European Geriatric Medicine最新文献

{"title":"Plato on the art of growing old.","authors":"Emily Daly, Simon Daly","doi":"10.1007/s41999-026-01626-4","DOIUrl":"https://doi.org/10.1007/s41999-026-01626-4","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221007","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":"Diagnostic uncertainty in respiratory sarcopenia: accuracy of available tests and clinical implications: a systematic review and meta-analysis.","authors":"Deivd Siqueira, Helga Souza, Harrison Euller, Daiara Xavier, Renata Pereira, Juliana Fernandes de Souza Barbosa, Shirley Lima Campos, Daniella Cunha Brandão, Diego Dantas, Armele Dornelas de Andrade","doi":"10.1007/s41999-026-01619-3","DOIUrl":"https://doi.org/10.1007/s41999-026-01619-3","url":null,"abstract":"<p><strong>Purpose: </strong>Respiratory sarcopenia (RS) is an emerging clinical condition associated with pneumonia and mortality, but its diagnosis remains uncertain because standardized criteria are lacking. This systematic review and meta-analysis evaluated the diagnostic accuracy of peak expiratory flow rate (PEFR), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) for identifying RS in older adults.</p><p><strong>Methods: </strong>Eight databases were systematically searched for studies involving adults aged ≥60 years. Risk of bias was assessed using QUADAS-2. Test-specific and overall pooled sensitivity and specificity were calculated for PEFR, MIP, and MEP according to the operational definitions adopted by the primary studies.</p><p><strong>Results: </strong>Seven studies comprising 2,466 participants were included (mean age range, 70.2-80.6 years). Overall pooled sensitivity was 0.614 (95% CI 0.453-0.753) and specificity was 0.726 (95% CI 0.443-0.898), with substantial heterogeneity (bivariate I²=0.929). Test-specific analyses showed distinct profiles: MEP-based approaches had relatively higher sensitivity and lower heterogeneity, MIP-based approaches had comparatively higher specificity, and PEFR-based approaches showed lower and more variable diagnostic performance. Meta-regression found no statistically detectable differences by sex or sarcopenia diagnostic criteria; however, these analyses were exploratory and underpowered.</p><p><strong>Conclusion: </strong>Respiratory muscle-related measures show variable diagnostic performance for identifying RS. Current evidence is insufficient to establish the superiority of any single test or recommend a clinical reference standard. Prospective multicenter studies using standardized criteria and diverse populations, together with international consensus on RS definition, are needed to support future clinical recommendations.</p><p><strong>Registration number: </strong>PROSPERO-CRD42023494910.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185611","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":"Through Van Gogh's eyes: social frailty and the limits of clinical seeing.","authors":"Murat Pehlivan, Burcu Balam Doğu","doi":"10.1007/s41999-026-01625-5","DOIUrl":"https://doi.org/10.1007/s41999-026-01625-5","url":null,"abstract":"","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170939","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":"In-hospital mortality in co-occurring dehydration and dysphagia: results from the nationwide GEMIDAS Pro registry.","authors":"Gero Lueg, Lukas Funk, Bendix Labeit, Sara Peranovic, Regina Kerkmann, Jannis Bartel, Maryam Pourhassan, Nina Rosa Neuendorff, Rainer Wirth","doi":"10.1007/s41999-026-01627-3","DOIUrl":"https://doi.org/10.1007/s41999-026-01627-3","url":null,"abstract":"<p><strong>Purpose: </strong>Dehydration is common in older hospitalized adults, but its prognostic relevance and relationship with dysphagia in acute geriatric care remain uncertain. We examined the prevalence, clinical profile, and hospital outcomes of dehydration and whether it was independently associated with in-hospital mortality after accounting for dysphagia.</p><p><strong>Methods: </strong>We analyzed data from the GEMIDAS Pro registry on acute geriatric inpatient admissions in Germany between 2006 and 2024. We included admissions aged ≥ 65 years. Dehydration and dysphagia were identified from main or secondary ICD-10-GM diagnoses. Multivariable logistic regression examined factors associated with dehydration and in-hospital mortality. A four-group model assessed mortality according to the separate and combined presence of dysphagia and dehydration.</p><p><strong>Results: </strong>Among 1,343,561 admissions, dehydration was documented in 177,091 (13.2%). Admissions with dehydration had lower cognitive and functional status, less functional improvement among survivors, and higher in-hospital mortality than those without dehydration (5.8% vs 2.6%). Dysphagia was independently associated with dehydration. After adjustment including dysphagia, dehydration remained independently associated with in-hospital death (adjusted OR 1.35, 95% CI 1.32-1.38), as did dysphagia (adjusted OR 1.68, 95% CI 1.64-1.73). Mortality increased from 2.2% with neither condition to 4.7% with dehydration alone, 8.6% with dysphagia alone, and 12.1% when both were present. The combined group had the highest adjusted odds of mortality (OR 2.12, 95% CI 2.03-2.21).</p><p><strong>Conclusion: </strong>Dehydration was common and associated with adverse hospital outcomes in acute geriatric care. Its overlap with dysphagia identified a vulnerable subgroup and supports combined consideration of swallowing and hydration in clinical care.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172049","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":"Integrated physical and mental healthcare for older adults in Europe: from concept to implementation-a joint EuGMS and EAGP perspectives paper.","authors":"Lucy Beishon, Anne Nobels, Mariana Alves, Nenad Bogdanovic, Rachel Cowan, George Crowther, Bernardo Flôr-Rodrigues, Vincenza Frisardi, Carmel Geoghegan, Stéphanie Miot, Pinar Soysal, Nele Van Den Noortgate, Katherine E Walesby, Tomas J Welsh, Ozlem Yilmaz, Richard C Oude Voshaar, Carolien Benraad","doi":"10.1007/s41999-026-01620-w","DOIUrl":"https://doi.org/10.1007/s41999-026-01620-w","url":null,"abstract":"<p><p>Older adults commonly experience coexisting mental and physical multimorbidity, alongside frailty and polypharmacy. This clinical complexity is associated with poorer health outcomes, including higher rates of acute hospital admission, longer lengths of stay, increased dependency at discharge and higher mortality. Despite this, physical and mental health services for older adults are fragmented across Europe, often operating in a parallel rather than integrated manner. As a result, many patients receive poorly coordinated care. In response, there is growing interest in the development of integrated care services for these patients across Europe. Although a range of service models have been proposed, what constitutes \"best practice\" remains unclear and is likely to depend on local population needs, service configuration, healthcare context and healthcare workers education. The European Geriatric Medicine Society and European Association of Geriatric Psychiatry have initiated a Task and Finish Group to develop expert-based recommendations for integrated physical-mental health services for older adults across Europe. In this perspectives paper we consider the challenges associated with delivering integrated physical-mental healthcare for older adults, drawing on clinical and service level observations. We suggest that current approaches to integrated care are often limited in scope and variability and may not fully address the needs of older adults with combined physical and mental illness. A broader conceptualisation of integration may be required. We outline implications for future research, service development, and policy, with a focus on improving alignment between healthcare systems to address the needs of this growing population. This work was endorsed by the European Geriatric Medicine Society.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149846","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":"Prevalence and appropriateness of solid oral dosage form manipulation in long-term care facilities.","authors":"Alba Malara, Alberto Zucchelli, Caterina Trevisan, Gilda Borselli, Raffaele Antonelli Incalzi, Graziano Onder, Antonio Cherubini, Andrea Cignarella, Alessandra Marengoni, Alessandro Morandi, Anna Castaldo, Giuseppe Dario Testa, Dario Leosco, Andrea Ungar","doi":"10.1007/s41999-026-01618-4","DOIUrl":"https://doi.org/10.1007/s41999-026-01618-4","url":null,"abstract":"<p><strong>Purpose: </strong>Medication administration in long-term care facilities (LTCFs) is complicated by multimorbidity, frailty, cognitive impairment, polypharmacy, and dysphagia. Solid oral dosage form (SODF) manipulation is common but may compromise medication safety. We aimed to determine the prevalence of SODF manipulation and evaluate its appropriateness in Italian LTCFs.</p><p><strong>Methods: </strong>We conducted a national multicenter point-prevalence study (Prescription-Day LTCFs 2024) in 82 Italian LTCFs. Of the 3400 enrolled residents, 3174 were included after excluding residents with acute conditions and facilities enrolling fewer than five residents. The study population had a mean age of 84.8 years, of which 74.1% were women, with high multimorbidity, dementia (47.9%), polypharmacy (mean 7.3 medications), and dysphagia (14.7%). SODF manipulation included tablet crushing or splitting, capsule opening, and mixing medications with food or liquids. Appropriateness was evaluated using a hierarchical framework integrating the SIFO Handbook, the Friuli Venezia Giulia \"Do Not Crush\" list, the TRC 2025 update, the Summary of Product Characteristics, and expert review.</p><p><strong>Results: </strong>Among 20,290 oral prescriptions (15,214 tablets and 802 capsules), 4655 SODFs (23.0%) were modified. Of these, 27.9% were inappropriate and 10.8% likely inappropriate. Overall, 1006 residents (31.7%) received at least one inappropriate or likely inappropriate modification, and 11.9% received three or more. Inappropriate manipulation was more frequent for capsules than tablets (68.8% vs 37.7%). Frequently involved medications included pantoprazole, trazodone, and amlodipine. Residents exposed to inappropriate manipulation were more likely to be frail and to have dementia or dysphagia.</p><p><strong>Conclusions: </strong>SODF manipulation is highly prevalent in Italian LTCFs, with more than one-third of modifications being potentially inappropriate. The frequency of manipulation exceeded the prevalence of dysphagia, suggesting organizational and behavioral drivers. Standardized guidance and greater prescriber and pharmacist involvement are needed to improve medication safety.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138994","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":"Fecal and urinary incontinence in older men with hip fracture: a geriatric syndrome with prognostic significance.","authors":"Aino T Hellman-Bronstein, Tiina H Luukkaala, Seija S Ala-Nissilä, Maria S Nuotio","doi":"10.1007/s41999-026-01624-6","DOIUrl":"https://doi.org/10.1007/s41999-026-01624-6","url":null,"abstract":"<p><strong>Purpose: </strong>Hip fracture in older men is associated with disproportionately poor outcomes compared to women, yet the prevalence and prognostic significance of incontinence in this population remain understudied. This study aimed to determine the prevalence of urinary (UI) and fecal incontinence (FI) in older men with hip fracture, evaluate their association with 1-year mortality, and identify factors linked to UI at post-fracture out-patient comprehensive geriatric assessment (CGA).</p><p><strong>Methods: </strong>This retrospective study analyzed data from 644 men aged ≥65 with first hip fracture (2007-2019) at Seinäjoki Central Hospital, Finland. Cox proportional hazards regression assessed associations of baseline UI (yes/no) and FI (yes/no) with 1-year mortality (n=549). Binary logistic regression identified baseline and CGA-derived factors associated with UI at 6-month post-fracture (n=331).</p><p><strong>Results: </strong>Mean age was 81,4±7,8. Pre-fracture, 45% of men had UI and 12% had FI. One-year mortality was 34%. In multivariable-adjusted Cox regression, FI independently predicted mortality (HR 1.72, 95% CI 1.15-2.58), while UI did not. Other independent predictors included age, polypharmacy, non-independent mobility, poor nutritional status, and delayed urinary catheter removal. At CGA, 47% had UI. Cognitive disorder (OR 3.22, 95% CI 1.63-6.35) and non-independent mobility (OR 3.07, 95% CI 1.58-5.97) were independently associated with UI, as were CGA deficits in cognition, function, and physical ability.</p><p><strong>Conclusion: </strong>Pre-fracture FI is independently associated with increased 1-year mortality in older men with hip fracture, while UI is closely linked to cognitive and functional decline, emphasizing the syndromic nature of incontinence in these patients. Incontinence assessment including both UI and FI may help identify patients at highest risk of adverse outcomes.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129034","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":"Very late-onset myasthenia gravis: a systematic review and meta-analysis of clinical severity and long-term outcomes.","authors":"Ioannis Liampas, Silvia Demiri, Antonis Polyviou, Alessandro D'Orsi, Vasileios Siokas, Dimitra Veltsista, Efthimios Dardiotis, Elisabeth Chroni","doi":"10.1007/s41999-026-01621-9","DOIUrl":"https://doi.org/10.1007/s41999-026-01621-9","url":null,"abstract":"<p><strong>Purpose: </strong>Very late-onset myasthenia gravis (vloMG; onset ≥ 65 years) may represent a clinically distinct subgroup, but its severity and prognosis remain uncertain. We systematically reviewed studies comparing vloMG with earlier-onset MG (non-vloMG) and examined whether findings differed from the conventional early-onset (EOMG) versus late-onset dichotomy (LOMG; ≥ 50 years).</p><p><strong>Methods: </strong>MEDLINE, Embase, CENTRAL, and Google Scholar were searched from inception to May 2026. Observational studies of adult MG comparing age-at-onset groups were eligible. The main quantitative outcome was severe early presentation, defined as Myasthenia Gravis Foundation of America (MGFA) class IV-V early at the disease course (at onset, diagnosis, or the earliest pretreatment assessment). Other baseline and longitudinal outcomes were summarized qualitatively because outcome definitions and follow-up duration were heterogeneous.</p><p><strong>Results: </strong>Ten studies were included. Four studies including 647 patients with vloMG and 1,620 with non-vloMG contributed to the primary meta-analysis. Severe early presentation was more frequent in vloMG than in non-vloMG (10.2% vs 3.8%; Odds Ratio 2.19, 95%CI 1.49-3.24; p < 0.001; I²= 0%). In contrast, the broader LOMG group showed no significant difference versus EOMG (5.6% vs 4.2%; Odds Ratio 1.12, 95%CI 0.74-1.71; p = 0.60). Qualitative synthesis suggested more common early bulbar and respiratory involvement, as well as need for intubation in vloMG, whereas long-term outcomes were inconsistent though often comparable among different age-at-onset groups, particularly when immunotherapy was used.</p><p><strong>Conclusion: </strong>vloMG is associated with more severe early presentation, but long-term disease control may not differ from non-vloMG. Future studies should standardize age strata, follow-up, treatment exposure, and confounder adjustment.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129029","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":"Association between early in-hospital physiological and functional changes and fall risk in older adults: a retrospective multicenter cohort study.","authors":"Takuya Nishino, Yoshiaki Kubota, Yasuo Miyagi, Nari Tanabe, Fumiko Yamaguchi, Hiroki Ito, Shizuka Soh, Ayako Yano, Masako Mizuno, Chol Kim, Yosuke Ishii, Kuniya Asai","doi":"10.1007/s41999-026-01622-8","DOIUrl":"https://doi.org/10.1007/s41999-026-01622-8","url":null,"abstract":"<p><strong>Purpose: </strong>To examine whether early in-hospital changes in functional status and selected physiological parameters were associated with subsequent falls among hospitalized older adults.</p><p><strong>Methods: </strong>This retrospective multicenter cohort study used electronic health record and administrative data from two tertiary hospitals in Japan between 2018 and 2024. Patients aged 65 years or older underwent landmark assessments on hospital days 3 (LM3) and 7 (LM7). Functional trajectories were defined from changes in transfer ability between admission and each landmark; physiological changes included serum albumin, hemoglobin, and sodium. The outcome was the first documented in-hospital fall within 30 days after each landmark. Associations were estimated using multivariable logistic regression with multiple imputation.</p><p><strong>Results: </strong>Of 112,103 eligible patients, 83,297 were included in LM3 and 61,071 in LM7. Patients ranged in age from 65 to 106 years in both cohorts; 40.6% of the LM3 cohort and 40.9% of the LM7 cohort were female. Persistent or worsening transfer impairment was associated with higher fall risk at both landmarks. Acute functional decline was associated with higher fall risk at LM7 but not LM3. Declines in hemoglobin and serum sodium were independently associated with higher fall risk in both analyses, whereas changes in serum albumin were not. Findings were consistent across sensitivity analyses.</p><p><strong>Conclusion: </strong>Functional and physiological changes during early hospitalization were associated with subsequent fall risk in older adults. Reassessment on hospital days 3 and 7 may complement admission-based assessment by identifying evolving vulnerability and supporting time-sensitive fall-prevention strategies.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128980","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":"Usability and feasibility of a wearable sensor-based monitoring system providing feedback on sedentary behaviour during inpatient and home-based geriatric rehabilitation.","authors":"Suzanne M Debeij, Miriam L Haaksma, Margot W M de Waal, Jolanda C M van Haastregt, Margriet C Pol, Marise J Kasteleyn, Eléonore F van Dam van Isselt","doi":"10.1007/s41999-026-01616-6","DOIUrl":"https://doi.org/10.1007/s41999-026-01616-6","url":null,"abstract":"<p><strong>Objective: </strong>This study explored the usability and feasibility of a sensor-based monitoring system that provides feedback on sedentary behaviour during inpatient and home-based geriatric rehabilitation from the perspectives of patients and healthcare professionals.</p><p><strong>Methods: </strong>This mixed-methods study, which is part of the Better@Home study, included a focus group with care professionals, patient surveys, and collection of activity data (e.g. sedentary time and bout duration) via a wearable sensor monitoring system. Usability was assessed qualitatively, while feasibility was assessed using both qualitative data and quantitative adherence to the monitoring system. Focus group data were analysed using the framework method; other data were analysed descriptively.</p><p><strong>Results: </strong>Twenty-six patients and nine care professionals participated. Usability was perceived as limited due to challenges on both the technology (e.g. measurement accuracy) and implementation level (e.g. tailored use and added value), which impeded integration into existing workflows. Feasibility was deemed sufficient since adherence levels were high.</p><p><strong>Conclusions: </strong>From the perspectives of patients and healthcare professionals, a sensor-based monitoring system that provides feedback on sedentary behaviour showed sufficient feasibility and limited usability. To facilitate the integration into existing workflows, measurement accuracy should be improved, and implementation should focus on tailored use that offers a clear added value, in line with patient goals.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117394","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}