Journal of Behavioral Medicine from 2010 to 2020; here, we provide an update on the opportunities and challenges we identified in 2019. We address the impact of the COVID-19 pandemic on behavioral medicine research and practice and highlight some of the digital health advances it prompted. We also describe emerging challenges and opportunities in the evolving ecosystem of digital health in the field of behavioral medicine, including the emergence of new evidence, research methods, and tools to promote health and health behaviors. Specifically, we offer updates on advanced research methods, the science of digital engagement, dissemination and implementation science, and artificial intelligence technologies, including examples of uses in healthcare and behavioral medicine. We also provide recommendations for next steps in these areas with attention to ethics, training, and accessibility considerations. The field of behavioral medicine has made meaningful advances since 2019 and continues to evolve with impressive pace and innovation.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523382","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":"Psychological value theory: predicting health-seeking behavior from symptom perception.","authors":"G Ryan Page, Philip Quinlan, Len Lecci, Dale J Cohen","doi":"10.1007/s10865-024-00531-0","DOIUrl":"https://doi.org/10.1007/s10865-024-00531-0","url":null,"abstract":"<p><p>We recruit Psychological Value Theory (PVT) to understand how symptom value influences health-seeking decisions. Estimates of the Psychological Value of relief from a particular symptom were previously collected and used to predict the speed of participants' decision and the choice they make in three discrete choice experiments. Experiment 1 presented participants with a scenario and asked them to identify which of two symptoms they would seek healthcare services to treat. For each participant on every trial, two randomly chosen symptoms were inserted into the scenario. Experiment 2 addressed how the Psychological Value of a group of symptoms is predicted from the individual symptoms. Experiment 2 replicated Experiment 1 using groups of two symptoms, and predicted choice based on three grouping functions. Experiment 3 replicated Experiment 2 using a yes/no task, whereby participants were asked if they would pursue a health care visit for a single set of symptoms. The results showed that PVT accurately predicted speed and choice in all three experiments. The Psychological Value of relief from a symptom was the primary driver of choice along with a response bias in favor of avoiding symptoms labeled \"severe.\"Health-seeking decisions are well modeled by a general-purpose, value-based computational model (PVT), with the Psychological Value of relief from health symptoms as a primary driver of health-seeking behavior.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510503","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":"Perceived discrimination and pain outcomes among black adults with chronic musculoskeletal pain: identifying modifiable psychosocial risk factors.","authors":"Katherine E Gnall, Julia E Hooker, James D Doorley, Jafar Bakhshaie, Ana-Maria Vranceanu","doi":"10.1007/s10865-024-00522-1","DOIUrl":"https://doi.org/10.1007/s10865-024-00522-1","url":null,"abstract":"<p><p>Chronic musculoskeletal pain (CMP) is highly prevalent, frequently associated with negative health outcomes, and disproportionately impacts Black Americans. Perceived racial and ethnic discrimination has emerged as a factor that may influence the experience of chronic pain in this population. Identifying modifiable psychosocial factors that influence the link between perceived discrimination and pain and that can be directly targeted in treatment is vital to reducing the disproportionate burden of CMP among Black individuals. The present study examines the moderating role of five risk factors (i.e., pain avoidance, pain fusion, experiential avoidance, pain catastrophizing, and pain anxiety) on the relationship between perceived discrimination and pain outcomes (i.e., pain intensity and interference) in a sample of 401 Black adults with CMP. We recruited 401 Black individuals (M_age = 35.98, 51.9% female) with self-reported CMP and assessed their self-reported perceived discrimination, pain intensity, pain interference, and pain-related psychosocial risk factors. Results indicated that higher scores on each of the psychosocial risk factors (i.e., pain avoidance, pain fusion, experiential avoidance, pain catastrophizing, and pain anxiety) were significantly associated with greater pain intensity and pain interference (all ps < 0.01). Further, pain avoidance (B = 0.12, p = .006), pain fusion (B = 0.13, p = .002), and pain anxiety (B = 0.13, p = .002) each significantly moderated the relation between perceived discrimination and pain intensity. Greater perceived discrimination was associated with greater pain intensity at higher levels of avoidance and fusion, and was associated with less pain intensity at lower levels of avoidance and pain anxiety. In interaction models predicting pain interference, both pain fusion (B = 0.14, p = .001) and pain anxiety (B = 0.10, p = .01) significantly moderated the relation between perceived discrimination and pain interference. Perceived discrimination was associated with greater pain interference at higher levels of pain fusion and pain anxiety, and was not associated with pain interference at lower levels of pain fusion and pain anxiety. The present findings provide important insights into psychosocial risk factors that moderate the link between perceived discrimination and pain outcomes, providing important clinical implications for the treatment of Black adults with chronic musculoskeletal pain.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376152","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":"Patterns of dietary quality, physical activity, and sleep duration among cancer survivors and caregivers.","authors":"Meghan B Skiba, Terry A Badger, Thaddaeus W W Pace, Michael A Grandner, Patricia L Haynes, Chris Segrin, Rina S Fox","doi":"10.1007/s10865-024-00523-0","DOIUrl":"10.1007/s10865-024-00523-0","url":null,"abstract":"<p><p>Fruit and vegetable intake (FVI), moderate-to-vigorous physical activity (MVPA), and sleep duration are each independently associated with cancer-related and general health outcomes among cancer survivors. Past research suggests that health behaviors cluster among cancer survivors, with caregivers demonstrating similar patterns. This analysis examined co-occurrence of FVI, MVPA, and sleep duration among cancer survivors and informal cancer caregivers and identified sociodemographic and clinical correlates of health behavior engagement. Using data from the Health Information National Trends Survey (HINTS), an exploratory latent profile analysis (LPA) was conducted among those self-reporting a history of cancer or identifying as a cancer caregiver. The LPA model was fit with daily self-reported FVI (cups/d), MPVA (minutes/d) and sleep duration (hours/d). Multinomial logistic regression models were used to predict profile membership based on sociodemographic and clinical characteristics. Four health behavior profiles were identified (Least Engaged-No MVPA, Least Engaged-Low MVPA, Moderately Engaged, and Highly Engaged). The largest profile membership was Least Engaged-No MVPA, capturing 37% of the sample. Profiles were most distinguished by MVPA, with the lowest variance in sleep duration. Participants reporting higher FVI also often reported greater MVPA and longer sleep duration. Profile membership was significantly associated with age, relationship status, education, income, rurality, alcohol use, self-efficacy, psychological distress, BMI, and cancer type. This study identified four health behaviors patterns and sociodemographic correlates that distinguished those patterns among cancer survivors and caregivers drawn from a nationally representative sample. Results may help identify for whom health behavior interventions could be of greatest benefit.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362325","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":"Implementing a behavioral physical activity program in children and adolescent survivors of childhood cancer: a pilot randomized controlled trial.","authors":"Maxime Caru, Smita Dandekar, Brett Gordon, David E Conroy, Emily D Barb, Shawna E Doerksen, Gayle M Smink, Daniel J McKeone, Nidhi B Shah, Robert J Greiner, Joseph W Schramm, Pooja Rao, Lisa McGregor, Kathryn H Schmitz","doi":"10.1007/s10865-024-00497-z","DOIUrl":"10.1007/s10865-024-00497-z","url":null,"abstract":"<p><p>Purpose We aimed to document the acceptability (enrollment rate) and feasibility (phone call delivery rate) of implementing a behavioral PA intervention over 12 weeks, in addition to documenting its effects on patient-reported outcomes and physical functioning. This study also describes the costs of carrying out a behavioral PA intervention. A total of 40 participants were randomized in a 1:1 ratio. The tailored behavioral PA intervention was developed based on the most recent PA guidelines in pediatric oncology and on the COM-B framework to enact PA behavior changes. The prescription (frequency, intensity, time and type (FITT)) was adjusted each week during the weekly support calls. The control group did not receive the intervention. 26 males and 14 females (13.6 years old on average and 2.9 years post-cancer treatment on average) participated in our study. The acceptability rate was 90.9% and the feasibility rate was > 85%. We found that 85% improved PA frequency, 80% improved PA intensity, 100% improved PA time, and 50.0% achieved the recommended PA guidelines. No adverse events were reported over the duration of the intervention. Physical function improved with longer 6-minute walk distances in the intervention group (465.8 ± 74.5 m) than in the control group (398.7 ± 92.9 m) (p = 0.016). PROs scores for all participants were within the limits of the normal range. The estimated cost per participant of carrying out this intervention was USD $126.57. Our 12-week behavioral PA intervention, based on the COM-B framework, was found to be acceptable, feasible and safe in childhood cancer survivors. This study is an important step in the right direction to make exercise standard practice in pediatric oncology.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"792-803"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909656","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":"Arriba por la Vida Estudio: a randomized controlled trial promoting standing behavior to reduce sitting time among postmenopausal Latinas.","authors":"Gregory A Talavera, Sheila F Castañeda, Maria D Lopez-Gurrola, Ana Rebeca Alvarez-Malo, Johanne Hernandez, Isel Estrada, Umesh Narayan, Chase Ruetuer, Loki Natarajan, Dorothy D Sears, Michelle Takemoto, Ya-Ju Chang, Yesenia Avitia, Ariela Haimovich, Luis Ornelas, Andrea De La Torre, Jordan Carlson, Matthew A Allison","doi":"10.1007/s10865-024-00493-3","DOIUrl":"10.1007/s10865-024-00493-3","url":null,"abstract":"<p><p>Postmenopausal Hispanic/Latina (N = 254) women with a body mass index (BMI) ≥ 25 kg/m² were randomized to an intervention to reduce sitting time or a comparison condition for 12 weeks. The standing intervention group received three in-person health-counseling sessions, one home visit, and up to eight motivational interviewing calls. The heart healthy lifestyle comparison group (C) received an equal number of contact hours to discuss healthy aging. The primary outcome was 12-week change in sitting time measured via thigh-worn activPAL. Group differences in outcomes were analyzed using linear mixed-effects models. Participants had a mean age of 65 (6.5) years, preferred Spanish language (89%), BMI of 32.4 (4.8) kg/m², and sat for an average of 540 (86) minutes/day. Significant between-group differences were observed in reductions of sitting time across the 12-week period [M_difference (SE): C - 7.5 (9.1), SI - 71.0 (9.8), p < 0.01]. Results demonstrate that coaching models to reduce sitting are feasible and effective.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"782-791"},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899558","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}